Answers for life.
A914CX-HS-131756-M1-4A00
Copyright © 2013 Siemens Medical Solutions USA, Inc. All rights reserved.
OR Cl...
A914CX-HS-131756-M1-4A00
Copyright © 2013 Siemens Medical Solutions USA, Inc. All rights reserved.
• Robert Sumter, PhD, E...
A914CX-HS-131756-M1-4A00
Copyright © 2013 Siemens Medical Solutions USA, Inc. All rights reserved.
Today’s Agenda
• How an...
Regional Medical Center at Memphis
• An academic medical center that includes a Level I
trauma center serving a five-state...
The Situation
• The MED elected to implement a perioperative
system as part of its strategic plan to ensure that its
EHR i...
Why Perioperative Management by SIS?
• Legacy system in OR and PACU
• Paper in PAT
• Paper in Anesthesia
– no data flow – ...
Clinical, Operational, and Financial Outcomes At-a-Glance
• Within one month after going live with the
Perioperative Manag...
SCHEDULING AND PAT
Scheduling Benefits
System Security
Legible
AFTER
Web Scheduling for PAT and OR
from clinics electronically.
Illegible
Con...
Pre-Admission Testing: Old Process
• Completed 3 page form upon arrival to PATS
• Form reviewed with patient for accuracy
...
• Perioperative Management by SIS allows us to
choose whether the patient assessment will be done
as a phone call or a PAT...
Appointment Screen
PAT Scheduling
Surgical Scheduling (with Block Times Shown)
NURSING PRE-OP
Nursing Pre-Op
• Specialty wizards designed for ASU Pre-Op
• SCIP measures incorporated in nursing assessments
• Patient i...
Nursing Pre-Op
Holding
ANESTHESIA
Anesthesia
BEFORE
Paper Block Forms
Paper Anesthesia
Records
Hand Written labs
from Meditech data
Paper Pre-Op
Paper Post-Op
AFTER
Au...
NURSING INTRA-OP
Intra-Op
NO electronic tracking of implants,
time consuming
Care Plans were NOT established
Paper changes, time consuming,...
PACU
PACU
PNDS care plans built.
Vital signs are now automatically entered by
connecting EKG Monitor to computer.
Able to track...
Family Waiting Room
PACU Vital Sign Graph
NURSING POST-OP
Nursing Post-Op
• Post-op instructions modified to each patient
• PNDS care plans built to meet the needs of majority
of p...
Nursing Post-Op
CHART VERIFICATION
Generation of Charges
Generation of Charges (Time Charges)
RESULTS
Perioperative Services: Benefits
Achieve Process Improvements
Chart for the Future
Decrease Double Documentation
Increased...
• aSurgical Care Improvement Project
SCIP
Num Den Rate Num Den Rate Num Den Rate Num Den Rate Num Den Rate
SCIP-INF - 1: P...
INSIGHTS
Build Complete/Accurate Procedure Cards
Have Updated Implant and Material File
Strong Dedicated Build Team -- Com...
Next Steps
Interoperability
•Lab interface
•Global Session Manager
–Single sign-on
–Patient, user and clinical context sha...
Summary
• Reduced perioperative costs
– Reduced overtime, while increasing hours of operations
– Reduced supply cost usage...
A914CX-HS-131756-M1-4A00
Copyright © 2013 Siemens Medical Solutions USA, Inc. All rights reserved.
Questions?
OR Clinical and Financial Success at The MED
OR Clinical and Financial Success at The MED
OR Clinical and Financial Success at The MED
OR Clinical and Financial Success at The MED
OR Clinical and Financial Success at The MED
OR Clinical and Financial Success at The MED
OR Clinical and Financial Success at The MED
OR Clinical and Financial Success at The MED
Upcoming SlideShare
Loading in …5
×

OR Clinical and Financial Success at The MED

1,843 views

Published on

As clinical and financial challenges evolve, providers look to operating room processes for opportunities to achieve improvements in efficiency, revenue capture, and care quality. IT for perioperative management can play an important role.

Robert Sumter, COO and CIO of Regional Medical Center at Memphis, describes the impact that Perioperative Management by SIS has had on his operating room processes.

