Advancing care delivery to support care teams across the continuum of care
The demands of health care have never been greater. Nursing is no exception, and as the pulse of care delivery nurses are feeling it: long hours, tight budgets and high levels of burnout. As health information technology continues to evolve, we strive to support those who are on the front lines.
Cerner’s solutions offer flexible yet robust functionality to help address all your strategic initiatives — managing your workforce, coordinating care delivery, connecting devices with the EHR, improving communication across patient care teams, complying with a dynamic regulatory environment or reducing the documentation burden among your clinical staff. In today’s dynamic health care environment, nurses must be agile, at the patient’s bedside and capable of operating at the top of license at all times.
In 2016, the clinical staff at Rogers Behavioral Health dealt with a lengthy admissions process that had a negative impact on time spent on patient care. In September 2016, the nursing admissions and social services assessments, both required by Rogers for the admissions process, took on average 404 minutes to complete, with nursing admissions taking 189 minutes and social services taking 215 minutes. Clinical staff and patients agreed that duplicate questions made the admissions process too long. Through efforts led by Rogers’ optimization team, a year later, clinical staff reduced the time spent on the nursing admissions assessment by 80 minutes, from 189 minutes to 109 minutes. The social services assessment went down by 88 minutes from 215 minutes to 127. Total admission time was on average 236 minutes, which meant that Rogers’ clinical staff could save 168 minutes per patient.
Truman Medical Centers (TMC) staff needed to optimize nursing workflow while increasing staff satisfaction and improving patient safety. The previous devices nurses used, such as pagers, old CareMobile® devices and health system-issued phones, were nearing the end of their productive life, and the time was right to implement new mobile technology — CareAware Connect™. Workflow conditions started improving when the Kansas City, Mo.-based client, and home of the KC one Health Innovation Alliance, became a testing partner for Cerner’s evolution of mobility solutions. The alliance that TMC has held with Cerner since October 2015 has a focus on creating healthier futures for the collectively served Kansas City community and to use TMC as a “living laboratory” for Cerner solutions.
In an effort to provide more efficient, effective care, Imperial College Healthcare NHS Trust (Imperial) implemented near real-time capturing of patient observations/vital signs directly into their electronic patient record, releasing an estimated 5,800+ nursing hours to patient care over a 15-month period.
The initial deployment of CareAware Connect™ shaved 27 minutes off the time it took to assign beds to admitted patients, equating to a potential $1.5 million in additional revenue for Nash General Hospital. The solution launch and workflow changes also yielded strong staff survey results, with a 62 percent improvement in overall technology satisfaction rating among registered nurses. Nash proceeded to win the 2014 American Nursing Credentialing Center (ANCC) Pathway Award for demonstrating innovation and technology to create a positive nursing practice environment. Even more recently, The Joint Commission published a paper submitted by Nash Health Care to its Leading Practice Library. The paper covers the design and deployment of CareAware Connect and Alarm Management and is now available to other hospitals to use as a model of success. “CareAware Connect allows team members to communicate quickly, address alarms, answer messages, and safely and efficiently care for our patients,” said Caroline Vierheller, MSN, MHA/I, RN, CEN, COHN-S, operations improvement program coordinator.
Medication administration has never been easier for the nurses and pharmacists at Fort HealthCare. The 72-bed hospital in Fort Atkinson, Wis., implemented RxStation® in June 2015. Since then, the automated dispensing machine has helped clinicians increase efficiency and improve patient safety. “Our old station had all of the medications in one big drawer, and you had to pick which bin,” said Inpatient Director Pam Kuehl. “With RxStation, it’s just the one drug that’s coming out. The system is automated to the point that the nurse doesn’t have to think. It makes it a safer process.” In addition to making sure the right medication is given to the right person at the right time, RxStation has also helped clinicians reduce the average time it takes to administer a medication. “We had a time study done from our other system to the new system, and we actually have saved 20 seconds per transaction of one med,” Kuehl said. “It’s not uncommon for one patient to have over 15 different medications, so that’s a lot of time that could be spent better at the bedside.”
Nurses at Adventist HealthCare, based in Gaithersburg, Maryland, are more satisfied with the electronic health record (EHR) after a clinical documentation performance improvement (CDPI) project helped streamline nursing workflows and decrease time spent in the EHR. The Adventist team collaborated with Cerner to develop the governance structure and tools necessary to streamline the use of their EHR. As part of the new governance process, Adventist created a system-wide steering committee comprised of nursing and clinical leaders to find ways to improve the EHR and internal communications. Nurses and clinicians collaborated, providing specific examples of how to improve the EHR for their departments, which opened the meetings for further discussion.
