In 2017, the care team at Crossbridge Behavioral Health experienced an increase in violence-risk assessments, timeliness of safety check documentation and medication administration scanning, while being able to connect to their patients’ health records from other Baptist Health facilities.
With patients moving between the emergency department (ED) and a behavioral health facility, Baptist Health leaders needed a way to standardize documentation into a single, unified chart.
They found the answer with the implementation of Cerner’s Behavioral Health solution at Crossbridge Behavioral Health, one of the organization’s facilities in Montgomery, Alabama.
“We get referrals from other Baptist Health sites where most of our patients come from,” said Laura Strother, treatment manager, Crossbridge. “With the electronic health record (EHR), before they even come into our department, we know their lab results, medical history and medication requirements. We can communicate with the hospitals to determine the level in which we need to intervene.”
Baptist Health leadership worked with Cerner ITWorksSM associates to implement the behavioral health-specific EHR at Crossbridge in April 2017. Since then, the technology has helped clinicians improve the continuity of care between physically separate inpatient and ED facilities.
“Since most of our patients need medical and behavioral health treatment, being able to work with ITWorks to merge those two worlds into a single treatment plan in the EHR has been helpful,” said Strother.
From April to December 2017, caregivers experienced a 79 percent increase in violence risk assessments documented at admission.1 Timeliness of 15-minute safety check documentation increased to 88 percent.2
Along these lines, one week after implementation, scanning for medication administration increased to 97 percent from the former manual process,3 allowing clinicians to help their patients be compliant with their medication.
“With medication administration, it gives transparency to the pharmacy, speeds up care and is more patient-centric,” said Ginger Henry, chief operations officer, Baptist Medical Center South.
For behavioral health facilities, there are Hospital-Based Inpatient Psychiatric Service measures, which are quality standards set by the Centers for Medicare and Medicaid Services (CMS), that need to be met by clinicians when documenting patient care. When a Crossbridge clinician charts in the EHR, alerts trigger if a required piece of information was not entered, making it impossible to sign a chart without inputting that information.
Crossbridge clinicians, who do rounds every 10 to 15 minutes, previously charted on paper and later added the information to the patient record. With safety checks now displayed in the Safety and Attendance MPage they can chart electronically in near real-time on computing stations and hand-held devices.
Previously, the director of nursing spent two to three days in the office manually reviewing paper records to keep up with CMS requirements. Now, with the new EHR, the director of nursing and other administrators can identify charting elements needed for review and create reports to speed up the process.
This capability gives these leaders more time to work with clinical teams to improve care as well as nursing relationships.
“Having this new and improved way of documenting, this new EHR, we are able to provide our patients continuity in their care. We can now see how they are progressing in their treatment,” said Sandy Zapata, RN, Nurse Manager, Crossbridge.
“We have made a lot of positive changes for our staff so they spend less time at a computer or behind a clipboard, and devote more time to patient care, which helps improve our patient outcomes.”
1From 19 percent in Q2 2017 to 98 percent in Q4 2017.
2From less than 83 percent from April – August 2017 to 88 percent in Q4 2017.
3From April 24 – May 1, 2017