1 GE Healthcare Centricity Enterprise Nursing Workflow Tools The system that supports a critical piece of patient care your nurses. Nurses are the cornerstone of patient care delivery. Their work spans the entire continuum of care, and requires interaction with every member of the care team. Supporting this complex workflow means giving nurses the tools they need to work more efficiently and collaborate more effectively helping them to meet the increasing demands for more cost-effective, safe and high-quality care. With its rich tradition of streamlining interdisciplinary workflow, Centricity Enterprise can help your organization enhance both staff and patient satisfaction. And by ensuring that all care providers have fingertip access to the most comprehensive and up-to-date patient information, the system can help you deliver the best possible care, with significantly less time devoted to administrative tasks.
2 Organize workflow A nurse s typical day involves balancing competing priorities and making sure the right patient gets the right care at the right time. Centricity Enterprise gives nurses the tools to quickly review the status of multiple patients and upcoming tasks, prioritize what needs to be done, and coordinate with other members of the care team. Clinician Homebase Centricity Enterprise Clinician Homebase provides a high-level, workflow-based view of multiple patients in an integrated display, enabling clinicians to focus on key elements of care, outstanding tasks, and exception indicators. Views can be tailored to show the most relevant information based on the user s role, and can be customized by individual users to highlight items such as new information or tasks that need immediate attention. Clinicians can prioritize and organize activities for individual patients or groups of patients, whether in an inpatient or ambulatory specialty environment. By providing instant access to critical patient information such as stat orders, medications due or overdue, and changing patient parameters Clinician Homebase supports the efficient and safe delivery of high-quality care. It is tightly integrated with other Centricity Enterprise modules, to maintain a single longitudinal patient record. Reduce administrative time Any nurse will say that taking care of patients not documentation is the reason they entered the profession. Yet nurses spend as much as 30 percent of each shift on charting and other administrative tasks. Streamlining these activities can translate directly into more time spent on direct patient care. In an era of nursing shortages, the benefits of electronic clinical systems extend to enhanced job satisfaction and better rates of nurse recruitment and retention. Charting care tasks and interventions Centricity Enterprise uses worklists to minimize the time required to document the activities performed for a patient. The worklist can be prepopulated with tasks, such as patient-care orders, nursing interventions, vital signs, intake and output, assessments and patient goals. Worklists can also be set to display the tasks for all of the clinicians, or can be tailored to display tasks relevant to particular roles such as nurse or nurse s aide. Individual clinicians can filter the task list to show only their assigned services for a specified period of time. Charting against an item on the worklist initiates assessment documentation as well. The documentation becomes part of the longitudinal patient records and can be viewed by different members of the care team in whatever format is most convenient for them. To help clinicians focus on outstanding items, the worklist can be set to remove items from the list once they are completed. Additionally, clinicians may create follow-up assessment tasks to remind them to return and reassess the patient s response to administered therapies.
3 Assessments Centricity Enterprise supports two methods of entering nursing and allied health professional assessments: Clinician Assessments and Noting (CAN), and Flowsheet Charting. Clinician Assessment and Noting CAN uses template-driven workflow in nursing-specific configurations to streamline the documentation process, while ensuring complete and accurate patient assessments. Templates are built around the guidelines and best practices of the institution, but the system is flexible enough to also allow ad-hoc assessment at any time. Clinician Assessment and Noting supports both structured data entry and free text, as well as the ability to bring patient data in from other parts of the Centricity Enterprise system. Assessment notes are generated as a by-product of capturing clinical data. Free-text sections can also be added. Clinicians can complete the documentation in any order that is convenient for them such as pausing documentation to enter orders or review results before completing the note. Incomplete notes can be placed on hold for future completion. To support complete and thorough documentation, CAN tracks which assessment categories have been addressed and reminds the clinician of any outstanding assessment areas, assisting in the elimination of incomplete, inconsistent, or inadequate documentation. Flowsheet Charting The Centricity Enterprise Flowsheet Charting application creates the electronic equivalent of the paper flowsheet commonly found in patient charts. Because caregiver worklists and flowsheets are integrated, clinicians can chart information, such as vital signs, intake and output, and assessments directly from the worklist charting screens, and automatically calculate values, such as body surface area, weight changes, Glasgow coma scale, gestation weeks, or pediatric height and weight percentiles. Interdisciplinary charting allows clinicians to quickly enter assessment information while reviewing previous findings. Flowsheet charting supports full head-to-toe assessments as well as charting by exception. Pop-up screens allow multiple findings to be entered on the same screen, such as a full Braden Skin Assessment. Additional timesaving features include the ability for the clinician to navigate through multiple assessment screens from toolbar buttons for quick access to the assessment types. After five years of using our clinical information system, most of our nurses would have a hard time going back to the old way of doing things. We are living proof that organizations can simplify documentation and streamline care processes, so nurses can spend more of their time doing what they enjoy caring for patients. Kim Williams, R.N., Director of Special Projects, PeaceHealth, Bellevue, WA
