Glossary

activity

A specific action that the interdisciplinary care team carries out to address a patient problem. Within a ZynxCare plan of care, each problem is associated with one or more activities that are grouped under the intervention section. Activities are organized into the following categories: Assessments, Communication, Education, and Treatments and Procedures.

assessments and diagnostics

Activities within a plan of care that evaluate, assess, and determine patient condition, knowledge, and medication use, as well as patient, caregiver, and family member risk factors, to develop the plan of care.

AuthorSpace

Zynx Health AuthorSpace provides a dynamic authoring environment that enables users to build and export content (such as order sets and plans of care) in formats that can be integrated into various hospital information systems.

base team

A base team is a group of users with access to all content. If appropriate permissions have been set, members within the group can release, modify, export, and view the content. By default, all environment users are assigned to a base team.

blue ribbon

A blue-ribbon icon () signifies that the associated topic or item addresses a performance measure defined by a national organization (e.g., Centers for Medicare & Medicaid Services, The Joint Commission).

communication

Activities within a plan of care that trigger or enhance interdisciplinary coordination by identifying providers relative to a given patient problem.

community environment

A community supports the sharing of content across accounts by allowing environments to publish and view content in a common area. All content in a community is View Only but may be duplicated to a local environment.

custom catalog

A collection of terms developed for an environment to use when creating content.

custom content

An order set or plan of care that has been modified for a user’s hospital or health system. Users can add, delete, or modify sections or items to create custom content.

education

Activities within a plan of care that teach patients, caregivers, and family members, enabling patients to meet expected outcomes and reach optimal health

environment

A collection of users who share common system preferences, export options, vocabularies, etc., in AuthorSpace.

environment manager

An Environment Manager has full access to all features of AuthorSpace and has access to Home, Environment, and Vocabularies links on the Control Panel. The Environment Manager can change user passwords, access other Environments, create teams and content folders, and manage milestones, the catalog, integrations, and workspaces (if available in the environment). The Environment Manager can also manage local and vendor vocabularies and allow the user to manage aliases. An Environment Manager has View, Modify, Release, and Export permissions by default, and these permissions cannot be disabled.

environment user

An Environment User only has access to the Home link on the Control Panel page. The Home link allows the Environment User to change his or her password or access other Environments. An Environment User can be assigned View, Modify, Release, or Export permissions by an Environment Manager.

event

A piece of meta-information that can be associated with an order set or plan of care. An event refers to an action (e.g., admission or discharge) to which the order set or plan of care applies.

expected outcome

Measurable patient-centered conditions/states, behaviors, or perceptions in response to interdisciplinary interventions. Expected outcomes can be assessed by the interdisciplinary care team at any point in time and are used to indicate whether a goal has been met or progress has been made in resolving a problem. In a plan of care, each problem has at least one expected outcome grouped under the Goal section.

external file

Refers to an outside document that can be uploaded from a hard disk and stored and accessed within AuthorSpace. Outside documents include clinical documents such as clinical protocols, or administrative information such as project plans and contact lists. You can upload files of any type and store them along with order sets and/or plans of care. These documents can be removed or updated as needed.

AuthorSpace does not support printing or exporting of external files regardless of security permissions.

external ID

The alphanumeric code associated with external vocabulary terms or workspace fields. The external ID can be a negative number. The external ID is organization-specific and may be used to clinically identify or catalog content. See term ID.

external vocabulary

Collection of data, concepts, and procedures developed by an environment or organization other than Zynx Health. An external vocabulary can be a standard vocabulary, vendor vocabulary, or local vocabulary. External vocabularies can be imported into Zynx AuthorSpace and mapped to equivalent terms in the Zynx PIVOT catalog. Each term in the external vocabulary has a unique external ID. The ID is assigned and maintained internally within the organization.

forecaster

A tool used to calculate the potential benefits of implementing specific evidence-based aspects of care, both in terms of quality of care and cost-effectiveness, and to model out the impact of these improvements on morbidity, mortality, functional status, and cost.

