Today’s healthcare industry is in transition, moving from paper based processes to highly customizable electronic medical records (EMR). This technology opens new opportunities to provide clinical staff information to develop treatment plans, ensure consistent application of best practices, improve medical coordination and communication, reduce opportunities for errors or unintentional omissions, and improve patient outcomes. However, EMRs do not provide adequate managerial insight into nursing unit or hospital performance. Business Intelligence (BI) is a usercentered process for accessing and exploring information, analysis, and developing insights leading to improved and informed decision making.
A comprehensive strategy was developed to leverage the EMR and utilize BI technology to facilitate performance improvement. Previously, clinical staff had little insight into out of compliance patients. Process failures would often go undiscovered until long after patient discharge. Managers initially tried to compensate by documenting compliance on daily paper cards which were moderately effective but very inefficient. Finally, performance improvement initiatives required lengthy delays of up to 60 days to evaluate efficacy because their dependence on retrospective data.
Standardized documentation templates, physician order sets, and best practice alerts (BPAs) assure structured communication about patient care processes and consistent application of bestpractices. Realtime clinical decision support tools were developed within the EMR to summarize active patient lists; and an automated interface was developed to display short cycle performance metrics and exception detail on a management dashboards updated as often as every 30 minutes.
The tools have been well accepted and all related publicly reported quality measures have experienced improved and sustained high performance since the short cycle implementation. Additionally, nurse manager auditing and reporting activities have been reduced 50% resulting in 1 hr saved per unit per shift. Clinicians benefit by receiving real time clinical support and actionable quality performance information. Dashboards communicate consistent messages to frontline managers and executive leadership; alert managers to complete important clinical processes before they become “measure failures” as well as alert them to process breakdowns for expedited remediation. Quality staff members are able to focus improvement efforts and quickly see the impact of those activities. Management decisions can be made based on current performance; and finally, patients receive better care while in the hospital.
To cite this abstract:Proctor A, Harte B, LaRochelle D, Hixson E, Auron M. Actionable Quality Improvement: Synergizing the Emr and Bi. Abstract published at Hospital Medicine 2012, April 1-4, San Diego, Calif. Abstract 97744. Journal of Hospital Medicine. 2012; 7 (suppl 2). https://www.shmabstracts.com/abstract/actionable-quality-improvement-synergizing-the-emr-and-bi/. Accessed July 20, 2019.