When Carolinas HealthCare System decided to take on a massive optimization project, staff members learned every click counts. The three-year optimization project impacted 12 facilities, more than 8,000 nurses and nursing assistants, and eliminated millions of clicks which left clinicians, celebrating. “We had Cerner in place for 10 years and needed to make a change,” said Becky Fox, MSN, RN-BC, assistant vice president and chief nursing informatics officer. “By simplifying, standardizing and optimizing documentation, it improved the workflow of our nurses.” The optimization project focused on five key areas: task reduction, position alignment, medication improvements, migrating from PowerForms to iView, and interdisciplinary plan of care (IPOC) implementation Task reduction identified and eliminated 66 routine patient care tasks, removing more than 18 million annual clicks.
Clairvia Staff Manager and Demand Manager solutions have been in use at Midland Memorial Hospital since 2008. In 2013, nursing began using technology within Cerner Clairvia℠ to help manage issues that are thought to cause dissatisfaction among some of their nurses; nurse fatigue brought on by inadequate staffing issues, overtime and irregular working hours.
Nurse managers at Children’s Hospital Los Angeles (CHLA) are optimizing their approach to RN staffing by using Cerner Clairvia℠ to implement creative staffing techniques and make equitable patient assignments. Cerner Clairvia helps hospitals calculate a patient’s acuity, or the care hours needed to move a patient towards wellness, based on information captured in the EHR. Accounting for the different level of care needs for each patient supports the organization in distributing fair and manageable workloads to members of the nursing team. After implementing Cerner Clairvia, CHLA studied its impact on nursing productivity and reports positive results. “We are able to pull productivity reports for all units that showed everybody was between 90 and 105 percent productivity. We could show where we flexed, where people floated to another unit and where we called people off,” said CHLA’s Nancy Blake, RN, PhD, CCRN, NEA-BC, FAAN, CHLA’s patient care services director in Critical Care Services. CHLA added Clairvia Outcomes-Driven Acuity to its staffing system in March 2014. CHLA designed the system’s mapping guide used to assess and assign patients’ acuity scores and statuses in relation to desired outcomes from standards set by the Nursing Outcomes Classification (NOC).
Mission Health pilots Cerner Patient Observer, results in zero falls, ROI and planned future enhancements Mission Health is piloting a brand new observation solution to help reduce patient falls, especially falls with injury. Through a testing partnership with Cerner, the Asheville, N.C.-based health system added Cerner Patient Observer to six neurosciences unit patient beds in August 2015. During the 3-month study, the average falls rate – as measured per 1,000 patient days of care – dropped from four per month to zero.
“We're moving a lot more patients, and we’re moving them more quickly,” said Shauna Lawson, RN, BSN, clinical analyst at Middlesex Hospital. “We're getting them to the right care venue in a timely and efficient manner, which helps improve not only the patient's overall care, but also their satisfaction.” Lawson is referring to successes from the implementation of Cerner’s capacity management solution, CareAware Patient Flow®, in June 2014. Before implementation, the hospital struggled with moving patients from venue to venue. Nurses had to complete up to 50 percent of scheduled transports, which pulled them from skilled clinical duties and patients. Today the transportation department handles 100 percent of scheduled patient transports and has added equipment transports not previously provided by the transportation team. Each transporter also completes an average of 33 jobs per 8-hour shift, which is 12 more completed jobs than the 21 Middlesex originally budgeted — an overall 57 percent increase in jobs completed.
Children’s Mercy successfully reduced interstage mortality from 20 percent to 0 for high-risk, single ventricle (SV) infants with the help of its innovative CHAMP (Cardiac High Acuity Monitoring Program). CHAMP combines traditional SV home monitoring with a tablet PC, so SV nurse coordinators can receive actionable data and video evaluation from parents during vulnerable SV infants’ interstage period. Nationally, five to 20 percent of infants with SV heart disease, such as Hypoplastic Left Heart Syndrome, will not survive the time period between the first and second surgeries, known as the interstage, according to data from the National Pediatric Cardiology Quality Improvement Collaborative (NPCQIC). The program uses an innovative application to connect with the Children’s Mercy electronic health record (EHR). This capability reduces delays of critical information, opening up communication and providing at-home support to parents during a critical time of need. “CHAMP is built with an encrypted cloud database, which allows data entered by the parent to be sent to the EMR daily.” Lori Erickson, RN, CPNP, APRN, high acuity monitoring APRN at the Ward Family Heart Center. “Timely communication of physiologic data from parents of fragile, cardiac infants to the Interstage team is a next step in home monitoring.”
