November 29, 2017 1

DOM Electronic Acuity Scoring

System (ePASS)

Kathy Wagner-Kosmakos, MS, RN; Judy Skolnik BSN,

RN; Robin Lewis-Cherry BSN, RN; and Donna Beitler

MS, RN-BC

Overview

This talk will walk through the process of

developing an electronic patient acuity

scoring system to assist the Charge

Nurse in assignment making.

Objectives

• After this presentation, the learner will be able

to describe the methodology used to develop

and implement an electronic patient acuity

scoring system.

• After this presentation, the learner will be able

to demonstrate the use of the Dept. of

Medicine electronic patient acuity scoring

system.

The Situation

• No standardized electronic patient

scoring system in the Department of

Medicine (DOM)

• The need to capture anticipated

workload for consideration in

construction of a fair staffing

assignment

The Background

• The Department of Medicine (DOM) had used

multiple tools to address patient acuity related

to making Nursing assignments.

• Staff dissatisfaction with patient assignment

• Inequitable assignments not reflective of

actual patient acuity/workload

• Subjective and unreliable methods

• Variations in staff experience level

• Safety

Assessment

• To address these disparities and identify

best practice a workgroup was formed

to develop a standardized tool for the

department. The workgroup consisted

of Nursing, Data Analysts, and

Armstrong Institute Human Factors

Specialists.

The Recommendation

• Develop a standardized patient acuity rating scale to quantify nursing workload

• Develop a decision making tool to give charge nurses guidance in making an equitable patient assignment

• Use data to support rationale for assignment and support staffing patterns

• Improve staff satisfaction, quality of working life, patient safety and outcomes

• Provide data for staffing patterns and acuity trends

• Reduce nursing workload and burnout

The Process

• Evaluated current acuity rating scales used by all DOM units

• Literature review

• Created an excel program stored in the I drive of the virtual desktop

• Partnered with Human Factors Engineers from Armstrong Institute

• Collaborated with DOM IT to create a web based tool

• Elicited feedback from the end users and revised the tool

The Team and the Timeline

• Team: Nursing, Human Factors Specialists,

Informatics and IT

• Fall 2013: Excel based, I drive Nelson 6

• September 2014- January 2015: Taskforce

established and usability testing done

• April 2015: Education and Competency

• May 2015: Initial units went live and reliability

testing continued

• October 2015- November 2015: remainder

of the Tele units went live

Next Steps/Vision

• Financial implications-justification of staffing patterns

• Development and Implementation of an IMC/ICU version

• Increased EPIC data pulls including patient decompensation predictor

• Color coding for medical emergencies and staff experience levels

• Interface with Command Center

• Alignment with JHH Strategic Priority : Biomedical Discovery

Access to ePASS

Demonstration

http://medtest.jhmi.edu/epass/main.aspx

Thank you