PURPOSE B A CK GR OUND CHALLENGES IMPLEMENTATION

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Electronic Orders Task Lists for Unit Coordinators

Promoting Efficient and Safe Patient Care

• ANALYZED

all EMR tools for potential solutions.

• Provide an electronic task list for Unit Coordinators (

UC

). • Facilitate communication and tracking of assigned tasks. • Promote safe and efficient patient care. 

• • COLLABORATED

with UCs to determine optimal solution and gain buy-in.

IDENTIFIED

tasks for the SPW with UCs and the Clinical Informatics Council; reviewed clipboards,  • Electronic Medical Records (

EMR

) retired the paper Kardex.

• UCs created home-grown paper processes to track and manage patient-care tasks (i.e., clipboards, personal notes). • UCs needed a standardized, up-to-date electronic task list to facilitate communication, delegate responsibility and track task status.

CHALLENGES ADOPTION

: SPW would only be effective if all UCs, across shifts and

SOLUTIONS BUY IN

: Active participation from UCs about the project has been top

• • • • • •

incident reports, paper processes, electronic orders.

BUILT

electronic prototype for demonstration.

MET

one-on-one with UCs to demo prototype, obtained feedback and added ideas for SPW tasks.

CONDUCTED

pilot in Emergency Department (

ED

).

AFFIRMED

usefulness from ED staff.

PROVIDED

progress reports and periodic demonstrations of the SPW to UCs for review before house-wide roll-out.

PREPARED

training materials.

units, used it and kept it current. Stale information renders it useless. priority.

LIMITATIONS

: EMR provides a role specific “Task List” called Service Provider Worklist (

SPW

). Physician orders can be

Example of Actual Physician Order Example of Task Related “Companion Order”

auto-routed to the SPW. However, when completed, they are no longer active. This was appropriate for some, but not for all orders. (

SEE INSET: ACTUAL PHYSICIAN ORDER

) order.”

COMPANION ORDERS

: For situations where the UC had a task to complete but the “actual order” needed to remain active, a task-related “companion order” was created to go to the SPW and not the “actual

(SEE INSET: ‘COMPANION ORDER’)

• Mandatory, two-hour hands-on classroom training for all UCs.

• Rolled out 24/7 live support for 2 weeks within 2 months of ED pilot.

“SPW helps me concentrate

on patients who need help during their visit and after discharge.”

– BETTY F., UC, MEDICAL

“SPW ensures UC organization and keeps them privy to all changes occurring on the unit in a timely manner.” –

SHARON H., UC, TELEMETRY

“SPW improves doctor communication. For example, change or advance diet orders, D/C orders and daily labs. The checklist is really great.”

– CHRISTINA B., UC, MED-SURG.

“The ED gets extremely busy. If a doctor orders a CT scan with oral contrast, a task shows up on the SPW. The UC can then let the nurse know to give oral contrast. This is extremely helpful when it’s busy. If the patient’s level of care changes, the UC gets notified.”

– LISA G., RN, ED

OUTCOMES

• Task list follows the patient through hospitalization.

• Responsibility is delegated. Task status is visible. Task completion is evident. • Display of patient EMR information is accurate, including hospital service, attending physician, level of care and DNR status.

• Order and draw of daily labs is timely, including TPN-related labs, CPK and Troponins. • Diet orders are advanced as tolerated, or revised for fluid restriction or paper setup.

• Delivery of care and preparation for discharge process for UC is streamlined. UC makes follow-up appointments for patients at high risk for readmission, faxes patient care information to skilled facilities and notifies nurse of order for patient discharge.

• Reliable and accurate patient handoff tool for UCs during shift change.

• • • MAINTAINING

a list of UC suggestions for additional tasks for the SPW.

PRESENTING

and

DISCUSSING

new tasks at monthly UC meeting.

REVIEWING

and

EVALUATING

existing tasks at UC meeting.

PRESENTED BY: Athena Fernandes

,

MSN, RN-BC : [email protected]

Anne Satterthwaite

,

BSN, RN-BC : [email protected]

Chester County Hospital

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