Aims: We intended to describe the current utilisation of IT in broad terms across NSW health, with the intention of identifying what is working and

Transcription

1 Aims: We intended to describe the current utilisation of IT in broad terms across NSW health, with the intention of identifying what is working and what is not from the viewpoint of the Junior Medical Officer (JMO). Furthermore, we set out to identify some "success stories", with an analysis of the factors leading to their sucess and how barriers to change were overcome.

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7 Methods: The IT working group of the JMO forum was each assigned two area health services to obtain information from in the form of a semi structured survey. This information was then pooled and evaluated in a qualitative nature through a round table discussion.

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11 NSW Health s Acute Care taskforce set up the JMO Clinical handover project to trial a variety of handover options and see which best met th eobections and key elements of successful handover set out in NSW policy.

12 FINDINGS Actue care Taskforce found that for JMOs elements successful handover included:

13 The electronic format is ammenible to meeting several of the the key principles set out in policy AND the JMO requiremenst for handover

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15 Accessible by clicking the Ad Hoc button on powerchart. Use usual log in, so same as accessing information on the ward BENEFIT, do not waste clicks by needing to open multiple systems, log in multiple times Everyone familiar with this software, and so can add to the list Easy to find on the computer BUT IN TRANSITION doubling up of e systems

16 Accessible by icon on computer desktop: Easy to find Requires time to log in MedCom Capabilities: Ward by ward organisation Flag sick patients Timed tasks Tick off jobs when done TALK ONLY ABOUT WAND: nurse/nurse system Electronic pro forma to update information for each patient on their ward during their shift. Exists electronically but in practice it is used both electronically AND printed out and amended by hand Available on all computers Available to all nursing staff to log in and update

17 Doctors have access but don t use / don t think it is useful 16

18 Case Study: JMO experience in a Network 12 hospital Official handover requirement: verbal MON is accessible via??/ INTRANET MON is inconsistently used for handover to overtime staff, and to flag sick patients More commonly MON is used to prioritise ward jobs by overtime staff Nurses enter ward jobs Doctors can prioritise jobs on the list tick off electronically when job is completed HANDOVER has to be done verbally this is officially how handover is done in Network 12 MON has the CAPACITY to be used specifically for e handover, but in practice it is not used this way MON is actually used as a tool for overtime staff to manage their workload and view all of their wards simultaneously (let the fingers do the walking). In this capacity it: Minimises interruption of tasks (eg. By page) May allow faster response to calls for sick patients Allows overtime staff to split work fairly if one rostered shift is quiet and another busy.

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25 Briefly discuss reasons for mistrust

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28 Information management (houses projects, runs the new projects or existing projects, developing time lines objectives etc) IT operations (deals with the servers) Knowledge development (designs and improves interface and helps integrate different systems) Client services (customer relations, manages intake for new projects) This would be the department that would be consulted regarding creating an new project. Projects need to be registered as part of a strategy plan Business (manages how to actually get a new computer in a department etc)

29 Each district has its own CIO Each hospital has desktop support Our group met with CIO and member of the Strategy and architecture department

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46 different capabilities of power chart in different networks. For example certain networks are able to flag patients for an 'online handover' on power chart. Apparently they are still upgrading networks with EMR 2. They've been rolling out the new version of EMR slowly over all the networks (they can't release it all at the same time as there isn't enough infrastructure/staffing). EMR 2 has increased features such as the online handover. Perhaps we could briefly discuss the new designs of EMR 2 in an effort to encourge more networks to utilise all the new features (when networks get them). Some of the other features of EMR 2 are including electronic notes in other clinical areas such as: ECHO, renal and cardiology as well as electronic endoscopy reprots and electronic ICU notes. I think I recall Blacktown or Westmead has electronic notes for renal department. Perhaps we could talk about the benefits? Another objective of IT services is to develop an online medications management system. This will paralell the development and roll out of EMR 2 but is still in the development process. Community Health care program is a new system that they are aiming to develop soon. It will include the online notes for mental health and child and family services as OUTPATIENTs. For anyone who has had to chase GPs and mental health for information on patients this will save a lot of time.

47 Met with CIO for Northern Sydney Health Area

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