goal

A subject heading that organizes expected outcomes in a plan of care.

intervention

A subject heading used to organize activities in a plan of care.

linkable

Describes content that can be "virtually inserted" into other content. For example, if version 1 of order set A is marked as "linkable," it can be linked into order sets B and C. If order set A is updated to version 2, its changes will be propagated into order sets B and C as well.

medications

In Zynx evidence and order sets, these are drug names that can be expressed as medication names (consisting of the generic active ingredient or brand name alone) or dispensable products (which consist of the active ingredient or brand name in conjunction with the strength and formulation).

modular order set

Modular order sets allow organizations to employ a building block approach to their order sets. More specifically, the modular approach involves the use of 1 or more condition-specific modular order sets in conjunction with a venue-specific admission modular order set. The condition-specific order set consists primarily of medications and diagnostic tests, whereas the admission order set consists of items that would generally be ordered regardless of the patient’s specific conditions (e.g., diet, activity).

order detail

Further description or clarification of key concepts for an activity in a plan of care, a medication order item in an order set, or a non-medication order item in an order set.

order set

A group of interventions that are specific to a condition or procedure and pertain to a venue of care. Zynx Health provides default order sets and allows for customization of order sets to meet hospital or health system requirements. Customized order sets ideally should be developed as a result of careful review of evidence and for creating a meaningful change in patient quality of care, and not driven by Information Technology milestones for meeting deadlines for a CPOE roll-out.

performance measure

Performance metrics that measure process, outcome, efficiency, structure, or patient experience of care.  Selected performance measures included in Zynx content are 1) used for public reporting or pay for performance programs or 2) useful for quality improvement programs. These performance measures are developed, adopted, and/or endorsed by the following organizations:

• American Association of Cardiovascular and Pulmonary Rehabilitation
• American College of Cardiology/American Heart Association
• Centers for Medicare & Medicaid Services
• The Joint Commission

performance measure library

A list of national performance measures as defined by various national organizations with a performance- improvement focus. The list shows the national organization, performance measure program, disease/ procedure, measure type, and measure venue. For each performance measure, a summary of the measure specifications is provided, as well as URLs to supporting documents on the Web.

PIVOT ID

PIVOT stands for Portable Intermediate Vocabulary of Objective Terms. Any term representing a concept in an order set will have a corresponding PIVOT ID in the Zynx catalog. PIVOT IDs can be mapped to their equivalent concepts in external vocabularies.

plan of care

A plan developed with nursing and ancillary health professionals that identifies the treatment needs, goals, and objectives of a participant (i.e., patient, family, caregiver, group) based on clinical assessments. The plan provides strategies for meeting goals and objectives and for evaluating the participant’s progress.

problem

A condition experienced by a patient that can be corrected or ameliorated in a clinical care setting. Problems may be acute or chronic in nature or may represent a functional or organizational risk. Problems may be actual or potential and may span one or more episodes of care. ZynxCare provides the basis for assessing, planning, and evaluating the care of patients with the most common problems that members of an interdisciplinary care team manage.

reason

A piece of meta-information that can be associated with an order set or plan of care. Reason refers to the module (e.g., acute myocardial infarction), procedure (e.g., appendectomy), or symptom (e.g., chest pain) to which the order set or plan of care applies.

reminder

Information included in an order set or plan of care that serves as an evidence-based note to the clinician at the point of care. A reminder is included in the order set or plan of care when the clinical evidence satisfies topic inclusion, but it cannot be directly translated into an order item or plan of care activity.

