Patient Tracker Helps Transform Care Delivery throughout BC's Interior Health Authority
(6/12/2009)

Transforming the way health care is delivered is a tall order for any organization, let alone for a conglomerate serving a large geographical area. But delivering care in the most efficient way possible is part of Interior Health Authority's (IHA) ongoing journey to transform health care delivery in its home province of British Columbia, Canada. And the main thrust behind its latest initiative involves implementing MEDITECH's Emergency Department Management (EDM) features simultaneously throughout six of its health care facilities.

This far-reaching and exciting project got underway when IHA applied for and received funding from the Ministry of Health Transformation Fund—which was established to help drive change in the province's health care system. Applying for the grant allowed the health authority an opportunity to present to the Ministry of Health their goals for improving care, as well as the reasons why they felt implementing MEDITECH's EDM was an important part of their mission.

"We saw the EDM, and especially the Patient Tracker feature, as a great opportunity to align our health care strategy with the Ministry's goals to increase efficiency in the delivery of health care services," says Lise Poirier, IHA's IMIT manager of clinical systems. "The positive results we are seeing already underscore for us the importance of this investment."

Tracker Technology Focuses on Patients, Streamlines Flow
As the initial stage of the EDM rollout, the IHA facilities have implemented the product's Patient Tracker feature. This has allowed clinicians to obtain a more concise view of the patient flow within their emergency departments.

"The tracker allows us to follow and manage our patients from the time they enter our facilities until admission or discharge," explains Poirier. "We can display a patient's whereabouts within the department at any given time, since tracker information is displayed on electronic white boards within the emergency departments."

Taking advantage of the feature's flexibility, IHA has set up trackers to display information specific to various ED locations and roles. For example, trackers have been set up for emergency departments, fast-track units (streamlined EDs for less serious visits), and trauma units, as well as for individual Admissions personnel and clinicians.

Real-Time Information Enables More Efficient Decision-Making and Treatment
The IHA facilities' use of the trackers has replaced the traditional "grease boards" and paper stacks—previously the only means clinicians had for discovering what kinds of cases were waiting for them. "After a patient was treated and discharged, the white board was wiped clean and manually updated," says Poirier. "Now, a nurse sees the patient at Triage and then sends him or her to Registration. Once Registration staff enter the patient's information into the system, the patient becomes visible automatically in the EDM."

The new trackers also include information such as priority/triage levels, bed number, test results and clinical indicators, and reasons for delays. "Additionally, we use the color coding feature not only to distinguish between lab and radiology results, but also to distinguish patient gender. That helps us to save space on the tracker to include other important information, such as registration times," says Poirier.

Registration times have been set up to automatically flag clinicians for when a patient may be waiting too long for an assessment. The visual display of information allows clinicians to quickly determine who is waiting and the level of care needed, allowing for more efficient decision-making and treatment.

Many of Interior's physicians are also using the tracker and finding it to be a useful tool. Interior Health ED physician, Dr. Michael Ertel, explains how the tracker has improved the way physicians manage their workloads: "For the first time, we are able to get an overall view of what is happening in the department with respect to volume, the number of admissions in the department, and the number of patients waiting to be seen."

The hospital also benefits from being able to track whether staff are meeting quality targets—such as seeing adult patients within two hours and pediatric patients within one hour. "Personally, I appreciate being prompted to reassess patients when all their investigations have been completed," says Ertel.

Continuing on the Journey to ED Excellence
Now that the EDM is enabling IHA's sites to track data electronically, the organization is easily providing required statistical data to the Ministry of Health. "The data capture and reporting is also extremely useful, since it provides us with feedback so we can assess where we need to further improve care delivery," adds Poirier.

Going forward, implementing the remaining EDM components within the six sites is an important part of IHA's long-term strategic plan. "To further our ED goals, we are working toward more clinical documentation and Physician Order Entry," says Poirier. "This will enable us to be less paper-dependent and will allow us to look at best practices electronically."

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