Nurses know the frustration of asking a multitude of questions during the admission process—many of which may be unnecessary—taking time away from patient care. Island Health leaders on Vancouver Island, Canada, knew they needed to find a way to simplify the process. Working with Cerner, they utilized the essential clinical dataset (ECD) to reduce the number of questions asked when nurses complete the adult admission history form, saving more than 95 hours a month.1
“The admission form was over-engineered to think of everything you could possibly want to know on admission,” said Samantha Stockand, RN, BSN, CPHIMS-CA, clinical strategist for clinical informatics. “Some of the nurses were extremely frustrated. They had to wade through an overbuilt form, and others were paralyzed by the sheer volume of the data.”
Since the redesigned form’s launch in December 2018, nurses ask only the most important questions and avoid asking questions repeatedly.
“By the time patients got to us, they’d been asked the same question possibly four or five times,” said Stockand. “We heard a common complaint: ‘You ask me the same questions over and over. Don’t you communicate?’”
Before the ECD initiative, nurses would fill out 19 sections of questions comprised of 143 discrete task assays (DTAs: individual fields of data) for every admission. Since the launch, nurses complete 10 sections of questions and 71 DTAs—reducing the average number of clicks necessary to complete the form from 90 to 50.2
Focusing on the most critical questions and reducing clicks saves time. Previously, clinicians spent an average of 7 minutes, 50 seconds in the EHR for each single-signed PowerForm; utilizing the ECD dropped that to 3 minutes, 46 seconds. Across the organization’s acute care sites, that’s equal to 96.5 hours each month redirected from charting to patient care.1
Nurses enjoy the new intake forms and the ability to spend more time interacting with patients. “It has been an overwhelmingly positive response,” Stockand said. “They say, ‘This is amazing. It’s so much simpler, and there’s a reduction of duplication. The data points in the form are relevant to my patients.’”
Stockand says Island Health plans to take this success and replicate it in other parts of patient care journey.
“Our next steps are continuing to partner with Cerner in looking at what the physical admission assessment will become.”
For more information, visit our essential clinical dataset Model Experience page.
1 Comparing average time to complete the adult admission history documentation for August–October 2018, of 7 minutes and 50 seconds to May-July 2019, at 3 minutes and 46 seconds, applied across an average number of admissions in all Island Health acute care sites (1,435 signed PowerForms).
2 Comparing the average number of clicks required to complete the adult admissions history document during the period August-October 2018, to May-July 2019.