ePR News V1, I3 (Feb. 11, 2013)

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Patient Record

“The right information to the right people, at the right time.”

February 11th, 2013, Volume 1, Issue 3

Reformatting forms, assessments and records without compromising health care quality

Embracing new technologies

Implementing the electronic patient record is more than adopting a new patient care system; it’s also upgrading our technological environment.

In December, the Wireless LAN (WLAN) service was made available to corporate devices at the MHS site, following the footsteps of the SMOL site. Computers no longer need to be connected to the corporate network through wires.

A typical patient, client or resident file at Providence Care accumulates hundreds of forms, assessments and records while the individual is actively receiving care and services.

With the ePatient record, forms, assessments and documents will be computer-based. The Clinical Documentation and Communication Practices Committee (CDCPC) ensures that all clinical documentation and communication practices included in the electronic patient record (ePR) are in alignment with the best practices, recovery model, and client-centered care.

Because of this major upgrade, the ePR will be accessible and available in more places, specifically at the point of care.

This significant commitment to technological upgrades will enable the advancement of our ePR Project.

Since there are so many different types of forms, assessments and records documents (i.e. Profession-Specific Assessments, Nursing Admission Assessment, Nursing Care and Observation Flow Sheet) , the CDCPC supervises and creates different working groups related to the clinical documentation and practices. The introduction of ePR will mean documentation processes will be streamlined and cohesive across Providence Care.

Providence Care____________________________________________________________________________________________________________________

e Patient RecordNews Who we are A team member of the Care Documentation Module

More nursing paper forms added electronically to ePR The Nursing module is building 40 nursing forms in the electronic patient record (ePR).

Admission Assessments, Wounds Assessment, Fall Risk Assessment and Flow sheets are a few examples of the forms included in the ePR system. Forms requiring a patient signature and inter-professional forms (i.e. Bedside Assessment) will be included in Phase 2 of the ePR Implementation.

Since mid-august, Clinical Analysts Pamela Kendall and Heather Frost have been hard at work testing the aspects of the nursing build as they have been completed.

This extensive testing ensures that every form included in the system functions properly and is suitable and streamlined with nursing practices.

With the completion of Phase 1, nurses will be interacting with a computer consistently from the beginning to end of a shift to document assessments (admission or daily/shift assessments), and interventions including medications and treatments administered. Every nurse will be able to review their tasks and track which are completed. They will also be able to review new orders as well as find data and documentation with ease. Nurses will spend less time on administrative tasks and more with patients/clients/residents!

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Do you know who are included in Order/Results Management (ORM)?

Staff groups or departments/services encompassed by ORM include: Shari Brown is the Project Manager for the care documentation aspect of the ePR Project and is responsible for managing the Nursing and Order/Results Management (ORM) related portions of the ePR project.

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Intake Coordinators and Discharge Planners, Allied staff, Food and Nutrition Services (FANS), Respiratory Therapy (purchased service from KGH), Staff involved with the delivery of ECT and TMS treatments, Staff involved with the delivery of EEG and EMG testing, and Staff groups who will interact with an electronic Bed Board depicting patient bed assignment (along with various other important pieces of information) – Housekeeping, Portering, Patient Records and Registration staff, Infection Control Practitioners.

What is the ORM team working on?

The ORM team ensure that the right person gets the right information when a referral is made.

Providence Care____________________________________________________________________________________________________________________

e Patient RecordNews The road-map built with PajMa Models In preparation for the build of the electronic patient record (ePR), the project team along with QuadraMed Implementation Consultants completed workflow interviews in the spring and early summer of 2011. The ePR Clinical Analysts then began further detailing our current state or how we currently “do business” utilizing the Patient Journey Modeling Architecture (PaJMa) methodology developed by Dr. Carolyn MacGregor and Dr. Jennifer Percival from the University of Ontario Institute of Technology (UOIT). Four students from UOIT assisted in developing PaJMa models for some of our patient care units.

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All Care Units at Providence Care were detailed as diagrams that map out client/patient interactions from admission to discharge across the organization, and how information flows between clinicians within the circle of care.

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Many staff will recall the large models posted on each patient care unit. The models provide a visual representation of the flow of information during a patient’s journey from admission to discharge. The models show who the patient interacts with, when and where healthcare professionals obtain patient information, how it is recorded, and the technology used while communicating and facilitating care (i.e. on paper, fax, telephone, or computer). Six to thirteen models were completed per care unit.

Through the development of the PaJMa models change agent, it allowed staff to aid in identifying processes which needed to be changed and put forward ideas. This engagement also helped generate excitement for the upcoming change. Current state workflow models were completed for all patient care units at both hospital sites in June 2012 and served as the baseline for the build of the electronic record.

Completing the models facilitated identification of similar processes across patient care units and across hospital sites, as well as opportunities to streamline processes. This in turn led to the development of working groups such as the Patient Tracking and the Transfer, Discharge and Death Working Groups. As planning and building of the ePR has progressed, the project team has utilized the PaJMa models as the basis to delve more deeply for detailed workflows of specific clinical areas.

With the ePR build well underway, the project team has developed a deeper understanding of the QuadraMed system and so the ePR Clinical Analysts will now be developing future state models at each hospital site. The future state models will depict how workflows will occur when the system “goes live” in 2013 with the ultimate goal of demonstrating improved communication through an integrated patient record which will benefit staff but most importantly our patients, clients and residents.

An example of a PajMa Model Providence Care____________________________________________________________________________________________________________________

e Patient RecordNews Making a referral with all the right information

From left to right: Shari Brown, Project Manager, Tracy Down, Practice Support and Kathleen Fitzpatrick, Project Manager.

Providing effective and safe care for patients/clients/residents starts with accessing complete and accurate information and data. The Order /Results Management (ORM) team understands the importance of data sharing in the improvement of care quality. The ORM team, including Tracy Down, ePR Professional Practice Support, is now developing electronic referrals/ orders for all Allied staff. The main goal of the team is to ensure that the right information gets to the right person when a referral is made.

A new addition to the ePR Project team The ePR team is very pleased to announce that Véronique Scott has joined the team as the new ePR Communication Officer. Her role will be to handle all ePR related communications and work closely with the ePR team to better inform all employees about this exciting project.

Véronique has previously worked on a similar project at McGill University Health Centre. Her expertise and her skills are a great addition to the ePR Project team.

Welcome Véronique to Providence Care!

Allied Health and Specialty Clinics involving diagnostic interventions require specific information before delivering care and the ORM team is working to ensure that all the information needed will be captured in the electronic referral done through the coming electronic patient record. In addition the ORM and Nursing modules are planning how information will flow between assessments to reduce the need to repeatedly ask our patients/clients for the same information.

Once Phase 1 is completed, ORM related staff will be able to: • Receive and view allied referrals from any Providence Care computer • Access full chart review for Providence Care and KGH/HDH integrated

electronic patient record system • Reduce data duplication (i.e. Computrition will be connected and interact

with our QuadraMed system)

Contact Us ePatient News is designed and produced by the Providence Care Communications Department in association with the Providence Care ePatient Record Project Team and Decision Support Department. If you would like to suggest a topic for us to cover or you have questions about the ePatient Record, please send us an email at ePR@providencecare.ca

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