Frederick Memorial Hospital Improves Clinical Processes, Achieves Stage 6
(11/18/2009)

Processing 9,000 paper orders and administering up to 5,000 medications per day, every day, leaders at Frederick Memorial Hospital (Frederick, MD) knew they had to make changes. And after performing a study on order legibility and delays, that settled it; the time had come for Frederick to take full advantage of its MEDITECH system capabilities, and automate its ordering and medication administration processes. This decision not only improved clinician workflows and the patient experience, it also contributed to Frederick becoming one of the most recent honorees of HIMSS' Analytics prestigious Stage 6 designation.

"Achieving Stage 6 recognizes our ongoing initiative to provide safe, quality care," states Vice President and Chief Information Officer David Quirke. "Without question, the MEDITECH technology we have in place is helping Frederick Memorial to meet its goal of delivering the best care possible."

Multi-Disciplinary Approach Key to CPOE Adoption Strategy
Joe Sainz, director of information services at Frederick, recalls the inefficiency of the organization's old processes. "Having to enter each paper order manually into our MEDITECH system contributed to some delays from when an order was written by the physician until it was actually entered into the system," he says. "As with many other hospitals, illegible written orders also posed a challenge. Any time an order is illegible, or the attending nurse is unclear about which physician wrote the order, it causes a delay."

To address these issues, the hospital initiated a campaign called "Enhancing Patient Care Through Technology," which included the implementation of MEDITECH's Computerized Physician Order Entry (CPOE) and Bedside Medication Verification (BMV) solutions. Thanks to the strong leadership of Frederick Memorial's Vice President of Medical Affairs, Dr. Manny Casiano—who works closely with the hospital's physician champions—the hospitalists, nurse practitioners, and Emergency Room physicians are entering their orders directly into the MEDITECH system. "On average, about 40 percent of our orders are entered using CPOE," says Sainz. "We are continuing to work with our physician champions to increase CPOE compliance as we roll it out to the physicians."

In addition, the physicians are working side by side with the I.S. department throughout order set development. "Our physician champions work very closely with our I.S. department, as they create and test the order sets," says Sainz. "This close working relationship enables our physicians to have an active voice in addressing any workflow issues that may arise."

Nursing and pharmacy leaders also play an active role. "CPOE impacts how physicians and nurses communicate with one another, and our physician, nurse, pharmacy, and I.S. teams continue to address this," says Sainz.

BMV Helps to Eliminate Medication Errors
Implementing Bedside Medication Verification capabilities was another large part of the hospital's journey toward enhancing patient care. "Our nurse and pharmacy leaders did a wonderful job working together to ensure a smooth transition to BMV," says Sainz. "The nursing team is particularly enthusiastic about automating medication administration, and the nurses continue to help roll out BMV throughout the hospital."

With nurses involved throughout the implementation, Frederick Memorial has seen an impressive level of scanning compliance among its nursing staff. "Our reports show 76 percent of all medications and 86 percent of all patient wrist bands are being scanned at this time," says Sainz.

"This is an exciting time for the hospital. As we continue to implement BMV and other Advanced Clinicals across our hospital, we have the opportunity to make a very strong impact on efforts to improve patient care and eliminate medication errors."

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