Humpty Dumpty sat on a wall, but Humpty Dumpty did not have a great fall, if he was admitted to Nicklaus Children’s Hospital. Nicklaus Children’s, part of Miami Children's Health System, reduced its falls rate by 41% with the help of its cleverly titled and globally acclaimed Humpty Dumpty Falls Prevention Program™. Both the Joint Commission and the Institute of Medicine identifies inpatient falls as a significant patient safety risk, and have required organizations to have a fall reduction program with interventions in place. Children’s growth and development, coupled with natural curiosity, makes them exceptionally prone to falls during a hospital stay, but at the time many published falls protocols were geared towards the adult population. In response to this void in pediatric safety, Nicklaus Children’s began developing the first program of its kind to specifically address the unique falls prevention needs of children.
Cerner’s innovative leaders are devoted to achieving your organization’s goals (indeed, the goals of your care teams and patients alike) for today and tomorrow. With more than 900 nurse associates integrated throughout the organization, Cerner thinks the way you work. Alongside clients, Cerner nurses leverage clinical intelligence and data-driven strategies to design, implement and optimize meaningful solutions that provide a better technology experience for nurses and support quality patient outcomes.
Knowing how nurses work— We understand nurses because we are nurses. More than 900 nurse associates are integrated throughout Cerner, working alongside our clients to design meaningful solutions and provide an array of professional services to improve health and care.
Care in the right context— Cerner offers specialized workflows for nurses providing care in a variety of settings and venues. Our solutions support the unique needs of the clinician and patient population in women’s health, oncology, perioperative, ambulatory, critical care, emergency medicine, home health, long-term care and pediatric environments among others. Cerner solutions supporting nursing workflows are available in markets across the globe.
Collaborating across teams — Working collaboratively across teams is critical for quality patient care, but is sometimes a challenge. Working in silos can prevent clinicians from pulling comprehensive patient information together, which can put patient care at risk. Care planning provides clinicians with documentation-driven plans of care, including multidisciplinary clinical pathways and care protocols. Including expected outcomes and interventions allows for flexibility in customizing plans to patient-specific needs. This means the nurse can facilitate care that considers multiple aspects of a patient’s well-being.
Connecting care across the continuum — Patient data collected at one venue is not always accessible elsewhere, leading to repeat tests, missing patient data and incomplete medical history, which can also impact the quality of work for clinicians. We go where health care happens, which is sometimes beyond the four walls of the hospital. By making patient data shareable among primary care physicians, specialists, hospital physicians and patients, we’re helping to remove barriers that block effective care. One of the most practical applications of health IT for long-term post-acute care providers involves increasing electronic access to information that is already collected, either for documentation or reporting purposes.
Checking the rights — checking the five rights of medication administration—right patient, drug, dose, route and time —is critical in ensuring patient safety. With capabilities like barcode medication administration and medical dispensing cabinet integration, Cerner can help decrease the likelihood of an adverse drug event. When administering IVs, nurses perform a wristband check, medication check, dosage confirmation and device confirmation with a barcode scanner that is integrated with the EHR. Connected infusion pumps communicate with clinical documentation in real-time to ensure the right volume and rate are captured without manual intervention. When all of these things take place, organizations can better catch mistakes before they happen.
Infection isolation — Nurses are on the front lines of patient care, where both the patient and nurse are susceptible to infectious disease. However, it can be difficult to identify the subtle signs of the deadliest pathogens. Cerner Infection Control monitors patients to ensure they can be appropriately isolated from other patients. Cerner also offers St. Johns Sepsis Agent, which helps hospitals reduce sepsis cases through early detection of sepsis symptoms.
Monitoring patients, when you can’t — Falls are the most frequently reported adverse events among adult patients. It can be difficult and costly for nurses to monitor patients with a low risk of deterioration. But for patients with fall risks or other intermittent medical conditions, vigilance in critical moments can avoid dangerous events. By developing innovations like remote patient monitoring, nurses can rest assured that in the event of an emergency in a patient room, the monitoring technician can quickly send help.
Going where nurses go — Health care doesn’t stop and nurses need access to solutions whoever care is needed. To keep patient care moving forward, nurses can use CareAware Connect™ to send a secure message to other care team members asking them to review a patient’s status remotely if they’re not on-site.
Communicating across teams — we know that care rarely stays within one discipline during a patient visit. Cerner’s commitment to the care team encourages smoother communication across multi-disciplinary care teams. Our core mobile solution can display a patient’s care team members along with an option to contact them, making it easy to reach the right clinician. Our labor and delivery physician-geared solution, FetaLink+®, save time by allowing the nurse and physician to review the same data. No more describing a strip over the phone.
