With some prompting by way of Medicare incentives, Cook County North Shore Hospital is moving toward keeping all of its medical orders and nursing notes on computer. At the March 22, 2012 hospital board meeting, RN Pam Faye demonstrated how computerization could prevent mistakes from happening.
Medications are now individually packaged with bar codes to identify them. When a nurse enters a hospital room to dispense a medication, he or she scans the bar code on the medication and the bar code on the patient’s wristband and waits for confirmation that this is the right medication before opening the package and dispensing it.
A computer program prompts nurses to go through a list of observations to note on patient charts, standardizing the language of the notes and helping nurses to make sure they have checked everything they should be checking.
Nurses went online with the new program in March, and doctors will be using the system starting next January.
If computers go down, an in-house server that backs up data every 12 hours can be accessed, and medication cabinets can be unlocked if everything goes down, Faye said.
“The nurses have been very supportive,” Faye said, “and the doctors coming on board are being supportive. …It’s not easy!”
The new system requires staff to learn how to do things differently from the way they were taught, Hospital Administrator Kimber Wraalstad said.
Are there any drawbacks to this? Physician Sandra Stover said delivering patient care could be slowed during busy times if not enough computer workstations are available. Some hospitals have computers in each room. Right now, Stover said, nurses sometimes scribble data on scraps of paper and input it into the computer system later. Having enough computers to go around would speed up care and assure more accurate documentation because the computer could be accessed when working with the patient, she said.
Administrator Wraalstad’s written report to the board states, “The Meditech Patient Care System Module (PCS) went ‘live’ on Tuesday, March 6, 2012. Pam Faye and Chris Silence have spent the last six weeks training nursing staff to use this module. The nursing staff also spent several weeks completing documentation on ‘test’ [not real] patients to develop familiarity with the software.
“While there were some bumps, the implementation of the module went fairly smoothly. As occurs when learning new systems, the nurses have commented that they are slower in completing certain tasks. With more use and familiarity, it is anticipated that speed and efficiency will increase.”
The Health Information Technology for Economic and Clinical Health Act was signed into law in 2009 as part of the American Recovery and Reinvestment Act. It requires health care providers to keep records in a way that is useful and efficient. Meditech is the company that supplies the software being used to comply with the requirements of this legislation.
Financial report
“February was slow across the board,” reported Controller Yvonne Gennrich, but the year-to-date loss of $70,908 is less than what was budgeted and less than the loss at this time last year.
The 310 emergency room visits in January and February were down from 356 last year, possibly a result of the fact that with little snow, fewer people were participating in winter sports. The home health program is over 26 percent busier so far this year than last year, with staff having made 371 visits the first two months of the year.
The 10 percent decrease in employee health insurance premiums this year is making a difference on the bottom line, Gennrich reported.
Leadership training
Administrator Wraalstad said some of the staff would be receiving leadership training in March and April. Employees are often promoted to management positions with no training in leadership, she said. The hospital’s strategic goals include a plan to develop leaders.
Wraalstad’s written report to the board states that department managers, “emerging leaders,” and “employees interested in developing leadership skills” would be offered this training.
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