I.T.
Leader at Adena Health System Shares Transformative
Experience with ORM Implementation
(10/15/2009)
As a 20-year MEDITECH customer, Adena Health
System (Chillicothe, OH) had experienced the benefits of I.T.
integration throughout most of its care areas. A glaring
exception was in the Operating Room, where their only
automation involved a best-of-breed solution for peri-operative
care only. That all changed in 2006, when Adena turned to
MEDITECH's integrated Operating Room Management (ORM)
solution, to bring the department up to speed.
But technology alone wasn't quite enough to transform Adena's
OR. In order to automate every piece of operative care, the
organization depended upon Systems Analyst Tina Septer to
help prepare staff members for the culture changes to come.
And, with the support of key staff leaders and executives,
Septer and the I.T. team at Adena proved to be the driving
forces behind the project's success. We recently sat down
with Septer to discuss her facility's successful
implementation strategy, and any advice she may have for
other hospitals within the MEDITECH community.
Q:
Why did Adena Health System choose to implement MEDITECH's
ORM product, and how does it fit in with your organization's
strategic goals?
Septer: Well,
we see ourselves on a constant mission to improve care
quality and patient safety. We want to continue growing and
staying innovative, and one of our main goals is to be
completely paperless by 2010. As a long-term MEDITECH
customer, we trust and value this vendor's products to help
us move forward. Furthermore, we knew MEDITECH's integrated
ORM solution would support our surgical care and electronic
objectives.
From a financial perspective, we also saw the ORM product as
a tool designed to help us improve our charge capture
capabilities. By automating our charges, we knew we would be
able to meet our inventory and lean capture goals.
Q:
Could you describe your ORM implementation timeline?
Septer: In
January 2006, the ORM software was delivered to our hospital.
We went LIVE with ORM and Scheduling approximately eight
months later. By November of that year, nursing documentation
was fully automated in the OR, as well as in our PACU.
Q:
Are care providers using the ORM functionality off-site as
well?
Septer: Yes,
our off-site ambulatory and endoscopy suites are using ORM
for nursing documentation.
Q:
How did you use the contributions of senior staff, to prepare
others for the new technology and process changes? Did their
leadership make a difference?
Septer: The
implementation would never have been so successful without
the support of key individuals. For example, our Surgical
Services System Coordinator, Karen Latham, has worked at
Adena for 20 years and has a strong clinical background; she
understands how our hospital runs, how each floor operates,
and how important it is to engage everyone who will be using
the new electronic solution. Also, our Surgical Services
System Director, Michelle Stemple, was extremely instrumental—particularly
in explaining to staff where our organization was going in
terms of ORM technology, and how we planned on getting there.
Early on, both Michelle and Karen attended multiple medical
and surgical staff departmental meetings, in order to gain
the necessary support to move ahead with our hospital's OR
transformation. Michelle and Karen were able to obtain staff
feedback and keep the lines of communication open throughout
the entire process. As a result, management and staff
respected what they had to say, and, in return, became
committed themselves to making the ORM implementation a
success. It was a joint effort.
Q: What was
your own management approach like? How did you prepare for
the ORM transition?
Septer: For us,
it worked best to develop a training approach that matched
the "flow," or processes, within each surgical area.
We tailored training to specific groups, teams, and floors,
and kept things consistent within each group.
One thing I learned is that having a strong network in place
and the right amount of network support is just as important
as having a strong software solution. We made sure that our I.T.
department was on board with the project from the beginning,
and we always had the right amount of technical resources in
place to support the ORM product.
Q:
From an I.T. management perspective, what do you like most
about ORM?
Septer: When we
have an upgrade, there is very little downtime, and that
makes my job a lot easier! Nurses have become so accustomed
to the solution, they hate those rare occurrences when we
need to schedule downtime and temporarily take users off the
system.
Q:
What has been the overall impact of ORM, and the MEDITECH
system, on the clinical staff?
Septer: Nurses
really appreciate the integration within the MEDITECH HCIS.
