Ongoing Update – Cochrane Report – March 24, 2017

The following was sent on behalf of Damian Lange, Director Clinical Operations, NRGH, and Dr. Ben Williams, Medical Director, Oceanside, to all Nanaimo Regional General Hospital, Oceanside Health Centre and Dufferin Place physicians and staff

Dear Colleagues,

As outlined previously, Island Health President and CEO, Dr. Brendan Carr has asked that we provide you with regular updates.

NRGH Local Quality and Operations Committee Meeting

The NRGH Local Quality and Operations Committee had its fourth meeting on March 23rd. This Committee includes NRGH clinical and medical leaders, representation from the Medical Staff Association (MSA), as well as multiple guests including regional and local representatives impacted by CPOE suspension. The following are highlights:

  1. Emerging Consensus to Better Support Users and Maintain EHR Functionality

    Over the last several weeks, the committee has heard from operational and technical teams starting to take the necessary and complicated steps needed to suspend CPOE. As the committee has learned of the implications of CPOE suspension, it has become clear that CPOE cannot be suspended safely or expeditiously. An informal poll of committee members has indicated a very high level of agreement that work should focus on providing support for physicians and other users, not CPOE suspension.

    CPOE is fundamentally intertwined with other advanced EHR functionality and suspending its use would significantly impact practice components such as bar-coded medication administration and the electronic MAR. Suspending CPOE jeopardizes the benefits that have been realized by our patients, including enhanced medication safety; reduced antibiotics, medical imaging, laboratory and blood product turn-around times; and a new ability to clearly and legibly share our patients’ information across time and space.

    Last week, the Committee asked that a more detailed plan on supporting physicians and other users be brought back to the committee. Dr. Fyfe presented an overview of the plan to the Committee this week. This plan includes a wide variety of supports, some targeted at all users, and some specific for particular physician departments. A summary of the proposed supports will be provided to the Medical Staff Association Executive who will be circulating the documents to their members for feedback.

    The Island Health Executive and Board have been kept up-to-date on the committee’s deliberations, and agree that CPOE cannot be safely or expeditiously suspended and that additional supports are needed for users. The Executive has indicated that these supports will be adequately resourced and must include measures to improve confidence in the system.

  2. Qualitative Survey Data

    Island Health Research has submitted to the Committee Co-Chairs a summary of the qualitative data received in the recent survey on CPOE suspension. A very brief outline was read at the meeting.

    The summary will be sent to committee members who will discuss at the next meeting how to best share these results with staff and physicians. Expect to hear more after the Committee’s April 6 meeting.

  3. Patient Voices

    Like other Island Health Quality bodies, the NRGH local Quality and Operations Committee includes patient representatives. These Patient Partners presented their perspective last night on continued use of the Electronic Health Record. These perspectives were very appreciated by all members of the Committee and we thank our patient partners for bringing patient voices to the forefront.

    In brief, our patient partners acknowledged the challenges that users have faced, and asked that we continue to find ways to use the potential of the electronic health record to improve care.

  4. Yours Sincerely,

    Damian Lange
    Director, Clinical Operations, NRGH

    Dr. Ben Williams
    Medical Director Oceanside