streamlining and transforming documentation
TRANSCRIPT
STREAMLINING AND TRANSFORMING DOCUMENTATION:
the vendor view
Denise Rasmussen
© 2018 Epic Systems Corporation.
ThenWhat’s to Come…
NOW
AGENDA:
noun BURDEN
bur-den bər-dᵊn
2. A duty or misfortune that causes hardship, anxiety, or grief
3. The main responsibility for achieving a specific aim or task
1. A load, especially a heavy one
Time spent documenting
Number of times logging in/outDuplicative documentation
“Nobody looks at the data I enter” = Perceived low value
“We only document our Care Plan for TJC”
DOCUMENTATION BURDEN
CHARTING BY EXCEPTION1990
Study Protocol B: 382 Nurses, 1083 10-Hour shifts
Data Collection Method: Nurses self-reported location, activity, and
cognitive category on PDA every 15 minutes.
TIME MOTION STUDY2008
INCREASING DIRECT PATIENT CARE
Pre-EMR42.1%
Post-EMR51.4%
Pre-EMR25%
Post-EMR75%
EFFECTIVE + EFFICIENTNURSING DOCUMENTATION
WHAT ELSE IS POSSIBLE...• Mark as Reviewed
• Single Sign-On
• Nurses picking what and how often to document on the head to toe
• Coding and mapping to avoid duplication
“Measurement is the first step that leads to control and
eventually to improvement. If you can’t measure something, you
can’t understand it. If you can’t understand it, you can’t control
it. If you can’t control it, you can’t improve it.”
- H. JAMES HARRINGTON
Study Protocol B: 382 Nurses, 1083 10-Hour shifts
Data Collection Method: Nurses self-reported location, activity, and
cognitive category on PDA every 15 minutes.
TIME MOTION STUDY2008
Small sample Click Estimates
Study Protocol B: 382 Nurses, 1083 10-Hour shifts
Data Collection Method: Nurses self-reported location, activity, and
cognitive category on PDA every 15 minutes.
TIME MOTION STUDY2008
Small sample Click Estimates
NEAT
All Users Measures Time
WHICH FLOWSHEET TEMPLATES SHOULD I FOCUS ON IMPROVING FIRST?
WHICH FLOWSHEET TEMPLATES SHOULD I FOCUS ON IMPROVING FIRST?
WHICH FLOWSHEET TEMPLATES SHOULD I FOCUS ON IMPROVING FIRST?
TIME IN CONTENT
Activity
Navigator
Flowsheet Template
Care Plan
Activity
Navigator
Flowsheet Template
Care Plan
TIME IN CONTENT
Outliers from ‘like’ cohort
WHERE SHOULD WE FOCUS OURTRAINING PROGRAMS?
PEER STORY
Data used: January 2017 & December 2017 NEAT Workbooks
Sample: 435 Nurses (They had data in both workbooks and attributed to same department.)
Intervention: Extensive nursing documentation build improvement programs in Q3 of 2017.
SSM estimated
140,000,000 clicks savedand NEAT measured a
17 minute per day reductionin nurse system documentation through extensive build improvement
programs in Q3 of 2017.
WHERE TO GO NEXT…
NURSING HAPPINESS =PATIENT HAPPINESS
QUESTIONS?
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