4 Enhance quality of care and patient safety Centricity Enterprise can help nurses improve the quality of care they deliver by improving communication among caregivers, providing access to best-practice guidelines, and creating checks and balances that prevent common errors. Patient Summary Patient-centered care delivery in either the inpatient or ambulatory setting starts with a high-level overview of data to enhance understanding of each patient s condition. From there, Centricity Enterprise Patient Summary helps facilitate the transition of nursing staff at the end of a shift, and provides a useful summary for the primary care physician to review at the post-discharge follow-up visit. Patient Summary Patient Summary s encounter-driven review screen displays problems, allergies, findings, patient-care team information, orders, interventions, goals and other information to help nurses quickly understand each patient and organize the day s tasks. Vital signs, assessments, and lab results are updated on the screen as new data is entered in the system. Users can filter the way findings and orders are displayed. The screen also contains a free-text note entry box that can be used as a message board by clinicians to share interdisciplinary notes and comments. Enterprise Order Management Orders comprise the links that unite individual providers into a care-giving team. Enhanced interdisciplinary communication fosters the delivery of coordinated, efficient, best-quality patient care. Enterprise Order Management integrates ordering workflows across the healthcare continuum, from inpatient to ambulatory. Automate order entry, streamline workflow by reducing repetitive and time-consuming tasks, and customize entries by users to reflect their own ordering preferences. When orders are entered, the appropriate care activities are automatically added to each provider s worklist. This robust and extensible ordering system supports all types of orders including Computerized Provider Order Entry (CPOE) and nursing orders across all care settings. Nurses can plan patient care, place orders under their own authority, use and maintain order sets, and manage the timing and performance of their work. In addition, Enterprise Order Management supports advanced-practice nurses by allowing them to directly place orders that are within their scope of practice. Once an order is entered, it must be transmitted to the clinician responsible for carrying it out who then must read it, accurately interpret it, and act on it. Any gaps or ambiguities can cause delays or errors that can harm the patient. The tight integration of orders in Centricity Enterprise allows prescriptions and orders to flow seamlessly across the transition points of care, providing checks and balances that preserve the five rights of medication administration and ensure accuracy at every step of the way. Clinical decision support can alert nurses when new orders are ready to be carried out, and can also notify users as orders go through each stage of signature or verification.
5 Bar Code Medication Administration Centricity Enterprise offers integrated functionality that can help prevent errors at all stages of the medication cycle. CPOE has been broadly recognized as a critical tool for preventing medication errors associated with prescribing and transcription. Integrated pharmacy systems help prevent errors in dispensing. Bar Code Medication Administration (BCMA) provides further safeguards at the end of the medication cycle by confirming that the right dose of the right drug is being given to the right patient via the right route at the right time. If there are any discrepancies, Centricity Enterprise alerts the nurse before the medication is administered. BCMA facilitates the identification of other potential sources of error such as mispronounced or misspelled prescriptions, drug allergies, drug conflicts, partial/multiple dose errors, or duplicate orders. Scanning the unique bar code on a unit dose of medication enables clinical staff to verify dosage and expiration date. Scanning the patient s bar-coded wristband confirms patient identification and any known allergies to the medication. Medication administration is automatically charted in the system, ensuring timely and correct documentation and automatic charge capture; clinicians can supplement the entry with notes about the site or other comments as necessary. For time and patient management, the system uses icons to show which medications are overdue and what IV solutions are currently being infused. It also tracks medications that are administered too early or too late, and notes near-miss avoided errors. Medication Reconciliation Patients may be taking a variety of medications before they arrive at the hospital or they may have been prescribed a drug but are not taking it as prescribed. Outpatient medications may need to be continued in the hospital, or may conflict with medications ordered on admission. Medication Reconciliation enables nurses and pharmacists to document on admission what the patient reports he or she is taking, while viewing a record of outpatient prescriptions and charting any discrepancies (e.g., patient is taking medication only twice a day instead of three times a day) in the patient s profile. This ensures that the physician or nurse practitioner has a correct, up-to-date medication list for inpatient medication-order entry, and can appropriately continue current medications or generate new prescriptions on discharge.
