STAGE 7 SPOTLIGHT Truman Medical Centers: Improving Nurse Satisfaction
Healthcare organizations all over the world have followed the HIMSS Analytics Electronic Medical Record Adoption (EMRAM) Model as their strategic roadmap for effective electronic medical record (EMR) adoption and maturity. The eight-stage (0–7) model measures EMR functions against industry benchmarks and guides organizations as they move closer to an optimal technology-enabled healthcare environment.
Being validated as a Stage 7 organization lends significant financial, clinical and operational benefits. Here is an overview of Truman Medical Center's application of the EMR functions and their validation.
Truman Medical Center (TMC) is a 600-bed, two-hospital, not-for-profit healthcare system serving the greater Kansas City metropolitan area. It is the largest safety-net provider of uncompensated care in the State of Missouri, with more than $120 million of care provided in the last fiscal year.
TMC provides a full range of health services, specializing in chronic disease management, high-risk pregnancies, sleep disorders and cancer care. They provide both prompt, actionable emergency services and local primary care for families, leading the way to a healthier community.
New leadership in the nursing department identified three primary goals for TMC to work toward in order to improve patient care- increase nursing satisfaction, improve nursing efficiencies and to ensure these led to improvements in patient safety and quality care. The team collaborated with IT leadership to devise a plan on how to accomplish these goals by utilizing a device “uplift,” for the care team. The latest in single device handheld mobility, Cerner Connect, was the key component to the plan.
The EMRAM Implementation
TMC rolled out their plan throughout 2016 and 2017, in the following phases:
TMC upgraded their infrastructure to handle expanded team use. This upgrade included better tools for IT to monitor utilization, performance and priority vs. non-priority bandwidth ratios, which lead to a much more satisfied end-user community.
TMC implemented a solution that transferred forms to electronic versions that allowed patients to use iPads for form review and signature.
Physician Mobility solution (PCTouch)
Using the iOS platform, the team rolled out capabilities that enabled providers to view patient records via their phones and tablets, while also being able to dictate, document, annotate and sign documents, place orders and capture images directly into the care record.
The technology for medication scanning, breast milk management and blood transfusion administration was combined to be accessible through a single handheld device. The nursing workstations were updated with new technology and the scope of bar-coded medication scanning from acute care to ambulatory care.
The mobile access enabled nurses to have enhanced access to patient information such as orders, results and immediate updates on critical vital signs. This access also allowed care team members to be dispatched when needed.
Nursing satisfaction increased due to faster network capabilities which, in turn, helped with recruiting for new nursing staff.
The team recorded the nurses' daily steps before and after the implementation. One comparison done on a nurse over the course of a 12-hour shift reduced her number of steps taken from approximately 15,000 steps one day to 7,800 the next day due to having the secure communications available on her handheld device.
As Amy Peters, MBA, BSN, RN and Chief Nursing Officer put it: “We have a highly engaged group of nursing professionals and a fantastic opportunity to deploy the technology Cerner offers. This not only benefits our nurses by putting current technology in their hands, it also benefits our patients by helping to support safe patient care with everything that we do.”
By implementing comprehensive EMR functions, TMC was able to reduce inefficiencies in their nurses' days which enabled them to provide better care and entice new nurses to apply to TMC.
TMC's EMR function implementation was only the first step in an on-going improvement process. Like TMC, healthcare organizations everywhere can use the EMRAM Stage 7 Achievement process to ensure that healthcare facilities keep up with technology, and every member of the organization functions as a more efficient unit with patient satisfaction at the forefront of their day-to-day operations.