  • Be the first to comment

OR Clinical and Financial Success at The MED

  1. 1. Answers for life. A914CX-HS-131756-M1-4A00 Copyright © 2013 Siemens Medical Solutions USA, Inc. All rights reserved. OR Clinical and Financial Success at The MED July 18, 2013
  2. 2. A914CX-HS-131756-M1-4A00 Copyright © 2013 Siemens Medical Solutions USA, Inc. All rights reserved. • Robert Sumter, PhD, Executive VP, COO, CIO • Currently responsible for clinical and professional information technology and process improvement operations at The Regional Medical Center at Memphis (The MED) Today’s Speaker
  3. 3. A914CX-HS-131756-M1-4A00 Copyright © 2013 Siemens Medical Solutions USA, Inc. All rights reserved. Today’s Agenda • How and why The MED selected its perioperative solution • Lessons learned from the six-month implementation • The value of a complete perioperative record, including automating anesthesia • Results from automating surgical services
  4. 4. Regional Medical Center at Memphis • An academic medical center that includes a Level I trauma center serving a five-state region • Using perioperative automation to position to meet challenges of: – Growing surgical volumes – Managing surgical expenses and improving revenue capture – Becoming a data-driven organization – Delivering and documenting high-quality care
  5. 5. The Situation • The MED elected to implement a perioperative system as part of its strategic plan to ensure that its EHR infrastructure was positioned for Meaningful Use • The MED’s goals included: – Managing perioperative costs – Improving technology support for clinical workflows – Eliminating manual processes – Creating a complete, fully automated perioperative record that was interoperable with the hospital’s new Siemens Soarian® solution
  6. 6. Why Perioperative Management by SIS? • Legacy system in OR and PACU • Paper in PAT • Paper in Anesthesia – no data flow – redundant documentation • Paper Charge Capture – lost charges • Manual reports – delayed analysis Needed continuity of care and patient information to flow with the patient. Patient Information
  7. 7. Clinical, Operational, and Financial Outcomes At-a-Glance • Within one month after going live with the Perioperative Management by SIS solution: – Decreased length of PAT visits by 70% – Decreased anesthesia documentation time by 50% – Increased on-time case starts by 41% – Decreased calls for patient status information by 90% – Reduced room turnover time by over 20% – Achieved 100% compliance with SCIP measures in the OR in the first quarter after go-live – Reduced nursing overtime by 12.5% Since go-live: – The MED recognized $10 million in additional charges over projected budget
  8. 8. SCHEDULING AND PAT
  9. 9. Scheduling Benefits System Security Legible AFTER Web Scheduling for PAT and OR from clinics electronically. Illegible Confidentiality BEFORE Faxed Scheduling Sheets
  10. 10. Pre-Admission Testing: Old Process • Completed 3 page form upon arrival to PATS • Form reviewed with patient for accuracy • Vital signs added to form • Nurse completed assessment form (VS,HT,WT) • MAR completed by hand entering all meds • All forms sent to ASU for input by ASU nurse the morning of surgery
  11. 11. • Perioperative Management by SIS allows us to choose whether the patient assessment will be done as a phone call or a PATS visit MAR completed by selecting meds from pharmaceutical list, including strength, frequency and route of dose Patient is then sent to the OR Information is entered into SIS All information rolls over from the PATS Module to the ASU Module Morning of surgery is now a verification process as opposed to a data entry process HT & WT, VS, Medication Reconciliation Verification remains on paper at present. Results: Length of Visit went from 115 to 35 minutes Pre-Admission Testing: New Process
  12. 12. Appointment Screen
  13. 13. PAT Scheduling
  14. 14. Surgical Scheduling (with Block Times Shown)
  15. 15. NURSING PRE-OP
  16. 16. Nursing Pre-Op • Specialty wizards designed for ASU Pre-Op • SCIP measures incorporated in nursing assessments • Patient information gathered in PATS flows to Pre-Op record, decreasing duplicate charting. • PNDS care plans built for pre-op patients and are modified for each individual patient’s needs.
  17. 17. Nursing Pre-Op
  18. 18. Holding
  19. 19. ANESTHESIA
  20. 20. Anesthesia
  21. 21. BEFORE Paper Block Forms Paper Anesthesia Records Hand Written labs from Meditech data Paper Pre-Op Paper Post-Op AFTER Auto-populates scheduling and PAT information Auto-populates across all perioperative phases of care Auto-populates previous cases Wizards enable documentation by exception • Decreases the documentation time • Increases ease of use Customized wizards to accommodate specific needs of each OR Anesthesia