Reminder items are created only for topics that are presented in the evidence. For example, a topic regarding the use of a prediction rule to guide triage decisions for patients with community-acquired pneumonia cannot be translated into an order item, but an order set reminder item can serve as a timely evidence-based reminder to the physician at the point of care.

rules

Sample guidelines available in ZynxOrder that show how evidence can be translated into alerts and reminders within electronic medical record systems. Rules are written for various clinical scenarios that may apply to a single venue of care or multiple venues of care.

section

A category used to organize order items in an order set or plan of care. For example, Zynx Health standard order sets use the following sections: Condition, Vital Signs, Activity, Nursing Orders, Patient/Caregiver Education, Respiratory, Diet, IV Fluids, Medications, Blood Bank, Laboratory, Radiology, Diagnostic Tests, Specialty, Consults, and Noncategorized. Sections may contain subsections and sub-subsections. Each plan of care offered by Zynx Health addresses a specific patient problem. Plans of care include a Goal section (containing Expected Outcomes) and an Intervention section. The Intervention section contains subsections (i.e., Reminders, Activities, Checklist Details).

standard vocabulary

Industry-specific terminology for data, concepts, and procedures that can be imported into Zynx AuthorSpace and contains vocabulary terms that can be mapped to equivalent terms in the Zynx PIVOT catalog.

Starter plan of care

A starter plan of care is an abridged version of a standard Zynx plan of care. Because a starter plan of care has had less commonly used items removed while retaining relevant evidence links and national performance measures, it can be used as a quick-start template to guide organizations toward their own rapid customization efforts.

status

Indicates the state of an order set or plan of care (i.e., Draft, Released, Retired, Review):

• Draft: The order set or plan of care has not been released and is currently being modified.
• Released: The order set or plan of care has been released. A released item is never deleted.
• Retired: The order set or plan of care has been superseded or forcibly retired and should not be used.
• Review: The order set or plan of care or linkable content is being reviewed. The order set or plan of care or linkable content can still be edited in Review status.

team

A team is a group of users assigned to content. Depending on user permissions, users within the group can release, modify, view, or export the assigned content.

term ID

A field in AuthorSpace that contains the external ID for an external vocabulary term. This field is only displayed if the external vocabulary was imported with external IDs. See external ID.

treatments and procedures

Activities within a plan of care that deliver care, prevent injury, and perform actions that enable patients to meet expected outcomes and reach optimal health.

venue

A piece of meta-information that can be associated with an order set or plan of care. Venue refers to a clinical location (e.g., ICU, Emergency Department) to which the order set or plan of care applies.

ViewSpace

An environment for reviewing and/or commenting on your organization’s order sets and/or plans of care.

ZynxCare

ZynxCare offers knowledge for nurses and allied health professionals (e.g., physical therapists, occupational therapists, respiratory therapists, nutritionists, social workers) in the form of evidence-based synopses linked to customizable plans of care. The content contained in ZynxCare provides the basis for assessing, planning, and evaluating the care of patients with the most common problems that members of the interdisciplinary care team manage.

Zynx Catalog

A collection of healthcare concepts that contains terms for use in order sets (e.g., medications, laboratory tests, consults) and plans of care (e.g., expected outcomes, checklist details).

ZynxEvidence

ZynxEvidence is a comprehensive source for evidence-based research, guidelines, and hospital performance measures. It serves as an in-depth reference source for evidence-based quality improvement and can be used to impact the key drivers of clinical outcomes and costs in your organization.

Zynx Forecasting

Zynx forecasting, available in the ZynxEvidence, and ZynxMeasurement products, is a tool to forecast the impact of evidence-based clinical decision support on clinical outcomes, processes of care, and financial results.

Zynx Forecasting: Default Values

Default values are representative patient statistics that can be used as inputs to the forecasting calculators when actual patient statistics are not available, so that approximate potential benefits due to improvements in the processes of care may be calculated. A set of default values is provided in the Forecasting Calculator sections for most forecasters. The default values are also used as representative inputs in the Sample Calculations.

Zynx Forecasting: Definitions section

The Definitions page provides concise definitions of input and output descriptions; of indications for and contraindications to the recommended intervention; of inclusionary and exclusionary criteria; and of other terms presented in the Forecasting Calculator section. Some definitions also appear in pop-up boxes throughout the forecasting modules.

Zynx Forecasting: Forecasting Abstraction Form

The forecasting abstraction form can be printed and used to collect the data needed as inputs for the Forecasting Calculators.

