Nursing Research on the Green
Kari Hamson-Kalis MSN, RN, CNL Shannon Hulett MSN, RN, CNL
Gundersen Lutheran Medical Center
- Background: The CNLs at Gundersen Lutheran recognized the need to utilize informatics to improve coordination and management of patient care throughout the stay and upon discharge. Leveraging this resource, the CNLs with support from Information Systems designed electronic tools to provide point in time reports of patient status allowing interdisciplinary staff to efficaciously manage the needs of patients.
- Significance: Multiple demands of complex healthcare environments Must manage/coordinate care that results in safe, high quality, cost effective outcomes Decrease fragmentation across the continuum of care Need to efficaciously identify, prioritize, respond to, communicate and track the ever-changing needs of patients and families Must leverage electronic resources such as the electronic medical record (EMR)
- Purpose/objective: Understand how the electronic medical record is utilized to efficaciously manage care throughout hospitalization, including discharge.
- Methods: Workflow processes were determined through interdisciplinary collaboration Electronic tools were designed Staff were educated Application of tools was hardwired into interdisciplinary staff practices
- Results: Medical Oncology Unit Direct Expense/Discharge 8% HPPD 15.5% Delays to Skilled Nursing Facilities 26% Continuous Observation Hours 52% Injury from Falls 66% RN Overtime 32% Patient Satisfaction 6% General Event Reporting 94% Cardio-Pulmonary Unit Direct Expense/Discharge 22% HPPD 1% Continuous Observation Hours 54% Injury from Falls 22% RN Overtime 37% General Event Reporting 67% The electronic medical record is a valuable healthcare resource that can be used to efficaciously coordinate/manage care of multiple patients in demanding healthcare environments. Electronic tools extend our eyes and ears and give us direction as we collaborate with interdisciplinary staff.
- Clinical Implications: Enhances the work of nurses and interdisciplinary staff Promotes staff engagement and patient satisfaction Results in cost savings, decreased delays, smooth transitions of care and increased safety
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