This document discusses playing for change in the emergency department (ED) of a hospital. It identifies gaps in the current ED system related to manpower, equipment, guidelines and personnel training. It also discusses issues like the ED being seen as an orphan department and lack of coordination, motivation and ownership. The document proposes connecting ideas to reality by implementing an electronic medical record (EMR) system in the ED. It summarizes a study that assessed ED providers' perceptions of implementing EMR in the trauma center ED over time, finding improved perceptions regarding usability, applicability and potential for research support. The conclusion advocates for a journey from the current ED to a future e-ED (electronic ED) as a way to champion playing for

1. PLAYING FOR CHANGE
Dr Sanjeev Bhoi MD.FACEE
Additional Professor
Department of Emergency Medicine
AIIMS

2. Objective
• Gaps
• Issues and hurdles
• Games of Mind
• Playing for Change

3. Gaps
•System-
•Manpower
•Equipment
•Guidelines and protocols
•Heath care personnel
•Training

4. Issues and hurdles
• Casualty:-
• orphan child of the
hospital
• Lack of Team
• Coordination
• Abused,miused by
established
disciplines

5. Issues and Hurdles
•CMO a traffic police
•Nurse- injectionolgist.
•MLC
• Computer facility

6. Game of Minds
• Lack of motivation
• Apathy
• Callous attitude
• Commonly Misused
Oppressed by
established specialty
• Victim of lack of
ownership

7. Video
Playing for Change

8. Championing Playing for Change
• Leadership
• Ownership
• Making a Team
• Connecting ideas into reality
• Introspecting within

9. Ownership
Mine Ours

10. Leadership

11. Making a Team
Team- Team

12. Connecting Ideas into Reality
ED
• MLC
• Emergency Medical
record
• Nurse Monitoring Chart
• Patient monitoring
• Reviewing images
IT
• E-MLC
• Computerized Medical
Record systems
• E- vital sign monitoring
• E-patient monitoring
• PACS, KiosKs

16. Introspecting within
• Emergency Department
• E-Emergency Department

17. To assess the perception of Emergency care providers
towards the implementation of Electronic Medical
Record system in Emergency Department of a level -1
trauma centre
Courtesy :Sonia Chauhan
(Trauma Nurse Coordinator)

18. METHODOLOGY
• Study design- Qualitative survey
• Performance centre - ED of JPN Apex Trauma
Centre, AIIMS.
• Study duration-February to October 2010 (3
surveys)
• Study Group-22 Emergency Care Providers
Doctors 8
Nurses 14
Total 22

19. Study Tool
Structured, closed ended questionnaire consisted of 12
questions based on:
 Usability
Applicability
 Security
 Helpful in research of EMR.

20. SURVEY ON CPRS IN ER (JPNATC, AIIMS) BY HEALTHCARE WORKERS
Are you aware of CPRS (computerized patient record system)?
a) Yes
b) No
If your answer to the above question is ‘Yes’ please proceed below:
Usability:
1. Do you have problem in logging into CPRS?
a) Never
b) Sometimes
c) Very often
d) Always
2. Overall, how easy is the computerized MLC form?
a) Not at all
b) To some extent
c) easy
d) Very useful
3. Overall, how easy is the computerized transfer notes?
a) Not at all
b) To some extent
c) easy
d) Very easy
4. Overall, how easy is the computerized discharge summary?
a) Not at all
b) To some extent
c) easy
d) Very easy
5. Overall, how easy is the computerized entry of patient vitals?
a) Not at all
b) To some extent
c) easy
d) Very easy
Applicability:
6. Do you think this system is helpful in overall patient care?
a) Never
b) Sometimes
c) Very often
d) Always
7. Do you feel demographics are more accurately entered in all forms
(MLC form, transfer out forms, discharge summary) by using the
computerized system?
a) Never
b) Sometimes
c) Very often
d) Always
8. Do you think computerized MLC form is helpful for police and
judiciary (courts)?
a) Never
b) Sometimes
c) Very often
d) Always
Security:
10. Do you think data can be manipulated in system (after sign off)?
a) Never
b) Sometimes
c) Very often
d) Always
11. Do you think this system will help in improving transparency and
accountability?
a) Never
b) Sometimes
c) Very often
d) Always
Research:
12. Do you feel this system can be helpful in research?
a) Never
b) Sometimes
c) Very often
d) Always

21. • Likert scale(LS) was used (Likert 1=wrost, likert
4=best).
• Surveys were done on day- 20 ,day- 45 day and 9
months of implementation of EMR.
• Response of emergency care providers(ECP) were
compiled
• Data analyzed by SPSS version 16.

22. Result
4
3.5
3
2.5
2
1.5
1
0.5
0
2.23
2.5 2.45 2.41
2.71 2.72
3
2.82
1.41
2.77
3.32
S1
S2
S3

23. Usability
Likert Scale
2.6
2.55
2.5
2.45
2.4
2.35
2.3
2.25
2.2
2.15
2.1
2.05
S1
S2
S3
Likert Scale

24. Application of EMR
3.5
3
2.5
2
1.5
1
0.5
0
likert scale
S1 S2 S3
likert scale

26. Mission with a vision
To
play for change
A journey from ED to e-ED