ED Accreditation Update: Preparation can help avoid IT problems
ED Accreditation Update
Preparation can help avoid IT problems
The best way to avoid (or at least minimize) problems with information technology (IT) implementation in the ED is to take certain steps to make sure you are adequately prepared, advises James Walker, MD, FACP, chief medical information officer of Geisinger Health System in Danville, PA.
"One of the most common issues is failure to really understand the work processes of triage nurses and other nurses, doctors, therapists, pharmacists, and patients — who are often forgotten entirely," Walker says.
Control teams at EDs in Walker's system spend two months mapping flow before implementation. The teams include a doctor, a nurse, one of the triage staff, a patient, and perhaps a consultant such as a cardiologist. They examine processes such as the way patients flow from triage into their rooms and the discharge process. "During this period, they often change processes, sometimes eliminate them, and sometimes add them for quality and safety reasons," Walker says. "If you do not do this, it's almost guaranteed IT will not improve the way things are done. It has to fit people's workflows."
Ideally, he says, this should even be done before the selection of the system. "Sometimes the vendor can change the software; sometimes you can do it locally," he notes. "Sometimes all you can do is training, but that's a horrible alternative."
In addition, says Walker, the ED's system should be integrated with the hospital's system. "The ED should really be part of the process of buying the system," he says. What if the ED manager has problems with a proposed system? "Often it's just a matter of getting the hospital and the IT people to sit down and map out the processes that they run across," Walker observes. "You've got to get ED representatives on the design team."
Standardization also is critical, Walker continues. "At one facility, every unit had different abbreviations for different processes," he notes. "You have to decide what all these things mean and work to standardize them before you do the health IT." If you try to do implementation without standardization, he warns, "it will really be a mess, and implementation will be that much harder."
Another mistake providers often make, says Walker, is that they underestimate the importance of testing a new system. "We once did 50,000 hours of testing an inpatient system before implementing it last fall," he shares.
Following implementation, says Walker, continue to change processes. "You can't change everything up front," he notes. "Six months after implementation, if all goes well, you might look at other things that could be changed."
By doing this, "you really do get continuous improvement," says Walker. "It creates a climate wherein you can identify ways to make care better and safer."
The best way to avoid (or at least minimize) problems with information technology (IT) implementation in the ED is to take certain steps to make sure you are adequately prepared, advises James Walker, MD, FACP, chief medical information officer of Geisinger Health System in Danville, PA.Subscribe Now for Access
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