Reducing alarm fatigue — Nurses sometimes experience more than 350 alarms per patient, per day. As a nurse juggles multiple patients and multiple tasks throughout his or her shift, it can be difficult to keep track of the noises and demands coming from every direction. It’s no wonder that the addition of device alarms creates additional nursing fatigue. Preventing nuisance alarms and recognizing meaningful alarms is key to reducing fatigue. With our intelligent mobile solutions and client collaboration, only actionable, critical alerts get pushed to a nurse’s attention.
Optimization — Cerner’s model experience is the product of data analysis, regulatory expertise, technical expertise, industry best practices and innovations from 35 years of experience across thousands of clients, including leading health systems operating Cerner solutions. Combined with Continuous Advancement services, which identifies opportunities to enact change and measure progress to goals in an interactive fashion, organizations are able to improve their workflow efficiency and quality, enabling clinicians to spend more time at the bedside.
Intelligence: care prediction — Staff nurses across the nation are reporting a dramatic increase in the use of mandatory overtime as a staffing tool. This dangerous staffing practice, in part due to a nursing shortage, is having a negative impact on patient care, fostering medical errors and driving nurses away from the bedside. Cerner helps hospitals calculate a patient’s acuity, the care hours a specific patient needs, based on information captured in the electronic health record (EHR). Accounting for the level of care each patient needs helps the organization distribute fair and manageable workloads to nursing team members. In the critical care environment, effective measurement and reporting of outcomes is essential. Cerner’s APACHE® Outcomes allows a nurse to objectively evaluate the quality of care delivered in an ICU setting. With a focus on process improvement and resource optimization, APACHE provides access to the one of the largest outcomes databases in the world, containing over half a million contemporary admissions, with the greatest depth of benchmarking capabilities.
Planning for discharge — Seamlessly moving patients throughout the hospital as their needs change is a team effort, and nurses play a critical role in ensuring there is an appropriate level of care needed for each patient. Cerner’s centralized operations approach includes bed management from CareAware Capacity Management and digital unit dashboards in the Logistics Center, aligning nursing across the hospital with EVS, Transport, Care Management and other team members. Cerner’s Transitions of Care algorithm provides post-acute recommendations for patient placement, identifying a care facility best suited for that patient’s needs.
Incorporates best practices, robust analytics and intelligent alerting to help ensure clinicians can act on actionable patient alerts.
Care teams across the continuum use our solutions to document and access critical patient data, streamline workflows and help with patient safety.
Our award-winning, acute EHR solutions provide real-time, patient-centered information instantly and securely anytime, from anywhere.
We are focused on automating the process of managing the health and care of populations across the care continuum.
Our care team communications solutions bring together care team members and ancillary staff to increase collaboration and efficiency, and positively impact the patient's experience.
We understand the challenges of managing hospital operations today, and offers solutions to help improve the patient’s entire throughput journey by coordinating the right caregiver with the right patient at the right place and the right time.
Our performance improvement solutions can assist your organization with clinical, financial and operational goals to drive improvement into the workflow.
Offer clinician mobile solutions that deliver communications (voice, text, alarms) and EHR workflow tools on a single smartphone device.
Our Capacity Management solutions provide transparency and alignment of assets (staff, patients and equipment) at the right time and right place to improve patient throughput, efficiency, productivity, and outcomes.
Providers are the front line of patient care, and should have an EHR that meets their needs in an efficient manner. Lights On Network® has the power to transform the EHR experience by pinpointing providers needing assistance, enabling them to spend more time with their patients.
Cerner’s CareAware Smart Pump Auto Programming Infusion Management connects infusion pumps to the electronic heath record to create the safest, fastest medication administration process in the industry today.
Better patient outcomes occur when you have the right care giver, in the right place, at the right time. We deliver automated and intelligent workforce management solutions for health care organizations to provide the best care at the lowest cost.
Deliver value through a model experience where our clients learn from each other, clinicians are given more time to provide care, financial friction is reduced, the patient is at the center, and together, we’re focused on making communities healthier.
RxStation Automated Dispensing Cabinet provides a single formulary across your health system to help nurses and pharmacists more safely and efficiently manage medication dispensing and administration.
Cerner Patient Observer is a virtual observation solution that allows a trained observation technician to monitor multiple patient rooms from a central monitoring station, reducing sitter labor costs and preventing falls and other adverse events that occur in hospitals.
To improve turnaround times for issue resolution, free up your staff for projects, and improve your overall end user experience, consider Cerner’s support services.