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Summer training project report
 

Summer training project report

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project on issues & challenges during implementation of incident reporting module of WorldVistA

project on issues & challenges during implementation of incident reporting module of WorldVistA

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  • (Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition.)

Summer training project report Summer training project report Presentation Transcript

  • SUMMER INTERNSHIP PROJECT REPORT Presented by DrTripti Dahiya
  • PROJECT TITLE STUDY OF ISSUES & CHALLENGES DURING INSTALLATION FOR OPEN SOURCE VISTA CPRS ON “INCIDENT REPORTING SYSTEM” AT JPNATC, NEW DELHI
  • FLOW OF PRESENTATION • Organization profile • Introduction • Review of literature • Objectives of the study • Methodology • Implementation steps • Key study findings • Discussion • Recommendation • Reference
  • ORGANIZATION PROFILE • GTI Infotel is an ISO 9001:2008 & ISO 20000:2005 organization providing the healthcare industry an open source EHR that is affordable and backed by a reliable support organization.
  • ORGANIZATION WHERE MODULE WAS IMPLEMENTED JAI PRAKASH NARAYAN APEX TRAUMA CENTER ,AIIMS (JPNATC) • First conceived in 1984 by Delhi Government • Finally India's first full-fledged trauma centre to treat victims of road accident- 2006 Aim and Objectives of the Trauma Center  To provide high standards of trauma care to the patients in accordance with international standards.  referral center for patients who require specialized trauma management and rehabilitation.  Network all regional Trauma Centers for all aspects of trauma care including patient care, data collection and establishment of a National Trauma Registry.
  • TASK DONE DURING THE INTERNSHIP • Worked on live project for the company & implemented incident reporting module in Jai Prakash Narayan Apex Trauma Center, AIIMS(JPNATC).
  • KEY LEARNINGS – Learned what all we do before implementing any module in the hospital – What process is done in the backend while configuration of module – Learned how to check the working of the module on test server – Learned about the features of radiology & nuclear medicine module of VISTA CPRS – Learned about the working in PACS in AIIMS trauma centre – Learned to prepare user guide for module implemented
  • INTRODUCTION
  • DICTIONARY MEANING • INCIDENT- an unusual or noteworthy occurrence • REPORT-a prepared account of an event, investigation, or evaluation, usually for formal presentation to an authority or group.
  • WHAT IS INCIDENT REPORT? • A document, usually confidential (protected from discovery by a plaintiff in a lawsuit), describing any accident or • Deviation from policies or orders involving a patient, employee, visitor, or student on the premises of a health care facility. • (Mosby's Medical Dictionary, 8th edition)
  • INCIDENT REPORTING MODULE OF VISTA Component of quality management sub-system Helps in improving the quality for delivering healthcare services Organizes the data into defined categories for reporting and tracking at medical facility level Part of patient safety improvement program Aims at Preventing injuries to patients, visitors, and health personnel Allow the entry of more than one patient associated with a single incident (e.g.. fire or patient to patient assault) Allow for the manipulation and reporting of the data via the Ad Hoc Reporting mechanism
  • PROBLEM STATEMENT  Only few studies are available on implementation of different modules of VistA CPRS  No formally prescribed reflective study on incident reporting module  Healthcare systems are moving towards a fully electronic health record (EHR) in order to better manage patient care.  This study will help the people who will work on implementation of Incident reporting module in future.
  • RATIONALE OF THE STUDY  People face many problems while Implementing the incident reporting module &get stuck on it  No formal help is available to guide people regarding the ways to resolve the problem.  Focus Of The Study :  To lay down the issues faced during the implementation of incident reporting module  To suggest suitable, practical and effective remedial measures against selected major issues  Benefit people who will work on this module in future.
