“Out With The Old and In With The New” Implementing the Use of an EMR in Our Surgery Center
PROBLEM: Underutilized EMR System in regards to Medication Reconciliation Continuing Use Of Paper Chart for Patient’s Medication & Allergy Lists Not Currently Meeting Meaningful Use Requirement
Admitting Procedure Handwrite patient‘s medications, allergies, height, weight, & vital signs on paper chart Physician & Anesthesiologist must both view the chart Discharge The hand written medication list must be reconciled sent home with the patient At The End Of The Day All Charts must be scanned into the computer into the patients EMR The Flow
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.
The Benefits of EMRs Complete and accurate information Better access to information Patient empowerment
What is Medication Reconciliation? Medication Reconciliation: Is it all correct? Have any changes been made?
The Statistics Source: Cornish PL, Knowles SR, Marchesano R, et al. Unintended medication discrepancies at the time of hospital admission. Arch Intern Med. 2005;165:424-429. [go to PubMed]go to PubMed
How to Make the Change Lewin’s Change Theory Kurt Lewin (1951) 3 Step Model 1. Unfreeze 2. Movement 3. Refreezing
TimeLine 2013 MayJuneJuly Train all staff Reevaluate for any problems Present to staff & board success of EMR utilization
Now… Admitting nurse enters all medications, allergies and vital signs into the EMR This data is available to all who access to the system, no matter if they are in the surgery center or in the medical office Medications are now easily reconciled before and after the procedure A copy of the reconciled medications is given to the patient at the time of discharge
Additionally… After the information is entered into the EMR it is then printed and placed in the paper chart. This serves two purposes.
Behind the Scenes Our Pre-Op Nurse attempts to call and speak with each patient 24-48 hours prior to their scheduled procedure to interview the patient & will enter their information into the EMR.
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. Keep in Mind…
Solutions… Utilizing EMR System Reducing Use Of Paper Chart for Patient’s Medication & Allergy Lists Currently Meeting Meaningful Use Requirement
References Cornish, P. L., & Knowles, S. R. (2005). Unintended medication discrepancies at the time of hospital admission. Archives of Internal Medicine, 165, 424-429. Meaningful use. (n.d.). Retrieved from http://www.healthit.gov/policy-researchers- implementers/meaningful-usehttp://www.healthit.gov/policy-researchers- (2005). The case for medication reconciliation. Nursing Management, 36(9), 22.