Zynx Forecasting: Forecasting Calculator section

On the Forecasting Calculator page, the user can forecast quality and cost improvements that his or her organization may realize by implementing the Recommendation. These opportunities are translated into tangible endpoints (“outputs”) such as potential number of lives saved, hospitalizations prevented, or costs avoided. On the Forecasting Calculator page, the user can enter his or her organization’s data and make forecasting calculations. Zynx Health also provides representative default values to use in place of actual statistics when that data is not readily available. The charting feature allows the healthcare organization to track its progress over time. Simply click the Chart button after calculating. Data accumulated in the charting feature can be viewed in a table format or exported onto an Excel spreadsheet.

Zynx Forecasting: Forecasting Methodology section

The Forecasting Methodology section provides a detailed description of the forecaster selection and review process by describing the modelability of studies; topic selection; selection of supporting studies; literature screening, acquisition, and classification; selection of studies for Supplemental Literature sections; how calculations are generated; how contraindications to medications are defined; the editorial process; and quality control.

Zynx Forecasting: Forecasting Results – All Modules section

The Forecasting Results – All Modules section provides a real-time summary of the most recent calculations made (i.e., the most recent outputs generated) in all modules within a product (i.e., ZynxEvidence, ZynxMeasurement).

Zynx Forecasting: Forecasting Summary section

Each module that contains more than one forecaster includes a Forecasting Summary section (folder) summarizing the output definitions and calculated outputs for all forecasters within the module. The Output Definitions page contains all the output definitions used in the module. The Calculations Summary page shows all forecasting data that have been calculated in the entire module and refreshes in real time whenever a new calculation is performed.

Zynx Forecasting: General Information section

Once you select a Forecasting module, the Scope page in the General Information folder opens by default and describes the included and excluded patient populations for the module. In addition to the Scope page, the General Information folder contains the Forecasting Methodology page and may contain a Definition page. The Definition page, when available, provides a definition for each condition/procedure from national/professional organizations and consensus conferences.

Zynx Forecasting: Limitations section

The Limitations page lists the limitations of the forecasting calculation, as well as any assumptions made to facilitate the development of the equations.

Zynx Forecasting: Recommendation section

The Recommendation page contains a fundamental recommendation for each forecaster. The References section on the Recommendation page links to one or more Evidence Tables of the literature used to derive the Recommendation and the parameters upon which the forecasting equations are based. The literature cited on the Recommendation page undergoes a rigorous review by board-certified physicians with expertise in the principles and practices of both evidence-based medicine and critical appraisal of the literature. For a detailed description of the selection and review process, along with its potential limitations, visit the Forecasting Methodology page.

Zynx Forecasting: Sample Calculations section

The Sample Calculations page makes the Forecasting Calculator equations completely transparent by showing how the absolute risk reductions, relative risk reductions, and other statistical values from the literature are used to calculate the clinical and cost-related benefits. Sample Calculations are provided for each forecaster so that users can clearly understand the assumptions used in the Forecasting Calculator section and comprehend the scientific and mathematical underpinnings of the forecaster. Inputs to these sample calculations are the default values, which provide representative patient statistics for a hypothetical hospital. These sample calculations also provide examples of the types of potential benefits that an institution may realize by implementing specific process-improvement interventions.

Zynx Forecasting: Supplemental Literature section

The Supplemental Literature section provides a broader body of evidence for a given topic to augment the Guideline or Cost-Savings Opportunity evidence.

ZynxMeasurement

ZynxMeasurement offers tools to measure the impact of evidence-based clinical decision support on clinical outcomes, processes of care, and financial results.

ZynxOrder

ZynxOrder offers an advanced knowledge-management system for developing and maintaining evidence- based order sets, alerts, and reminders. ZynxOrder empowers organizations to put evidence-based healthcare into practice and, as a result, adhere to national performance measures and measurably improve the quality of patient care.

ZynxRehab

ZynxRehab enables your interdisciplinary teams to put evidence-based healthcare content into practice and, as a result, measurably improve the quality of care and comply with regulatory standards.