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by Dr. Anees Fareed
Published on December 15, 2019

Raising children can be one of the hardest tasks. No wonder it is often said ‘raising children is like chewing on stone’! And so, providing care to children is even more complicated. It’s hard, complex and must be provided with the utmost care and diligence because children are not just small adults!  Hence, it’s essential that the electronic health record (EHR) deployed in a pediatric hospital can handle the complexities of providing specialty care to our children in a safe environment. It requires specific functionalities, workflows, reference ranges and observations to support the work of pediatric care providers.

Cerner Millennium® – the EHR deployed in Al Jalila Children’s – has all the functionalities required to handle such complex workflows, in addition to also ensuring the safe practice of medicine. However, defining evidence-based and well-proven processes, alongside pediatric-specific workflows and content, remained a challenge for Al Jalila Children’s since its inception.

This is what led Al Jalila Children’s to sign a collaboration agreement with Children’s National Health System in Washington DC. The hospital has used Cerner for years and has developed pediatric-specialized content, workflows and processes. This collaboration between Children’s National, Bear Institute, Cerner ITWorks℠ and Al Jalila Children’s aims to achieve a robust system with advanced and evidence-based pediatric care via clinical pathways that will aid the provision of high-level medical care to children in the UAE. The collaboration agreement also aims to achieve cooperation in establishing technological strategy and governance structure.

AJCH-CNMC collaboration program - Objectives

As per the collaboration agreement, the Children’s National Bear Institute health IT advisory team travelled to Al Jalila Children’s Specialty Hospital on 9 April 2018 to conduct a gap analysis and came up with recommendations for improvement. Besides pediatric content and workflow requirements, the assessment looked at various aspects of health care IT management including health care IT readiness for current and future state, Al Jalila leadership opportunities, influencing organizational culture, benefit and outcome planning, governance opportunities, end-user satisfaction, training, policy, and standard operating procedures.

Considering the large scope and number of projects involved, the projects are planned to be rolled out in two major phases. Each phase is divided into multiple waves to gain better efficiency in project management and training, and achieve the best outcome. Wave 1 of Phase 1 projects went live in December 2018 followed by Wave 2 projects in July 2019. Wave 1 is aimed at optimizing basic operational workflows, processes and policies, while Wave 2 is focused more on pediatric-specific content such as PowerPlans, iView bands, and specialty playbooks relevant to pediatric sub-specialties.  

Key highlights of Waves 1 and 2

  • Twenty-seven pediatric-specialty PowerPlans plus almost a dozen sub-plans in various sub-specialty areas including NICU, PICU, nephrology, neurology, ED and hospitalists
  • Pediatric-specialty plays books in nephrology, pediatric and neonatal critical care
  • Pediatric hemodialysis workflows with recurring encounters
  • Pediatric dose range checking alerts for around 50 commonly used medications in pediatrics
  • Pediatric-specific order alerts
  • Optimization of almost 20 pediatric-specific iView bands and PowerForms
  • Automated patient isolation workflow based on screening form criteria
  • Automated pediatric admission assessment tasks generated upon admission
  • Optimized inpatient consultation, workflow and consult worklist

Key success factors of the program

  • Leadership: There has been strong support and commitment from Al Jalila Children’s leadership throughout the projects, which was essential for successfully rolling out the projects and ensuring end-user participation.
  • Partnership: The strategic partnership with Children’s National Bear Institute and Cerner ITWorks team played a significant role in making the project delivery successful, by leveraging the knowledge base of the Children’s National Bear Institute collaboration, and the strong commitment and skills of the Cerner ITWorks team in delivering value to the client.
  • Engagement: Clinical representatives including physicians and nurses, super users and champions were actively engaged in all stages of the project including planning, workflow design discussions, validation and training.
  • Superusers’ group: Establishment of a super users’ group capable of championing and facilitating the change management and training helped successful rollout of projects and facilitating system adoption.
  • Communication: A proper communication plan was set up to provide consistent and effective communication to end users on best practices, workflows, opportunities and upcoming health care IT initiatives and ensure transparency with all stakeholders throughout the program. A communication workgroup has been established consisting of AJCH leadership, IT, quality, medical team and marketing.
  • Training: A robust training plan was put in place to provide adequate guidance for all users impacted by the change. Multiple training methods, including classroom training, one-to-one coaching, training at the point of care, and online training materials have been adopted to ensure effective learning.
  • Ongoing support: The Cerner ITWorks℠ onsite team were key players in rolling out these projects with the support from AMS and Cerner Works.

This is a great example of how the whole ITWorks model creates a major impact and thus adds value to the client. Whatever Al Jalila Children’s has achieved in this short span of time would have been much harder to achieve, had it not been for the partnership with Cerner ITWorks. The strategic partnership certainly added value to Al Jalila Children’s Specialty Hospital – and allow “a place where you can be a child” to achieve its vision of becoming one of the leading pediatric hospitals in the world.