2 Implementing the Use of an EMR in Our Surgery Center “Out With The Old and In With The New”
3 PROBLEM:Underutilized EMR System in regards to Medication ReconciliationContinuing Use Of Paper Chart for Patient’s Medication & Allergy ListsNot Currently Meeting Meaningful Use Requirement
4 The Flow Admitting Procedure Discharge At The End Of The Day Handwrite patient‘s medications, allergies, height , weight, & vital signs on paper chartProcedurePhysician & Anesthesiologist must both view the chartDischargeThe hand written medication list must be reconciled sent home with the patientAt The End Of The DayAll Charts must be scanned into the computer into the patients EMR
5 What is meaningful use?Electronic health records can provide many benefits for providers and their patients, but the benefits depend on how they're used.Meaningful use is the set of standards defined by the Centers for Medicare & Medicaid Services (CMS) Incentive Programs.The goal of meaningful use is to promote the spread of electronic health records to improve health care in the United States.
6 The Benefits of EMRs Complete and accurate information Better access to informationPatient empowerment
7 What is Medication Reconciliation? Is it all correct?Have any changes been made?
8 The StatisticsSource: Cornish PL, Knowles SR, Marchesano R, et al. Unintended medication discrepancies at the time of hospital admission. Arch Intern Med. 2005;165: [go to PubMed]
9 How to Make the Change 3 Step Model Unfreeze Movement Refreezing Lewin’s Change TheoryKurt Lewin (1951)3 Step ModelUnfreezeMovementRefreezing
10 TimeLine 2013 Present to staff & board success of EMR utilization Train all staffReevaluate for any problemsMayJuneJuly2013
11 Now…Admitting nurse enters all medications, allergies and vital signs into the EMRThis data is available to all who access to the system, no matter if they are in the surgery center or in the medical officeMedications are now easily reconciled before and after the procedureA copy of the reconciled medications is given to the patient at the time of discharge
12 Additionally…After the information is entered into the EMR it is then printed and placed in the paper chart.This serves two purposes.
13 Behind the ScenesOur Pre-Op Nurse attempts to call and speak with each patient hours prior to their scheduled procedure to interview the patient & will enter their information into the EMR.
14 Keep in Mind…The EMR has not used in this manner and only contains scanned documents. Unfortunately, patient’s charts or other pertinent documents are not always scanned in an efficient manner, which means they are not always available to be viewed when needed.
15 Solutions… Utilizing EMR System Reducing Use Of Paper Chart for Patient’s Medication & Allergy ListsCurrently Meeting Meaningful Use Requirement
16 ReferencesCornish, P. L., & Knowles, S. R. (2005). Unintended medication discrepancies at the time of hospital admission. Archives of Internal Medicine, 165,Meaningful use. (n.d.). Retrieved from implementers/meaningful-use(2005). The case for medication reconciliation. Nursing Management, 36(9), 22.