As COVID-19 engulfed northern New Jersey this past spring, leaders at St. Joseph's Health developed strategies to cope with rising patient volumes and help maximize limited resources, including caregivers' time and energy. In late April 2020, the organization worked with Cerner's Continuous Improvement team to reduce the burden of admission documentation through an expedited admission intake essential clinical dataset (ECD) project.
ECD projects aim to clear clutter from nursing documentation, helping caregivers document essential patient data faster. The expedited admission ECD project — developed in response to the pandemic — pursues those goals while also capturing important COVID-19 infection screening data.
The Continuous Improvement team compared St. Joseph's Health's original acute nursing admission history form against Model Experience ECD and COVID-19 recommendations. In just six business days, they eliminated 22% of the form's distinct data elements while still gathering all required patient information.1
"The review highlighted questions on the form that weren't necessary, especially during a pandemic," said Janice Wojcik, MS, RN, CCRN, ACNP-BC, ACNPC, CPHQ, NEA-BC, director of nursing informatics. "That insight provided us with the information needed to make decisions focused on enhancing efficiency and effectiveness."
Eliminating fields helped nurses complete the form faster, saving 15 clicks and more than one minute, on average, per patient encounter.2
"With COVID-19, every minute counts," said Judy Padula, MSN, RN, NEA-BC, vice president, patient care services/chief nursing officer. "During the peak of the pandemic, the emergency department — which served as a front door to COVID-19 patients — required a more streamlined assessment process to allow for greater efficiency and more immediate, life-saving treatment."
The accelerated project focused on achieving quick results and required roughly 10 hours of input from Wojcik's team. The Continuous Improvement team multiplied the impact of that time by using the new adult admission intake form to revise the similar pediatric admission intake form. Because the project avoids significant workflow changes, nurses didn't need additional training.
The expedited project can also serve as a gateway to a full admission ECD project in the future, with the potential to save additional time using conditional logic and the Admit Workflow MPages®.
"COVID-19 forced everyone to do more with limited time and resources," said Linda Reed, RN, FCHIME, LCHIME, vice president, information technology and chief information officer. "It's underscored the importance of working smarter, and we'll continue pursuing opportunities to enhance efficiency while providing world-class care as we move into the future."
Cerner clients interested in pursuing an expedited admission intake essential clinical dataset (ECD) project should contact their relationship owner.
1 Discrete task assays (DTAs) included in adult admission patient history PowerForm decreased from 294 before the project to 227 in the revised form.
2 Comparing one-week averages from before COVID-19 affected the organization, Jan. 28 - Feb. 3, 2020, to after the project's completion, May 5-11, 2020. Average clicks to complete the adult admission history form decreased from 87 to 72. Average active time to complete the adult admission history form decreased from five minutes, 59 seconds to four minutes, 57 seconds.
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