Manual to Automated: ECT Periop Data No Longer Manually Documented
Automation in Peri-Operative Reporting
Automating clinical documentation into a form that is real time, retrievable, and able to trend is of paramount concern for all clinical treatments, both invasive and non-invasive. Below we highlight the wonderful work done by Behavioral Health staff at Hamad Medical Corporation and Cerner to automate the perioperative documentation of the ECT procedure at HMC Behavioral Health.
Electroconvulsive therapy (ECT) uses a small electric current to produce a generalized cerebral seizure under general anesthesia. ECT is used mainly to treat severe depression, but is also indicated for patients with other conditions, including bipolar disorder, schizophrenia, schizoaffective disorder, catatonia, and neuroleptic malignant syndrome.
At HMC’s sole Psychiatric Hospital, electro-convulsive therapy is provided to patients twice a week via an internal ECT service. The nurse tasked with recording data onto the perioperative report form had to do so manually, at the cost of both time and patient care. Prior to implementing the automated solution, the nurse was required to record all data from the ECT procedure onto a manual paper form. There was no ability to record this electronically which meant it also did not allow for data to be carried through to PACU, disrupting continuous patient care. On top of that, the data could not be aggregated for trending, which further hindered the clinicians ability to examine the effectiveness of care or examine any individual record against an aggregated whole, which would allow clinicians to identify outliers and do root cause analysis on any patient safety events.
At a glance
- HMC serves as the leading government sponsored healthcare organization
- 13 Hospitals
- 27 Primary Health Care Centers
- Specialist Hospitals include Psychiatric, Heart Hospital Cancer Hospital and more
- Provides care for over 2 million residents
- Recently ranked top 5 Healthcare organizations by leading U.K. think tank
- Real time entry of ECT peri-operative data
- Continuous care to PACU
- Improved efficiency
- Improved completeness of data points
- Efficient use of existing resources
- Outpatient Nurse 100% dedicated to patient care
- Creates retrievable data for trending
- Ability to further refine processes due to aggregating abilities of patient peri-operative data
- More focused care
Automated Peri-Operative Tool
Via intense focus groups, new processes were developed using the Cerner ECT Solution. The design was clinically centered and vetted via cycles of testing and learning. The new solution is below:
With this implementation, an ECT nurse saves an average of 10 mins per patient (110 hours a year) by not having to use hand written paper forms. No longer must they record peri-operative information onto paper and then transcribe into CIS. Formerly, the process relied on manual data point entry and then transcribed into the system as essentially non-retrievable data. The staff now are able to record data directly into the CIS system, eliminating transcribing and creating retrievable data. This also enables continuous care into PACU, as now the PACU staff have immediate access to the operative data recording during the session and are able to make real time decisions affecting patient care.
After having seen the value of automation, HMC’s Psychiatric Hospital is keen to enhance more of its operations using Cerner tools. This project demonstrated the value of continuous optimization to improve systems. No longer relying on hand written documentation transcribed as free text into the system allows Behavioral Health ECT staff to begin to further analyze data. Next steps include trending data and identifying new opportunities for improvement.