Welcome to. Our new NI Task Force Chair Crystal Vasquez DNP, MS, MBA, RN, NEA-BC Director, Ambulatory Operations, The University of Chicago

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1 Welcome to The Monthly HIMSS Nursing Informatics Task Force Call A Community of 6,000 NI leaders Your place for news, resources, research and topics Our NI Committee Our new NI Task Force Chair Crystal Vasquez DNP, MS, MBA, RN, NEA-BC Director, Ambulatory Operations, The University of Chicago

2 Get Connected Chapters & Clinical Informatics Engagement Clinical Informatics Insights enewsletter CNO-CNIO Vendor Roundtable Nursing Informatics Executive Engagement Nursing Informatics Awareness OJNI Call for Manuscripts Survey Development & Research Interested in participating? Contact

3 Technology Key to Improving Efficiency and Containing MERS Monday, July 27 th, 2015 John Olmstead, RN, MBA, CNOR, FACHE Director of Surgical & Emergency Services

4 Conflict of Interest John Olmstead, RN, MBA, CNOR, FACHE Has no real or apparent conflicts of interest to report. HIMSS

5 Learning Objectives Analyze Community Hospital s use of technology in response to a potentially deadly virus Outline how the same technology is used to improve safety, efficiency and patient satisfaction Recognize how the same common technology can be used to improve processes in your own facility 5

6 An Introduction to the Benefits Realized for the Value of Health IT 6

7 Who is this guy? Hospital Leadership since 1999 Published 34 articles in various journals Managing Partners: The How-To Manual for Nurse Manager Success published on Amazon.com, 2013 John Olmstead, RN, MBA, CNOR, FACHE Director of Surgical & Emergency Services The Community Hospital Munster, Indiana 7

8 Where the heck is Munster Indiana? 8

9 He works WHERE? Community Hospital, Munster, Indiana: 30 minutes south of downtown Chicago 445 bed hospital performing 14,000 surgical procedures 65,000 ED visits 9

10 April 30 th, 2014 Named Top 50 Hospital by Healthgrades for past 7 years Spring 2014 to-do list Round on units Check in with managers Catch up on Deal with media nightmare 10

11 imersion in Healthcare John, clear your calendar and report to Administration A flu patient SO WHAT What is MERS? Male Nurse? Man Purse? 1 st Middle East Respiratory Syndrome (MERS) patient to be seen in the Western Hemisphere 11

12 MERS Background Viral respiratory illness coronavirus First identified Saudi Arabian patient, June 2012 May 2014: 50% death rate Improved since then to 30%! All cases have resided in or had recent travel to the Arabian Peninsula 12

13 A Phantom Menace Returns? The Spanish Flu Years: ,000,000 dead Roughly 5% of the world s population The Bubonic Plague? Years: ,000,000 dead Roughly 20% of the world s population 13

14 MERS Encounter: Day 1 10am leadership meeting Life as you know it is about to change.. CDC teleconference Given marching orders: FIND OUT WHO WAS EXPOSED to the patient! Staff Other patients Visitors 3pm leadership meeting CDC Go Team en route Discussed where CDC would set up shop and prepare hospital closure 50 employees directly exposed to patient 24+ visitors in Waiting Room Meet with all exposed employees 14

15 MERS Encounter: Day 2 8am Increased awareness throughout the hospital due to counseling sessions with exposed employees Prepare to release all information to the public Prepare for media onslaught due to panic from releasing information to the public 10am 2pm All info leaked to the press CDC/ Indiana Governor s Public Health Briefing televised 4:30pm News Media arrives 15

16 Live from Munster, Indiana 16

17 MERS Encounter: Days 3-4 Multiple national conference calls: CDC Indiana Department of Health Illinois Department of Health Massachusetts Department of Health Innumerable nationwide physician experts Hospital medical & nursing leadership Daily check-ins All exposed employees performed 2x daily check-ins to review symptoms High amount of employee call-offs A nervous public 17

18 MERS Incident Team Day 5: Governor Pence visits! 18

19 Day 5: Governor Pence visits! 19

20 Public Media At this point, it appears that MERS picked the wrong hospital, the wrong state and the wrong country to try to get a foothold. ~ Indiana Health Commissioner William VanNess 20

21 MERS Encounter: Days 6-10 Continued monitoring of the 50 employees Continued conference calls Routine media updates NO new infections Final result: all 50 employees negative for infection 21

22 Luck or skill? How did we control employee panic? How did we control public panic? How did we stop the spread of infection? 22

