SEHA enhances pediatric care across the emirate of Abu Dhabi
Abu Dhabi Health Services Company (SEHA) looks after more than one million children in Abu Dhabi and the other six emirates, with physicians expected to be flexible enough to deal with all childhood illnesses for young people of any age.
To support them in providing fast, complete and high-quality care for their patients, SEHA decided that 2016 would see their Malaffi paperless records system focus on helping to make their professional lives easier.
A change was necessary, as physicians were having difficulty in reporting adverse events, struggling to identify acute kidney injury (AKI) patients on nephrotoxic drugs, and needed help to navigate complex IV ordering for pediatric patients.
There was also a lack of standardization in pediatric care across SEHA, and nurses were expected to complete a 21-stage process to document initial immunizations.
While faced by all these challenges, clinicians leveraged clinical decision support to optimize the use of aspirin to minimize the risk of Reye’s Syndrome and reduce the time taken to write orders for critical care patients. Clearly, something needed to be done.
Fixing the issues
Collaboration was the first key step, with a multi-disciplinary team of physicians, nurses, pharmacists, lab professionals and more got together to decide where their focus should lie.
Work began with the development of a custom summary MPages® view component to help clinicians identify when high-risk individuals had received their medications, especially useful when working with AKI patients.
In order to reduce dosing errors for IV medications, 210 order sets were developed for Pediatrics and a further 92 for NICU, to help make the ordering process safer and quicker.
These critical care order sets are now available to use across SEHA’s sites, and alongside additional training tools and communications mechanisms, are helping to increase adoption and standardize care.
The clinicians’ collaboration also identified a solution to simplify immunization documentation, eliminating the duplication of data entry and letting nurses focus on providing patient care.
Order set use across Pediatrics, PICU and NICU grew significantly as a result of the changes. From a 2014 baseline of 10,000 across the organization, use had increased to more than 120,000 order sets across all settings.
There have also been notable improvements to documentation of immunization administration for pediatric patients, as nurses no longer need to leave the electronic health record (EHR) to carry it out.
With over 2,175,000 vaccines administered each year, this equates to at least 15,225,000 manual documentation steps removed across SEHA, depending on how many patients receive multiple vaccines at the same time.
Patient safety is potentially positively impacted as a result of the alterations, with quicker and more visible identification of those receiving nephrotoxic medications helping to avoid the risks associated with AKIs.