It’s Monday morning at 7:45 a.m. RN Jesi Davis finds an unoccupied computer work station on her third floor unit at Cowichan District Hospital, taps in to the computer with her prox card, and enters vital information for the patient she has just seen. What was completely foreign a few weeks ago – using the electronic health record for clinical documentation – is almost starting to feel like habit.
“It’s a big learning curve,” said Davis, who squeezed in her training for ‘ClinDoc’ on a night shift before go-live.
Davis said staff continue to adjust to documenting electronically, but are already seeing the benefits.
“One of the benefits of electronic charting, I find, is it’s just really easy to see patient trends,” she said. “If you have a question, it can be a lot of laborious work to go back through all the charting and look and see if something was mischarted or see what the trend is. With the electronic charting you can just open up the computer and have it all laid out in front of you. So it does make a big difference.”
Thanks to the commitment and efforts of staff and leaders and round-the-clock support, CDH is the latest Island Health acute care site celebrating a successful IHealth ‘go-live’ for electronic clinical documentation.
From paper processes to electronic charting
CDH made the switch from paper processes to electronic charting for patients on September 26, a change that contributes to safer, higher quality and more efficient patient care. Staff were supported onsite 24/7 by IHealth project staff, Clinical Informatics, and Provider Education and Experience (ProEX) for a three-week period, with ProEX continuing onsite support until December 1.
“The staff really need to hear how thankful we are for all the extra work they did,” said David Huntley, CDH Site Director.
He commended staff across CDH for their role in the change, including their collaborative work to make sure ClinDoc was implemented on schedule. He also pointed to the partnership with the IHealth project team as part of the success.
“The support that we’ve gotten from the IHealth team has been fantastic. We’ve really worked collaboratively with them leading up to the change and ensuring that all of our teams were ready for the change,” he said. “And then having gone live, it’s just been so nice to see all the extra support that’s been on the site.”
LPN Emma Greville took a moment to share her perceptions a few days into the change.
“It’s a lot faster,” Greville said. “Charting at first, it was really scary. But now that I know what to do, it’s a lot easier.”
In addition to making easily findable (and legible!) information available in real-time, the shift to ClinDoc also enables important alerts and screening. These include Sepsis/SIRS alerts, Pediatric Early Warning Sign (PEWS) alerts, risk of violence screening, suicide risk screening, confusion assessment method
(CAM) screening and infectious disease screening – all of which help care teams create a shared plan of care, respond to patients with earlier intervention, prepare more appropriately when necessary, and reduce variations in care. Imprivata OneSign “Tap and Go” technology was also installed to save log-in time for clinical and medical staff on computers throughout the hospital.
Overcoming challenges and attaining 100 per cent training completion
CDH overcame a number of challenges to prepare for and onboard the change — such as staffing shortages, many over-census days at the site, and dealing with limited space available for new charting workstations in the aging facility. (CDH is scheduled for replacement with a new facility expected to open in 2026.)
Training staff through summer vacation times and the ongoing staffing crisis posed a challenge–however, staff overcame this obstacle as go-live day drew near.
That’s an accomplishment that staff should be proud of, said Jaswinder Bamra, Manager of Integrated Services, 3rd Floor at CDH.
“We weren’t sure if we would reach this milestone,” she said, “but with the support from the IHealth team and leadership, engagement from staff and collaboration of teams, we were able to overcome this barrier, getting to that 100 per cent completion rate of modules and successfully implementing electronic documentation.”
Dr. Graham Blackburn, Site Medical Director, said he can see a significant improvement to medical staff communication with electronic clinical documentation, now that patient information is quicker and easier to access for health care providers both on and off site.
“I think really clearly documenting what needs to be in the patient record is important,” he said, “But I think ultimately it’s about making the documentation easier for the clinicians and then transparent to the patients, which is the ideal future state.”