23 Once upon a time The year is 2009 ED = Fixer Upper 30% staff turnover 20% of payroll was OT Patient Satisfaction = 7 th percentile! Paper charting system Mediocre performance 23

24 Performance Examples Measure Standard CH ED (before) EKG within 10 min 90% 30% Pain tx within 60 min 60 min 180 min Pain rating on all patients 100% 20% Weighing every patient before tx 100% 10% 24

25 The 3 Ps People Patients Processes 25

26 Let s Get To Work! 26

27 People Predictability Policies, evals, schedules HR issues Safety Fill open positions Set and maintain standards Violence in ED 27

28 Safety First! RTLS Badges Original purpose: Panic Button Other handy uses Interacts with the Nurse Call System Reporting feature aids ability to gauge customer service levels 28

29 Safety First! Security cameras to cover all hallways 4 week DVR capability Running date/time tags Security monitors 24/7 ED Manager has easy access to digital camera footage 29

30 Patients Wireless Phones Private phone calls Texting ability One-touch text response capability Battery life = 1 week! Electronic medical record system Transparency allows efficiency 30

31 Patients Nurse Call System Manager reports Improved communication Integrated with wireless phones and RTLS Patient satisfaction HCAHPS success Quiet Environment Pain Control Call Response Allows family to participate in care 31

32 Processes.SUCCESS Measure Standard CH ED (After) EKG within 10 min 90% 95% Pain tx within 60 min 60 min 30 min Pain rating on all patients 100% 100% Weighing every patient before tx 100% 90% Measure Before After Patient Satisfaction 7 th percentile 95 th percentile OT as a % of Payroll 20% 5% Staff Turnover 30%+ 6% 32

33 That was THEN 33

34 Rewind to Day 1 Who was exposed? Staff Other patients Visitors Answers in 45 minutes Location data through Nurse Call System with RTLS Tags Security Cameras EMR 34

35 Comparison of self-reported and RTLS reported visits to patient RTLS-reported total visits ** No ED staff in patient s room for longer than 7 minutes! 35

36 Knowledge = Power = Control Knew who was exposed Knew how long they were exposed Knew who was NOT exposed Waiting Room patients and visitors Other employees Able to confidently communicate this knowledge to the public 36

37 Moral of the Story Worried about: MERS? Ebola? (fill in the blank) How about: Acute Flaccid Myelitis Enterovirus D-68 Resistant Strain TB 37

38 Remember the 3 Ps! People Patients Processes 38

39 So what s next? The Ultimate Greeter s Desk Built-in Positive Pressure air flow Bullet-proof lining Bullet-proof doors & windows Panic button warning 39

40 As long as we re at it Hallway Call Lights Using the RTLS Badge Linked to RN via wireless phones 40

41 Hospital-wide initiatives Hospital Equipment Tracking Potentially to include Patient Throughput Tracking! 41

42 My DREAM Indoor GPS app Included in downloadable hospital app Benefits: Linking patients to hospital for life creating TRUE CUSTOMER LOYALTY! 42

43 A Review of Benefits Realized for the Value of Health IT Patient Measure Before After Pain tx within 60 min 180 min 30 min Pain rating on all patients 20% 100% Patient Satisfaction 7 th percentile 95 th percentile Staff Measure Before After OT as a % of Payroll 20% 5% Staff Turnover 30%+ 6% Treatment Measure Before After EKG within 10 min 30% 95% Pain tx within 60 min 180 min 30 min Pain rating on all patients 20% 100% Weighing every pt before tx 10% 90% 43

44 A Review of Benefits Realized for the Value of Health IT RTLS/Nurse Call Data Provided immediate knowledge of who was exposed to MERS, and for how long Prevented Spread of Contagion Efficiency and real-time data helped prevent the spread of MERS Saved Cost of Hospital Shutdown Every Day Efficiency Savings 44

45 Questions? John Olmstead, RN, MBA, CNOR, FACHE Director of Surgical & Emergency Services Community Hospital, Munster, Indiana 45

46 Save the Date August 3, :00pm CST/1:00pm EST Enhanced Skillsets for Future Nursing Informatics Leaders (Joint Webinar led by AMIA NIWG & HIMSS Nursing Informatics Community) Presented by Judy Murphy RN, FACMI, FHIMSS, FAAN and Willa Fields DNSc, RN, FHIMSS Register: ber=42896 HIMSS16 Las Vegas, NV February 29 March 4, 2016 NI Symposium Monday February 29, 2016