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Sam Stockland of Clinical Informatics works with Emily Zetell
Sam Stockand of Clinical Informatics gives elbow-to-elbow support to Emily Zetell, completing her training in the drop-in centre at Royal Jubilee Hospital

Success! Launching Clinical Documentation in Cerner EHR at RJH

Thanks to the dedication and engagement of hundreds of staff at Royal Jubilee Hospital (RJH), the launch this fall of electronic clinical documentation is emerging as a smooth and successful experience.

The IHealth project launched in two stages at RJH over the past month, with clinical documentation in Cerner PowerChart now in use by medical, nursing and clinical staff at the hospital. This makes it one of the largest changes in the transition for Island Health staff to electronic health records (EHR).

“We’re extending a big ‘Congratulations’ to all the EHR users who participated in making this important change to their clinical practice,” says Manpreet Khaira, Interim Executive Director of Victoria acute hospitals.

Moving to the use of electronic clinical documentation has a direct link to improving quality of care and standardizing information so that more information is immediately available across multi-disciplinary care teams, and, eventually, across Island Health services and locations.

The richness of data available through the EHR will feed into care planning and decisions related to a wide range of issues, for example, from Sepsis and delirium alerts to violence assessments, Best Possible Medication History (BPMH) and medication reconciliations.

Support of staff has made the difference

Following initial anxiety among some staff, warm feelings are being reciprocated back from the hospital floors to the project team, as well.

“The support has been A-1,” says Laura, a registered nurse working in Surgical Day Care at RJH. “There’s always somebody coming in and checking up on us and it’s quite lovely.”

Laura was clear that she didn’t think she was going to be a fan of the new system.

“It’s not as bad as we all thought it was going to be. My worst fear was trying to navigate it. We’re getting used to this a couple of weeks in, but there’s always a fear of the unknown.”

Leah, an RN on 4S medical wing, is very positive about the changes.

“I like Clin Doc – it’s a lot easier to use, and saves a lot of time, too,” she said.

Since going live, Clinical Informatics, Provider Education and Experience (ProEx) and IHealth project staff have been making frequent rounds of the facility, answering questions, giving support and collecting suggestions for enhancements to the system.

Continuing with enhancements and support

The IHealth team has also offered Skill Sharpener sessions for CNEs, CNLs and unit nurses, focusing on the areas where data shows that more support is needed: informal team communication using the EHR, handoff communication, chart annotations and comments in interactive view.

The Cerner EHR development team is adding enhancements to the platform in response to requests from medical staff, nurses and clinicians alike. In the weeks following the initial go-live, the team has processed 86% of the 1,594 incident tickets sent to them (as of October 19), with no critical incidents outstanding.

Visits to the drop-in support centre and the central support line are tapering off, as well. Support for end users will continue until November 5, in PCC 201 8:00 a.m. to 4:00 p.m. Monday to Friday, and around the clock on the support phone line (1-877-755-7001).

Victoria General Hospital is also launching electronic clinical documentation on a slightly later timeline. Medical staff and some units went live on October 4, while the rest of the nursing and clinical staff at the hospital are getting ready to go live next week.

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