a case study: the clinical and operational impact of electronic health records in senior living
DESCRIPTION
Benedictine Health System will share lessons learned from its implementation and use of an electronic health records system (EHR) in a senior living setting. Presented from both an administrative and clinical perspective, staff will discuss how they streamlined processes and enhanced financial and clinical performance. Learn how consistent assessment tools and documentation support delivering quality care and better clinical outcomes for residents. From a financial perspective, learn how the right EHR can help manage service plans and track levels of care. >> Faculty: Mary Kay Vasterling, Clinical/Quality Manager, Nazareth Living Center || Ronda Griffin, Director of Assisted Living and Operations, Nazareth Living CenterTRANSCRIPT
Ronda Griffin, LNHA Director, Assisted Living and Operations
Mary Kay Vasterling, MSN
Clinical/Quality Manager
The BIG Three • Why is an EHR essential to the future? • How do you plan for such a big change? • What are the REWARDS of EHR
implementation?
Why?
• Technology improves outcomes • How?
• Broad access to resident information • Improves !nancial outcomes • Saves time • Better tracking of performance and quality measures • Response to increased regulation
Our Story
• Nazareth Living Center is a 250 bed SNF/ALF co-sponsored by Benedictine Health System
• In 2009, Electronic Health Record(EHR) was implemented across the BHS system
• System wide implementation offered advantages related to developing timelines and sharing resources
Planning
• Choose the right EHR • Easy to navigate • Intuitive/easy to complete required fields • Financially feasible for your organization • Meets your end-user requirements
• Clinically • Financially
Planning
• Build your team • End users are critical to success
• Nurses, CNAs, A/P and A/R staff • Product team – the best of the best • De!ne process for feedback and changes
• Develop the timeline • Administrative responsibilities • IT needs - hardware and equipment purchase • Clinical responsibilities (increased staffing levels) • Time to train, location availability, scheduling • Assess all departments staffing needs for go live
Planning
• Identify People • Subject matter experts (SMEs) • WHO has administrative rights?
Granting access Task responsibility Monitoring usage and compliance
Planning • Basics
• Assess BASIC computer use skills • Keyboarding and using a mouse
• Train the obvious • Is the computer plugged in? • How do I turn it on? • Checking cable connections • People will be embarrassed to ask simple questions
Planning
• Trouble shoot everything • Train away avoidance of the new system
• Persevere! • Adhere to deadlines • MUST have dedicated time for team
Planning • Use all available tools
• Color coded timelines/worksheets • Checklists • Parking lot issues and attendants
• Progressive Elaboration • Follow your processes • Don’t get lost on the journey
How Now?
• Go Live • Plan for data crossover • Final push immediately before go live • Data input on clinical and !nancial side: AHOD (ALL Hands on
Deck)
How Now?
• Go Live • SUPPORT, SUPPORT, SUPPORT
• Contact list SMEs/Super users to answer questions • SMEs/Super users - on site 24 hours
What were the challenges?
• Understanding how many processes the EHR could help streamline
• Orders to ancillary providers can be transmitted directly from EHR • Saves nursing staff time – no need to ‘let providers know’ a
service is needed • Quality monitoring of contracted services
What were the challenges?
• Implementation team must understand deadlines. Success is dependent on this. • Staff would have liked more ‘after go-live’ training opportunities to learn/relearn short cuts
What’s the reward? • Clinical information is available 24/7, regardless of
their physical location • Doctors, NPs, supervisors, administrators, on or off
site • Staff know where to get information (not who) • Less repetition of documentation
• Monthly summaries that took 8 hours to complete with pen/paper take less than an hour.
What’s the reward? • Nurses share these as the biggest benefits
of EHR: • QUICK review of resident orders and activity when they come into
work • Message list - a quick self check at end of shift • Search and !nd information quickly • Efficiency of (almost) paperless:
• Filing in charts, copying information, physically handling a hard chart repeatedly
What’s the reward?
• Assessment information is consistent • Assessment information is complete
• Compare resident information over time (medications, ADL ability, wound resolution, events such as falls)
• Respond to increasing regulatory oversight of Assisted Living Facilities
What’s the reward? • Financial rewards include:
• Accurate billing (what organization can’t use help in this arena?)
• Powerful database - maintain up to date accounts • Capturing charges for products or services:
• Inventory barcode systems and ancillary services can be integrated into an EHR product
What’s the reward?
• Financial rewards include:
• Documentation IN ONE PLACE • Knowledge of aging accounts and collection attempts
• Staffing decreases after go live!
What’s the reward? • Integration of all information
• Documents scanned into database - easy retrieval/viewing • Seamless transitions of care and improved resident outcomes
• NLC has resident movement between ALF/SNF/ALF, EHR helps maintain accuracy of medication lists and physician orders. Reconciliation process is easy and not dependent on “waiting for orders”.
What’s the reward?
• EHR saves time • Is always legible • Enhances ability to track resident change
in condition, quality measures, staff performance
Ronda Griffin, LNHA
Nazareth Living Center
Mary Kay Vasterling, MSN
Nazareth Living Center