  • REVIEW OF LITERATURE • S M Evans, Qual Saf Health Care 2006, Attitudes And Barriers To Incident Reporting: A Collaborative Hospital Study – OBJECTIVE -To assess the awareness and use of the current incident reporting system and to identify factors inhibiting reporting of incidents in hospitals. – METHODOLOGY- Anonymous survey of 186 doctors and 587 nurses from diverse clinical settings in six South Australian hospitals. – RESULTS -It was found that both doctors and nurses (98.3%) were aware that their hospital had an incident reporting system both doctors and nurses believe they should report most incidents, but nurses do so more frequently than doctors
  • REVIEW OF LITERATURE • R Lawton, D Parker, Qual Saf Health Care 2002, Barriers to incident reporting in a healthcare system ― OBJECTIVE - To investigate the willingness of healthcare professionals to report the mistakes of others. ― METHODOLOGY- Study was conducted on 315 doctors, nurses, and midwives from three English NHS trusts who volunteered to take part in the study. Structured questionnaire was used where 9 different situations were given describing either a violation of a protocol, compliance with a protocol, or improvisation (where no protocol exists) which was presented with a good, poor, or bad outcome for the patient & they were asked to indicate how likely they were to report the incident described in each situation to a senior member of staff. ― RESULTS-It was found that, reporting of an incident to a senior member of staff is generally not very likely, particularly among doctors, it was most likely when the incident represents the violation of a protocol with a bad outcome
  • OBJECTIVES OF THE STUDY GENERAL OBJECTIVE To study the issues & challenges during implementation of incident reporting module. SPECIFIC OBJECTIVES  To put forward the issues & challenges faced during incident module implementation  To suggest the effective remedial measures to overcome the problems while implementing incident reporting module.
  • METHODOLOGY STUDY AREA - JAI PRAKASH NARAYAN APEX TRAUMA CENTRE-AIIMS,NEW DELHI STUDY DESIGN-ACTION RESEARCH
  • STEPS OF INCIDENT REPORTING MODULE IMPLEMENTATION
  • DUTY DOCTOR INFORM TO OTHER DOCTOR IF REQUIRED(LEG.ANAE STHETIST) NURSE INFORM THE DUTY DOCTOR WRITE IT IN INCEDENCE REPORTING REGISTER INFORM THE NURSING INCHARGE RECORD IN PATIENT’S FILE & IN CPRS IN NEW NOTES INFORM TO OTHER DEPARTMENT IF REQUIRED (EG.IN CASE OF EQUIPMENT PROBLEM INFORM MAINTENANCE DEPARTMENT) CORRECTIVE MEASURES INCIDENT OCCURED 1.WORK FLOW OF INCIDENT REPORT IN JPNATC
  • 2. INCIDENTS REPORTED IN JPNATC • Self ex-tubation • Accidental removal of – Drains – Chest tube – ICP catheter – Foley’s catheter – Ryle’s tube • Tube blocks (Trachestomy/Endotracheal tube) • Ventilator malfunction • Post CVP pneumothorax • Post intervention-patient deterioration • Consultation sent but not seen • X-rays not done • Death
  • 3.FORMAT FOR REPORTING AN INCIDENT • INCIDENT REPORTING REGISTER MAINTAINED AT JPNATC
  • 4.EXISTING TEMPLATES & BEING FOLLOWED IN JPNATC FOR INCIDENT REPORTING
  • 5.STUDYING THE USER MANUAL OF INCIDENT REPORTING Learn the features being given in the software Learn how to configure the module in the backend & How we can match it with the workflow of JPNATC.
  • 6.GAP ANALYSIS VISTA MODULE SOFTWARE USED IN JPNATC 1.Allows entry of more than one patient associated with an incident 1.It don’t have this feature 2.Allows to select the time & date according to need 2.It don’t have this feature 3.Generate the list of incidents occurred during a particular period of time 3.Can’t generate the list of incidents occurred, in order to see the incident report, user need to look into patient’s complete history individually 4.Generate the list of incidents, location vice 4.It don’t have this feature 5.Entry method-Roll & scroll 5.Entry method –Done using GUI screen
  • 7.GATHERING THE REQUIREMENT Interviewing the staff of the hospital  Inquire regarding the features they need in new incident reporting module of VistA CPRS
  • 8.CONFIGURING THE MODULE IN THE BACKEND • Configuring the features of incident reporting module of VistA • Customize it according to the current workflow of JPNATC • Method of entering the details in VistA - Roll & scroll method
  • FEATURES CONFIGURED
  • HOW TO WORK ON PUTTY • What is PUTTY? • PUTTY is a free & open- source emulator, serial console & network file transfer applications • It supports several network protocols, including SCP,SSH,Telnet & rl login
  • HOW TO ENTER A NEW INCIDENT Select option 14 (i.e. quick incident entry) from option name QAN on putty Enter the details of the patient related to incident
  • HOW TO EDIT THE FULL DETAILS OF THE INCIDENT •Select option 10 i.e. QAN INCIDENT REPORTING FOLLOW UP •Select from the 4 options to see the patient whose details were entered though quick incident reporting option •Enter the details related to the incident
  • HOW TO SEE THE LIST OF INCIDENTS OCCURRED LIST OF INCIDENTS OCCURRED Select option 29 i.e. QAN view open incident Show us the list of incidents
