megan zigomanis, eastern health: implementation of an emm system at a palliative care and...
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Members of Eastern Health: Angliss Hospital, Box Hill Hospital, Healesville & District Hospital, Maroondah Hospital,
Peter James Centre, Turning Point Alcohol & Drug Centre, Wantirna Health, Yarra Ranges Health and Yarra Valley Community Health
Members of Eastern Health: Angliss Hospital, Box Hill Hospital, Healesville & District Hospital, Maroondah Hospital,
Peter James Centre, Turning Point Alcohol & Drug Centre, Wantirna Health, Yarra Ranges Health and Yarra Valley Community Health
Implementation of an EMM
system in a subacute and
palliative care facility
Megan Zigomanis
Lead Pharmacist
About Eastern Health
• 7 hospitals
• Various residential care facilities, community
based facilities and community health services
• 1301 beds
• In 2011/2012
o140,743 acute inpatient admissions
o3728 sub acute admissions
o141,251 emergency presentations
o169,992 outpatient services
Background• Lead agency for the Cerner Millennium clinical system
as part of the HealthSMART initiative by the state of
Victoria
• ‘Release 1’ went live at Eastern Health in August 2010
and included electronic medication prescribing on
discharge, results viewing, allergy and alert entry and
discharge summaries. It was implemented across the 7
campuses over the next 12 months
Background• Planning for ‘Release 2C’ at Eastern Health commenced
mid 2011. Release 2 was being led by 2 other health
services in Victoria and included electronic ordering and
administration of inpatient medications as well as
electronic ordering of pathology and radiology tests
• The HealthSMART program ceased at the end of June
2012 and the State continue to provide support services
for the agencies with production systems
Background• The Eastern Health Clinicals project
underwent rebranding as part of the of the overall ICT strategy of the organisation and this was planned to coincide with Release 2 activities
→
Scope and roll out plan• The decision was made at Eastern Health that
the sub acute / palliative care facility would be
the first site to go live. This allowed:
– more time to work through scope decisions for
specialist areas in the acute facilities
– more time to explore build options for complex
medications that would not routinely be used in sub
acute and palliative care
Governance
Site engagement• Members of the team were based at the
go live site for nearly 3 months prior
• This allowed for:
– Relationship building with key stakeholders
– Multidisciplinary workflow development
– Development of clinical champions
– Increased ad hoc training opportunities
Training and education• An online e learning system was not available at
the time so:
– Medical and pharmacy staff were trained in a one on
one capacity
– Nursing staff and allied health were trained classroom
style
– a ‘super user’ system was employed to assist with go
live and ongoing support once the project team left
the site
Go live and on site support• ‘Go live’ occurred at the end of November 2012
• It was a staged approach with each ward over a two day
period and one week apart
• A command centre was set up to manage the
deployment
• Twice daily meetings were held with all stakeholders to
discuss the progress
• Project team members were rostered on site in a
declining fashion for a 4 week period
Organisational Challenges• Translating theory into practice
• Communicating to senior management the magnitude of the change
• Standardisation and communication of existing organisational policy
• Communicating the magnitude of the effort to develop, maintain, and monitor the newly implemented system
• Turnover of project team members
System Challenges
• State wide footprint
• Functionality available
• An internationally developed system
• AMT catalogue nomenclature
• Managing dual systems
Benefits• Order legibility
• Order completeness
• Single record across campuses
• Remote access for clinicians
• Multiple access to the patient record
• Integration to pharmacy and radiology systems
Lessons learned• All project members should be familiar with as
many aspects of the system as possible
• Medical input is crucial from the start
• An e learning system is needed to allow the
training resources to be directed elsewhere
• The whole of the organisation needs to be
engaged not just the go live site
Acknowledgements
Thank you to all the members of the ehCare@eastern team for making this
implementation possible and to the change and clinical transformation team
for their assistance in preparing for today’s presentation.
Questions?
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