Greenwich
Hospital Shares EDM Success Tips
(03/26/2007)
The
Emergency Department (ED) is often the face of a
health care organization, and its performance is a
critical determinant of a hospital's success. To
ensure their ED was meeting the goals of the
organization and the standards of their patients,
longtime MEDITECH customer Greenwich Hospital (Greenwich,
CT) made the decision in 2005 to implement MEDITECH's
Emergency Department Management (EDM) application,
and went LIVE with the system in May of 2006.
"We needed to step into the next century, and
move away from a paper-based system to the electronic
medical record," says Maura Delehanty, RN, Nurse
Manager of Greenwich's Emergency Department. "We
knew that our Emergency Department needed to be
automated, to improve both clinician efficiency and
patient safety."
In order to make its ED clinicians and support staff
feel more comfortable about the new system, Greenwich
involved them in every step of the process. Several
staff nurses, physicians, and physician assistants
were invited to go to the MEDITECH corporate visit,
regardless of their role or position, so that they
could ask questions and learn more about the
implementation process. This helped to ease many
anxieties and prepare the staff for the year ahead.
"The most important first step a health care
organization can take before implementing any kind of
system is to get all staff on board," explains
Kevin Brown, MD, Medical Director of Greenwich's ED.
"It is a fatal mistake to not get the support
and buy-in from your staff."
During the implementation, the EDM core team met
regularly to learn and understand the system. "It
was almost as if we were learning to speak a new
language, like we were preparing to visit another
country," says Delehanty. These regular meetings
led to the group instituting transitional projects to
get clinicians prepared for new processes and
routines. The first transitional project was to move
from a hand-written triage form to using MEDITECH to
input an electronic form for each patient entering
the ED. As the go-LIVE date approached, physicians
began entering all orders through Provider Order
Management (POM) to get used to entering orders
electronically. "By getting physicians
acclimated to this process in POM first, it
dramatically increased their adoption rate of EDM
once we were LIVE," says Brown.
Teamwork within the department was important, but the
folks at Greenwich Hospital didn't realize how far-reaching
the system would be throughout the rest of their
organization. "It can be a culture shock for the
other clinicians in your hospital," says Brown.
"When we converted to a paperless environment,
the physicians from our other departments were asking
for the paperwork that used to come with the patient's
chart. We had to get them up to speed on the new
system and what that meant for their unique workflow."
Because the EDM system doesn't just apply to the
Emergency Department, Greenwich worked closely with
all departments, physicians, and nurses before and
after going LIVE with the new system.
Since going LIVE, Greenwich has seen immediate
results. A tracking feature follows patients
throughout their visit in the ED, including how long
they've been waiting, what test results are pending,
and if any treatment has been administered. The
tracker has helped staff cut down the wait times for
patients and expedite their treatment. The Pharmacy
department has enjoyed a more streamlined workflow
with the automation of approved, standardized
medication abbreviations. In addition, the nurses are
using "Clinical Paths" (i.e. order sets)
that have been developed by the ED attending
physicians. These, too, help to expedite treatment
for the patients.
The hospital has experienced patient safety
improvements as well. Because all patient information
is stored in PCI, other departments have access to a
patient's clinical history instantly. "When a
physician places a medication order, the patient's
allergies immediately come up before the order can be
completed," says Rob Castagnoli, applications
manager. "When a medication is ordered that is
weight-based, the system calculates the correct dose
for the patient. Overall, the EDM has improved
patient safety in every area."
The success of Greenwich's EDM implementation has
been a big boost for the rest of the organization.
"The other departments of our hospital are now
modeling their own processes and initiatives after
what we've done in the ED," says Delehantry.
"They see first-hand how it's worked for us, and
they are excited to make improvements of their own."
MEDITECH
Medical
Information Technology, Inc.
MEDITECH Circle
Westwood, MA 02090
781-821-3000
www.meditech.com