Secret Recipes for Successful Practitioner

SKILLED NURSING
Secret Recipes for Successful Practitioner Engagement
Debra Smith, RN, BSN, CN-­E, CIC, WCC
Emily A Carey, MS, RN-­BC
www.pointclickcare.com
© PointClickCare All rights reserved. PointClickCare is a registered trademark. The material contained in this document may contain confidential and/or privileged information and is protected via copyright. Duplication, redistribution or modification of the contents of this document is strictly forbidden without prior written consent from the author. Objectives
• Practitioner and organization benefits of Practitioner Engagement
• Marketing the mobile application
• Get the practitioners on board
• Increase compliance
• Ease of use for practitioners
• Workflow before & after
• Cost benefit analysis
“The mobile app is easy to use and signing the order reviews is quick and more efficient than it is on the web version.”
Riley Rose, NP
Mobile Application
The clinician has access to:
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Resident information/chart
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Orders needing to be signed
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Order reviews that need to be completed
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Secure conversations
Quick view
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4 tabs of resident chart
Facts – contains diagnosis, diet, allergies, pharmacy formularies, location
Orders – lists current pharmacy orders
Vitals – most current vitals – abnormal highlighted in red
Notes – recent progress notes
Mobile Application Demo
Mobile Application
• Tell the physicians all of the functions the app has to offer
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Quick view of chart
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Vital signs
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Review, Sign, Add, and Update Orders
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Labs
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Review and insert progress notes
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Secure conversations
Web Application
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Physician can access telephone orders from the web app easily
Set the view and tab to their preferences
View orders
Easy to sign from here
Web Application
• Mark all – after reviewing orders
• Electronically Sign and Next
• Moves right to next resident
• Repeat process
• Fast and easy, but mobile app is quicker
Market the App and Get Them on Board
Bringing the practitioner on board
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Have access to app ready
Feed them
Make the session interactive FAST! FAST! FAST!
Easily Accessible
Anywhere! Anytime!
Bring the practitioner on board •
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Share experiences
Start with the NP and PA
Have policies ready
Get backing from Administration
• Safe resident care
• Saves time
In the End
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Practitioner saves time
Delivers safe patient care
Costs decline
Compliance increases
Great marketing tool
Pays for itself
Now that you’ve heard advantages……
Here’s the before and after.
Workflow Starting Point
• Monthly orders list printed off for the doctor to sign
o Either sent to their office o Signed during rounds
– Upon signature monthly orders then filed into the Resident Chart
Workflow Before
• Daily Orders
o Print 2 copies of each order
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One copy in the chart
One copy to Medical Records
Which ever copy was signed first would remain in the chart
The copy that did not get signed then would be shredded Need Time Savings
• This workflow caused a lot of problems
o Time intensive
o Labor intensive
o Confusing o Time taken away from residents Before
• Original push came from our new Medical Director who had previously worked as a hospitalist for one of our referral partners
• Dr. Sperber notified the Informatics Department of her wrist and hand cramps when she signed orders
• Dr. Sperber had not physically signed orders in years Before
Investigation
The Informatics Team was on the case!
Solution
Magically the solution appeared in the Release Notes on the Home page
PointClickCare Release of Electronic Signatures for Orders!!!!!
Research
• The Informatics Team diligently began to read about this precious solution that we had been dreaming about to save our awesome Medical Director. Tools
• The Informatics Team contacted VP of IT to purchase the tools that we needed to solve the case.
Tokens
• The tokens from PointClickCare were not expensive and they paid for themselves in less than a day.
• United Church Homes began using the tokens to electronically sign order at 2 communities in October of 2014 as a pilot. • Chose to use the tokens because a majority of the doctors already used a similar device at our hospital partners. Success
• Pilot was so successful pilot was moved to full implementation within weeks.
• All United Church Homes Communities signed orders electronically by November of 2014. • This was a 2 month turn around time from pilot to full implementation. success
success
success
Cost benefit analysis
Cost benefit analysis was completed by the Informatics Department to determine whether or not the cost savings from paper, toner, and printer maintenance was going to be able to pay for the purchase of the full implementation of Practitioner Engagement
Before
• Cost benefit analysis revealed a quarterly savings due to:
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Cost of paper to print orders
– Case of paper $15
– Number of cases used for organization for orders 100
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Cost of toner replacements
– Toner replacement $550 replaced monthly
– Quarterly cost 16,500
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Cost of printer maintenance – Quarterly cost 25,000
Savings
• That was enough proof to purchase the full Practitioner Engagement solution
• This provided a solution to other existing concerns HIPAA
• The Health Information Portability Accountability Act
o Failure to comply with HIPAA can result in civil and criminal penalties o Each text message could be considered a violation
o HIPAA violation due to willful neglect but violation is corrected within the required time period
– Minimum 10,000 per violation, with an annual maximum of $250,000 for repeat violations – Maximum 50,000 per violation, with an annual maximum of $1.5 million Before
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Worried that staff were using text messages to communicate with practitioners Emailing the information is secure, but practitioners did not like receiving all of the email messages
Minimum 10,000 per violation, with an annual maximum of $250,000 for repeat violations Maximum 50,000 per violation, with an annual maximum of $1.5 million Before Secure Text Messaging
Secure Text Messaging
Full Implementation of Practitioner Engagement
Full Implementation of Mobility • Workflow o Practitioner can sign all orders using the application via their own device
o Practitioner uses the application to view entire chart to enable them to make sound decisions for our resident population
o Nurses have direct contact with Practitioner and are able to document their interactions with the Practitioner without difficulty In Summary
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Practitioner Saves Time
Simple and Easy – Anywhere, Anytime
Increase in Compliance
Facility Saves Money
QUESTIONS
Appendix
Resident information quick view
• Quick view of chart
• Sign phone/verbal orders
• Update/Add/DC orders
• Sign Order Reviews
• Secure Conversations
Progress notes
• Review progress notes written recently on the resident
Sign telephone/verbal orders
• Click on sign orders
• Choose the resident
Sign telephone/verbal orders
• Mark All
• Sign orders
• Will request password for verification
• Between each resident not each order
Order functions
• Add new orders • Update orders
• Complete order review
Order Reviews
• Sign order reviews monthly
• Mark all
• Sign order review
• Requires password for verification between each resident
Order templates
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Search over 1500 medication templates
Choose the medication desired
Save or
Physician can make changes to the templates as needed
Change the order template
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Ability to change each area of the order template
Change start date and duration
Change the dose
Change the frequency
Change the indication for use
Add additional directions