HUMS Hospital

Description: Currently, rejected orders (particularly laboratory specimens) are difficult to track across different disciplines. This wireframe introduces a Rejected Orders Tab within the Order Basket of the Patient Summary. This tab will unify rejections from Lab and Pharmacy into a single interface, ensuring that clinicians can quickly identify why an order failed and take corrective action.

• The “Rejected Orders” functionality shall be available across all patient care modules, including:

  - Outpatient (OP) Consultation
  - Inpatient (IP) Consultation
  - Emergency Room (ER) Module

• The Rejected Orders tab shall be accessible within the Patient Summary → Order Basket in each of the above modules.

• The “Rejected Orders” tab shall not be limited to laboratory, pharmacy, or physiotherapy orders.

• The system shall support and display rejected orders originating from all order categories available within the Orders module, including but not limited to:

  - Medication Orders
  - Lab Orders

• Any order that is rejected, cancelled, or not executed by the respective performing department must be surfaced within the “Rejected Orders” tab in the Patient Summary.

• All rejected orders, regardless of originating module, must be normalized into a unified structure for display within the “Rejected Orders” tab.

  Each entry must include:
  - Date and Time of rejection
  - Service Category (mapped to originating module/department)
  - Order Item (test, medication, procedure, or service name)
  - Specimen / Details (if applicable; otherwise display “N/A” or relevant execution detail)
  - Reason for rejection (system-generated and/or user-entered remarks)
  - Requesting clinician or department

Target Audience

1. Physicians: To review why their orders were not processed.

2. Nurses/Ward Staff: To identify specimens that need to be re-collected or medications that require adjustment.

3. Laboratory Technicians (MLT): To communicate specific specimen issues directly to the clinical team.

Functional Requirements

Order Basket Structure

The Order Basket shall be divided into three distinct tabs:

1.Pending Orders: Orders currently being drafted or held.

2.Submitted Orders: Orders successfully sent to the performing department.

3.Rejected Orders: Orders that were cancelled or rejected by the performing department.

The "Mapping" Logic

	Service Category	Order Item	Specimen / Details	Reason & Remarks
Lab Mapping	Displays Lab Discipline (e.g., Lab-Micro)	Displays Test Name (e.g., Comprehensive Pkg 2)	Displays required containers (e.g., 2 EDTA, 1 Plain)	System Reason + MLT Free-text Remarks
Pharmacy	Displays Department (e.g., Pharmacy)	Displays Item Name (e.g., Panadol 500mg)	Displays N/A or Dose/Route details	System Reason + Pharmacist/Staff Remarks

MLT Remarks

• The system shall provide a free-text "Remarks" field during the rejection workflow in the Laboratory Information System (LIS).
• This text in remarks must be pulled along displayed in the "Rejected Orders" tab to provide context (e.g., "Sample leaked," "Clotted," "Patient refused draw").

User Interface

• Tab Badge: The "Rejected Orders" tab shall display a numeric badge indicating the count of rejections (e.g., Rejected Orders (3)).
• Visual Hierarchy: Labels for rejection reasons should be visually distinct (e.g., Red text or specific icons) to highlight the failure.

Data Requirements

• Real-time Sync: The Rejected Orders tab must update in Rejected Orders tab, In real-time via notification (preferred), and on refresh / re-open of Order Basket.
• Badge count must update accordingly real-time as soon as a rejection is logged in the LIS or Pharmacy system
• Audit Trail: The system must log action type, User ID (logged-in user), with timestamp, User display name, Order Item + Specimen/Details
• Audit trail must be:
  - Append-only (no overwrite)
  - Viewable via “History” or “View History” action

Criteria

• The "Rejected Orders" tab is visible within the Patient Summary Order Basket.
• Lab orders correctly display the specific discipline (e.g., Hematology) in the Category column.
• Lab orders correctly list the required specimen types (e.g., EDTA Tube) in the Details column.
• Pharmacy orders appear in the same list without causing system errors.
• Free-text remarks entered by the MLT are visible to the physician in the UI.
• Multiple rejections for same order → display as separate rows
• Re-ordered item rejected again → appears as new row
• Missing remarks → display system reason only
• Long remarks → truncate with expand option

Access Control:

1. Only authorized users (Doctors, Nurses) can:
- View rejected orders
- Perform actions (Acknowledge, Re-Order)

2. MLT/ Pharmacist can:
- Add remarks
- Trigger rejection (via LIS or Pharmacy)

Action Behavior

Actions:

1. Acknowledge:
- Marks the rejection as reviewed by the user
- Logs audit trail (user ID + timestamp)
- Updates UI status (e.g., “Acknowledged”)

2. Re-Order:
- Creates a new order with same parameters
- Links new order to original rejected order
- Logs audit trail

Suggested Wireframe