They love how patient vital signs, intakes and outputs, and
medications from the OR Surgical Profile flow directly to
Patient Care Inquiry. And because real-time information is in
one concise, easy-to-access area, nurses can better manage
their surgical patients while documenting, making
modifications, and completing their day-to-day tasks much
more easily than before.
Q:
How has ORM affected communication among Adena's caregivers?
Has it had a positive impact on clinician workflows?
Septer:
Since going LIVE with ORM, communication among our clinicians
has definitely improved. Because all patient and surgical
information is available in real time and at the point-of-care,
there are fewer phone calls going back and forth between
departments. Patient hand-offs have also improved—nurses
can easily see vital signs, pending information, how much IV
fluid was given, and how well a patient tolerated a specific
procedure.
By looking at the intake section, nurses can also view the
number of patients scheduled for surgery on a certain day,
and how many patients are ready to be discharged. Prior to
installing ORM, we could never forecast something like this—it's
nice to be able to plan ahead and anticipate if we need extra
beds or more supplies. If we do need more beds, we can make
the necessary arrangements quickly and easily before a
patient's arrival.
In addition to planning ahead, the ORM solution assists our
nurses with surgery delays. If there is a delay between the
time a surgical case was scheduled to begin and when it
actually started, nurses and physicians can determine clearly
what the delay reason was by looking in the system.
MEDITECH: How
does patient safety come into play with your HCIS?
Septer:
Nurses especially like how they can access all relevant
surgical data and results through Patient Care Inquiry. They
also appreciate that the tools within the solution are
designed to help them work with fewer medication errors,
thereby enhancing patient satisfaction and safety. What's
more, ORM's integration with Pharmacy provides patient safety
checks for potential medication interactions, allergies, and
adverse reactions.
I'm also happy to say that the system supports our surgical
protocols. After asking the patient to verify his or her name
and where the surgery will be performed, the nurse can
document the required information along with the surgeon's
name, into the system. Since we chose to make certain fields
required before nurses can move to the next prompt, we are
ensuring all the necessary patient data—such as right
site, right surgery, and right patient—is documented
correctly and safely every time.
Q:
You've added Big Board functionality in your OR and in the
waiting room area. Could you describe any benefits you've
seen as a result?
Septer: In our
OR, we are displaying the Big Board on individual carts, as
well as on PCs, for clinicians and physicians who are
monitoring patients and performing surgeries. Nurses use the
OR Big Board to view and edit real-time information
associated with each surgery—including surgical
personnel, estimated duration of surgery, patient risks or
allergies, and laboratory results. The Big Board has become
an essential part of our nurses' day-to-day delivery of care;
they start their day at the Big Board and end their day there,
too.
Big Board functionality is in our waiting room so visitors
can see the status of their family member who is undergoing
surgery. By looking at a unique and confidential identifier,
individuals can track the patient as he or she moves from pre-surgery
to recovery. We've received a lot of positive feedback from
the community on this feature.
Q:
Are you experiencing any operational efficiencies from ORM,
at this point?
Septer: We are
seeing some operational efficiencies within our OR, thanks to
the integration between ORM and the MEDITECH Materials
Management product. By using preference lists for items such
as nursing notes, equipment, and medications, the right
supplies are available at the right time—and we are able
to keep surgeries running smoothly, without unnecessary
delays. When surgical items are selected off the lists, the
items are automatically deducted from the Materials
Management inventory, on an "as-used" basis.
Meanwhile, the automated flow of charges ensures accurate
charging and minimizes lost revenue.
Q:
What's next for Adena, going forward?
Septer: We hope
to automate all of our P.O.'s, so we can electronically
deduct items from inventory and request replacements. We are
also planning on adding Clinical Review capabilities, and
incorporating LSS into our physician practices in the near
future. In health care, there's always more to do, and we're
not slowing down any time soon.
MEDITECH
Medical
Information Technology, Inc.
MEDITECH Circle
Westwood, MA 02090
781-821-3000
www.meditech.com