Abington Memorial Hospital, an acute-care teaching hospital, has always been committed to implementing information technology to enhance patient safety. One of our first patient-safety initiatives was computerized physician order entry in 2001. Throughout the years, Abington has continued to develop its clinical information system with advanced decision support functionality such as alerts and medical logic modules.
Over the past two years, our effort has been transforming siloed documentation into a patient-centered record, embracing an interdisciplinary approach, clinical documentation integrates evidence base knowledge into daily processes. Clinical practice guidelines drive interventions and education ultimately impacting patient outcomes. The clinical documentation includes the patient profile, plan of care, assessment and intervention flow sheet, education record and outcome assessment. We developed a multiphase clinical charting rollout beginning on the medical and surgical nursing units.
In the critical-care nursing areas, we were faced with a new challenge. How could we best integrate the bedside monitoring devices with our robust, clinical information system? We established a multidisciplinary project team including nursing, physicians, biomedical engineering, clinical systems, interface technologies and technical services to select and implement the device-monitoring system in conjunction with the clinical documentation rollout. After an extensive review of vendors, we selected a device monitor solution that supported the integration to physiological monitors and other devices with clinical documentation. A server accepts raw data sent from the medical devices then filters the data and generates a standardized HL7 message to our clinical information system. The project implementation spanned a six-month time frame. A critical step in the project was developing extensive test plans to simulate and validate the accuracy of the information being transferred between the systems. In addition, after an evaluation of nursing workflow, we determined it was essential to place computers at the point of care. A computer was placed in every room allowing nurses to provide and document care right at the bedside. Each computer is hosted on a remote server allowing the IT team to troubleshoot problems without ever having to enter a critically ill patients room. The total project costs were approximately $270,000.