  22. 22. NURSING INTRA-OP
  23. 23. Intra-Op NO electronic tracking of implants, time consuming Care Plans were NOT established Paper changes, time consuming, lost charges BEFORE Automated charge capture by exception PNDS Care Plans Integrated tissues and implants automation AFTER
  24. 24. PACU
  25. 25. PACU PNDS care plans built. Vital signs are now automatically entered by connecting EKG Monitor to computer. Able to track PACU minutes via SIS Analytics. Charges are no longer entered by hand, but done automatically by computer. Families are updated on patient’s progress via tracking board. Charting time has been decreased allowing the nurse to spend more time at the bedside.
  26. 26. Family Waiting Room
  27. 27. PACU Vital Sign Graph
  28. 28. NURSING POST-OP
  29. 29. Nursing Post-Op • Post-op instructions modified to each patient • PNDS care plans built to meet the needs of majority of patients, but able to be modified to meet each patient’s needs Information from PACU Module flows to Post-Op Module, reducing charting requirements for nurses
  30. 30. Nursing Post-Op
  31. 31. CHART VERIFICATION Generation of Charges
  32. 32. Generation of Charges (Time Charges)
  33. 33. RESULTS
  34. 34. Perioperative Services: Benefits Achieve Process Improvements Chart for the Future Decrease Double Documentation Increased Charge Capture Improvements in Data Analysis Smoother Workflow
  35. 35. • aSurgical Care Improvement Project SCIP Num Den Rate Num Den Rate Num Den Rate Num Den Rate Num Den Rate SCIP-INF - 1: Prophylactic Antibiotic Received Within 1 Hour Prior to Surgical Incision 50 51 98.0% 43 44 98.0% 33 36 92.0% 33 33 100.0% 161 164 98.2% SCIP-INF - 2: Prophylactic Antibiotic Selection for Surgical Patients 51 52 98.1% 43 45 96.0% 35 35 100.0% 33 33 100.0% 162 165 98.1% SCIP-INF - 3: Prophylactic Antibiotics Discontinued Within 24 Hours After Surgery End Time 47 51 92.2% 41 42 98.0% 32 33 97.0% 31 31 100.0% 151 157 96.2% SCIP-INF - 4: Cardiac Surgery Pts With Controlled 6 A.M. P/O Serum Glucose 0 1 1 100.0% 0 1 1 100.0% 2 2 100.0% SCIP-INF - 6: Surgery Patients with Appropriate Hair Removal 156 156 100.0% 132 132 100.0% 142 142 100.0% 110 110 100.0% 540 540 100.0% SCIP-INF - 9: Urinary Catheter Removed on POD 1 or POD 2 42 42 100.0% 44 44 100.0% 46 47 98.0% 32 32 100.0% 164 165 99.4% SCIP-INF - 10: Perioperative Temperature Mgmt 155 155 100.0% 137 137 100.0% 140 141 99.3% 115 115 100.0% 587 588 99.8% SCIP-Card - 2: Surgery Pts on Beta Blocker Therapy PTA Received Beta Blocker During the Perioperative Period 8 13 61.5% 15 15 100.0% 15 17 88.2% 9 9 100.0% 47 54 87.0% SCIP-VTE - 1: Surgery Patients with Recommended Venous Thromboembolism Prophylaxis Ordered 121 122 99.2% 121 122 99.0% 126 126 100.0% 96 96 100.0% 464 466 99.6% SCIP-VTE - 2: Surgery Patients Who Received Appropriate Veneous Thromboembolism Prophylaxis Within 24 Hours Prior to Surgery to 24 Hours After Surgery 120 122 98.4% 120 122 98.4% 122 126 97.0% 96 96 100.0% 458 466 98.3% SCIP - Appropriate Care Measure (All SCIP Measures) 147 160 91.9% 133 139 96.0% 133 144 92.4% 116 116 100.0% 529 559 95.0% Legend FY 2012 < 95% 96-98% 99-100% FY2012 YTD4QFY20122QFY20121QFY2012 3QFY2012 One month after go-live: SCIP Measures hit 100% in the OR for the first time in history
  36. 36. INSIGHTS Build Complete/Accurate Procedure Cards Have Updated Implant and Material File Strong Dedicated Build Team -- Commitment Strong Staff Champions for Implementation Dedicated Training Time
  37. 37. Next Steps Interoperability •Lab interface •Global Session Manager –Single sign-on –Patient, user and clinical context sharing between Soarian and SIS •Medication Administration Check™ (MAK) integration –MAK patient record can be opened from the perioperative workflow –Medications ordered from the perioperative workflow can be administered and documented in MAK then sent back to the perioperative patient record
  38. 38. Summary • Reduced perioperative costs – Reduced overtime, while increasing hours of operations – Reduced supply cost usage • Improved clinical workflows – Eliminated many bottlenecks caused by paper • Automated processes from PAT to PACU • Converted to digital record • Used analytics to help drive decision-making • Increased revenue capture – Anesthesia and other areas
  39. 39. A914CX-HS-131756-M1-4A00 Copyright © 2013 Siemens Medical Solutions USA, Inc. All rights reserved. Questions?

×