Transcript: Gail Gerth, RN, BSN, Watertown Regional Medical Center

Strategic Planning for Stage 6
The closed loop medication system was a key strategic plan to go forward with the Stage 6. That was actually the piece that was holding us up from receiving Stage 6.

Nursing, there were some obstacles with going forward with Bedside Medication Verification. How were we going to get the computers to the bedside, which is where they needed to be if we are going to accomplish BMV? So we met with our hardware people, our I.T. support staff, our network administrator. We evaluated our hardware and our wireless access to make sure we had that infrastructure in place before we could proceed any further with BMV. Once we did that, BMV takes a lot of coordination with the Pharmacy department, and so our pharmacist, John Schloemer, he was the project manager for BMV and did an excellent job. 

And we kind of had two different teams working on BMV. We had our nurse managers meet to decide on the overriding principles and the philosophy behind BMV and were their percentage rates were going to be acceptable? What did they want to see their staff accomplishing with BMV? And then after that, we had a CORE team of nurses that we met with, which again, was very important because you have to involve those nurses because it's going to affect their day-to-day practice. All of a sudden, oh we got to get out the scanner before we can give the medications, and are the name bands going to work? Or, do we have to re-evaluate getting different patient bands because the scanning is going to go better? And once we had all those pieces in place, we could get our test equipment in and the CORE team met and practiced with the system and we worked out the process and we felt it was going to go forward very well.

With BMV, we did accomplish that we decreased our medication error rate and we found as we reviewed the statistics, that when a medication error did occur, it was because a nurse did not follow the process of using the whole BMV process. They skipped the scanning of the patient or they skipped the scanning of the medication and then they administered a med at the wrong time or the wrong dose or whichever. And we're going back through with nursing staff to revisit, why can't we get to that 100 percent, because ideally, you want to be at 100 percent and it's just like, what are the obstacles preventing us to get to 100 percent? So we're kind of in that process right now, doing focus groups with nursing to decide, what are those last couple pieces we're having issues with?

Electronic Health Records and Documentation
Our nurses have been very pleased with the electronic documentation system. I know if we ever have a downtime spell, they are clamoring to get back on the system because it is such an integral part of their everyday workflow. We are utilizing the EMR to gather information for the handoffs between shifts. They use the patient status board to get the latest information about when medications are due and troubleshooting any meds that are still left over from the previous shift to make sure those things are taken care of when they're doing hand-off to the next shift.

Exchanging Information
With exchanging information, right now we are not electronically, I said that before, electronically exchanging information with other places but we do within our community. We allow access from the Long Term Care facilities in our community to access our system electronically. They sign a confidentiality waiver and they only have access to their residents information and that's all. And they really appreciate it because if a resident gets admitted, their nursing staff can keep track of that patient and make sure that we're handling the care, if there were any special areas we're having issues with. There's a long term mental health facility for development mentally disabled patients and they especially, those patients have very special needs and if they see that we're struggling with a need with one of their patients, one of their clients, they can collaborate with us to make sure that we're following what works best for that patient because they're used to that client and their special needs. So it's been very, very nice.

In our sharing of health care information with our tertiary care partner, UW Health Partners, we are the first site in Wisconsin to have a telestroke program. So the patients seen in our Emergency Departments can be consultations from from the neurologist in Madison and from there they can make a diagnosis of 'What is the best course of treatment for this patient?' So that's another stride in sharing information across the health care continuum, making sure our patients get the best care possible.

Preparing for ARRA
I guess with all the things we are currently LIVE with, we feel like we are in a good place, that we will qualify for some of the stimulus money. We've been meeting, attending webinars about how the stimulus package will affect us and what can we take advantage of? What funds are out there and how do we apply for them and what are the requirements for that? So it's very preliminary at the current time.