New technology launched in Saskatoon Emergency Departments
Saskatoon Health Region’s eHealth team had a busy fall advancing the use of technological tools used for healthcare services at the three emergency departments in Saskatoon.
Each month from September to December, electronic documentation using the Sunrise Clinical Manager (SCM) application was implemented in all three emergency departments in Saskatoon, starting with Saskatoon City Hospital, then Royal University Hospital (RUH), and finally St. Paul’s Hospital.
It’s a patient-centered information system that contains all patient care information. Once documented (or entered into SCM), the information is always available, eliminating the need for patients to repeat themselves at multiple points in their care journey.
The three Emergency departments in Saskatoon have led the way in using SCM in Saskatoon Health Region. For the last number of years, they have used electronic documentation and an electronic status board, which is used as a communication tool among clinicians. Clinicians within the Emergency Department, and across the Region, have also used SCM to view patient visit history, regional lab results, radiology results and all documents that are transcribed through regional transcription services, such as discharge summaries and operative reports. Introducing electronic clinical documentation to the emergency department was a natural progression.
“As soon as someone writes a note in the system, any service across the Region can access it. There’s no more hunting for paper charts,” said Wes Hiebert, clinical lead for Saskatoon Health Region’s eHealth and Health Information department.
SCM is now used by nurses and physicians in emergency departments to document clinical information. These electronic documents contain all patient care information, and allow the entire care team to access it in a timely manner.
“One of the complaints before from patients was the number of times they were asked what was wrong, and their medical history,” said Hiebert. “With the electronic chart, anyone with permissions can access that patient’s information and have that information right there.”
Patients have already expressed their appreciation for the new system, especially when they or their loved one has a complicated medical history.
“Some clinicians were skeptical at first, but now they are starting see how patient information can come together so easily. Doctors are starting ask about changes that can be made to the system to arrange it so that it works better for them, so that’s a great sign,” Hiebert said.
Physicians have stated that they like the clear and immediate access to documentation for each patient, allowing them to see what their colleagues have prescribed or noted. The system allows clinicians to have a wealth of information available on a single system that will only continue to expand over time.
The Region’s eHealth team was also charged with changing over the Order Entry system at RUH to a new SCM-based system last fall.
“The order management system (OMS) at RUH – which is how blood work, diagnostic testing and other services for patients were requisitioned – had been computerized since the 1980s,” Hiebert said, “but the technology we were using was from the 1990s. The software had aged, and was no longer supported, so before we lost the application, we transitioned from the old system to placing these orders in SCM. Order entry in SCM is more flexible, more intuitive, more robust and allows users to search the system a lot easier.”
SCM is designed in a very similar way to a patient’s chart, so it’s easy for clinicians to use. It’s also quick to update, giving staff up-to-the-minute information on what’s happening with patients and potentially reducing errors commonly associated with lack of or poor communication.
“The minute a test is completed, the results are sent immediately to the system,” said Hiebert. “So the turnaround time for results is very quick.”
In fact, SCM provides users with updates as orders are moved through the system. It records when lab work was drawn, when it was received by the receiving department and when results are finalized. The old OMS did not have these features, which will help caregivers make more timely decisions and decrease duplication in test ordering.
With the SCM system, providers are also easily able to give specifics in their orders; for instance, if a patient needs to be put on contact precautions. This allows the receiving departments to organize their work flow more effectively and efficiently, and it eliminates numerous phone calls back and forth to ensure the tests are completed as ordered.
The flexibility of the new OMS allows users to input important information pertaining to each patient and the tests being ordered, allowing less potential for errors. Finally, because SCM uses current technology, the program can be built upon to adapt to future needs.
There have been some challenges with the implementation of the new system, but the team is working through them.
“Greater efficiency and less room for errors means more time for caregivers to spend with our patients,” said Hiebert. Patients will benefit from everyone having information at their fingertips, Hiebert noted.
For the launch of the new Order Entry system, staff from eHealth provided on-site, round-the-clock support to the units at RUH. They established a Command Centre in the basement of the building, and donned blue vests so they were easy for staff members to spot. In all, their team of 28, which included eHealth, external consultants and super users, provided 1377 hours of support for the RUH Order Entry Activation. The team was onsite 24 hours a day for 12 days.
The activation of both of these new systems at roughly the same time made for some long days for eHealth staff.
“It’s been a long journey, but we’re happy to see this functionality within SCM implemented. It was a lot of work, but very satisfying to see the results of the changes. It helps us know that we are doing the right thing,” Hiebert said.