  • HOW TO CHANGE THE STATUS OF INCIDENT REPORT FROM OPEN TO CLOSE OR DELETE Select OPTION 27 i.e. QAN RECORD MANIPULATION (Edit Status Incident Reporting Record) Enter the patient number & select from three options i.e. OPEN CLOSE or DELETE Select the option which you want to make as status of your report & press Enter
  • HOW TO SEE REPORT LOCATION WISE Select OPTION 17 i.e.QAN INCIDENT REPORTS (Incident reports main menu) & press Enter Will See 4 Options, Select Option Which Says INCIDENT REPORT BY LOCATION & Press Enter Select The Location For Which Incident Report Needs To Be Seen Get The List Of Incidents Occurred In The Selected Location
  • FEATURES CUSTOMIZED • List of incidents which were reported in JPNATC & which were not there in VistA . • Added new locations according to the locations present in JPNATC in Incident reporting module of VistA.
  • 8.TESTING THE WORKING OF THE MODULE • INPUTS – Patient’s name-NEW, PATIENT – Incident type -FALL – Date & Time of incident - Now (i.e. May 22, 2013 @ 14:28) – Severity level- 1 (i.e. Minor)
  • OUTPUT NEW, PATIENT IS REFLECTING IN LIST OF PATIENTS MET WITH AN INCIDENT •Thus, working of module was tested successfully on test server
  • 9.PREPARING THE USER GUIDE • According to the knowledge of the staff • On the basis of working of module • Specially designed for JPNATC STAFF • In order to help them to use incident reporting module
  • CHALLENGES FACED WHILE IMPLEMENTING THE MODULE – Understanding the Software & technical language – How to work on putty – Which method to use to enter a new incident as there are different ways to enter it – Where the module will reflect the output – Where to search for help if got stuck anywhere while configuring the module – How to resolve the problem – How to customize the module for hospital need – How to add new location & incidents in the module
  • KEY STUDY FINDINGS
  • INCIDENT REPORTING MODULE IMPLEMENTATION SCOPE & PLAN Clearly define the roadmap for the project The plan becomes the basis for ongoing progress assessment DESIGN Workflow of the hospital in relation to incident report Early awareness of gaps between desired and actual functionality STUDY •Read the user guide & installation guide of the module before starting to configure the module CONFIGURE Configure the module in the backend DO’S
  • INCIDENT REPORTING MODULE IMPLEMENTATION REFER Refer to hardhats Google group if face any problem during configuration of module TEST Test the working of module on the test server Check is it meeting the actual workflow of the hospital or not IMPLEMENT Implement the module in the organization & train the staff for using the module SUPPORT Prepare user manual for the staff for help DO’S
  • INCIDENT REPORTING MODULE IMPLEMENTATION Don’t start with configuring the module directly(Study the workflow of the organization first) Don’t Show The Working Of Module After Configuring It To The Client, Test It First Don’t leave the organization staff, after implementing the module ,train the staff how t use the module Don’t give the same log in I.D to all the staff, otherwise they can manipulate or delete the report Don’ts
  • DISCUSSION OF STUDY FINDINGS Implementation of incident reporting module requires : Team comprising of both technical & medical staff Planning Clearly defined goals of every team member Studying the work flow Design the implementation process Configure the module Implement the module Testing of module Proper Training of staff Support for future
  • Study what your client wants & what is there in the module Find out the gaps between the two During configuration process, if face any problem, then refer to hardhats hats Google group for help see previous queries & there solution related to our topic POINTS TO REMEMBER
  • RECOMMENDATIONS • Incident reporting module should be implemented in every hospital in order to improve the quality of healthcare delivery system. • Track the incident record, so that corrective measures can be taken on time. • Implementation of incident reporting module require – in-depth knowledge of the topic & – Proper plan of implementation • For help, always refer to hardhats vista group on Google  & user guide& installation guide of incident reporting module of VistA
  • REFERENCES 1. JPNATC profile http://www.jpnatc.com/ 2. GTI infotel profile http://www.gtiinfotel.com/ 3. U.S. department of veteran affairs (va);1985;vista; http://en.wikipedia.org/wiki/vista 4. incident reporting module of vista cprs www.va.gov/vdl/ Va software document library 5. Hardhats Google group 6. Qual saf health care 2006; www.qshc.com 7. Qual saf health care 2002,www.qshc.com
  • THANK YOU