1. Improving Accuracy of PCA Documentation in Epic
Isaac Chua, MD – Palliative Care Physician Fellow
Benjamin Kematick, Pharm D – Palliative Care Pharmacy Resident
Lunder 10, MGH
Improving Accuracy of PCA Documentation in Epic
TEAM:
Lunder 10 Nursing Staff
COACHES
Josh Lakin, MD
Victor Phantumvanit, Pharm D
PROJECT SPONSORS:
Paul Arnstein, RN, PhD
Michelle Stuler, RN
Melissa Lantry, RN
AIM: To improve PCA documentation accuracy on Lunder 10 by reducing intra-unit variation for mean time to clear PCA by 30%.
INTERVENTION: We hosted a pizza party for the Lunder 10 nursing staff for the purpose of conducting a root cause analysis / brainstorming session to identify obstacles that prevent consistent and accurate PCA documentation. We also reviewed what constitutes best practice for PCA documentation per MGH policy with the nursing staff. After the intervention, we ed an electronic survey to the Lunder 10 nurses to identify which obstacles that they feel are most problematic. Total of 26 nurses completed the survey.
RESULTS:
CONCLUSIONS:
Not enough post-intervention data to determine if we met our aim of reducing variation of mean time to clear PCA by 30%.
NEXT STEPS:
Will need to engage RNs to create a sustainable reminder system during handoffs for patients on PCA.
Will need RN unit champions in each unit to help audit charts. Perhaps create an incentive for RN to participate.
Will need to engage RN leadership in other units
Pre-intervention audits (n=5)
Post-intervention audits (n=1)
Most commonly cited obstacle for inaccurate documentation is lack of visual alerts in Epic during shift change (n=15).