6 Care Planning and Interdisciplinary Critical Pathways Care Planning supports pre-defined standards of care, while taking patient variability into consideration. This tool allows clinical users to identify a patient problem, and quickly see the appropriate care plan recommended for that problem. Users can easily select a plan from the list and apply it to the patient, or develop a plan from scratch. Care Planning is integrated into care documentation, allowing clinicians to chart progress toward patient goals, document interventions and capture variances. Once the care plan is applied, users can view it separately or in conjunction with other orders for that patient. Organizations can build and maintain Interdisciplinary Critical Pathways (including phases, orders, and goals) founded on evidence-based best practices to support the delivery of high-quality patient care by promoting consistency and decreasing variation in care delivery. The pathways foster the interdisciplinary care-services approach that is increasingly mandated by regulators, standards organizations and healthcare practitioners. Interdisciplinary Critical Pathways integrate clinical data (charted data, status of care goals, medication follow-up and assessment) with one-time charting actions. Clinicians view pathway goal actions within their respective worklists, and chart their goal results (met or unmet) directly from the worklist. If a goal is met, the action status is changed to complete, and is removed from the worklist. If a goal is unmet, clinicians are alerted via a user-defined pop-up screen that offers options for how to handle the variance. The interdisciplinary problem list is integrated into Care Planning and provides information about the medical, social and health conditions affecting a patient's health status. The system allows organizations to automate the documentation process, better anticipate patient care with more comprehensive patient data, and avoid delayed delivery of patient care caused by repetitious paperwork and lack of communication. Manage information GE Healthcare was one of the first software vendors in the industry to provide a patient-centered, lifetime medical record spanning the entire continuum of care. The Centricity Enterprise Clinical Data Repository is designed to support a lifetime patient record by collecting and maintaining information from multiple encounters and sources. The patient-centered repository provides a longitudinal view that includes patient activities, encounters, results, reports, histories and assessments. Providers can access comprehensive current and historical patient data when and where they need it. The relational database makes it simple for any member of the clinical team to quickly access critical patient information with the goal to help improve productivity and patient safety. Clinical results Time is of utmost importance in healthcare, and Centricity Enterprise Clinical Data Repository ensures that providers have immediate access to essential, current information. Results are maintained as part of a patient's lifetime electronic medical record, enabling providers to track patient progress over the short term, while building a comprehensive, cross-continuum long-term record. Document Display
7 Document Display Document Display provides flexible views of the entire patient chart, regardless of where or how it was captured. Clinicians can view a list of services along with the corresponding narrative, or can filter the list to display: Provider progress notes Transcriptions Radiology results Cardiology results Laboratory results Micro results Nurses notes Nursing assessments Incidental encounters Telephone encounters and more Document Display provides links to externally stored images, such as radiology or scanned images from other GE Healthcare core systems, or systems from other vendors. Clicking on one of these links launches a Web viewer which overlays the Document Display screen, maintaining document context for the image. Security provisions ensure that users are able to view only the image they initially selected from within Centricity Enterprise, and not any other images on the external system. Document Display is tightly coupled with the Inbox, so users reviewing results from the core clinical areas can also sign, acknowledge or forward the results following their review. This functionality streamlines workflow by providing a single point of access and documentation to relevant patient information and key authorizations. Clinical Flowchart Viewer Clinicians can use the Clinical Flowchart Viewer module to aggregate a variety of results for an individual patient from different clinical categories such as lab results and administered medications in a single table or graph. Robust graphing capabilities, flexible medication display, and filtering controls enable clinicians to sort by findings, laboratory results, charted actions, and observations. Clinicians can define different default views for inpatients and outpatients, select which data to display such as administered medication comments, most recent results, or reference ranges and filter results by whether they are final or preliminary. With all this information aggregated in one easy-to-read view, Clinical Flowchart Viewer greatly reduces the amount of time required at shift change to communicate patients status. Summary With Centricity Enterprise, nurses and allied health professionals have the tools they need to document, share, manage, and apply patient information, so they can provide safer and better care. By organizing patient lists for more efficient workflow, reducing time spent on documentation, providing checks and balances to help prevent errors, and fostering interdisciplinary collaboration across the entire care team Centricity Enterprise can help clinicians deliver the best possible care the first time, every time.
8 2008 General Electric Company All rights reserved. General Electric Company reserves the right to make changes in specifications and features shown herein, or discontinue the product described at any time without notice or obligation. This does not constitute a representation or warranty or documentation regarding the product or service featured. GE, the GE Monogram and Centricity are trademarks or registered trademarks of General Electric Company. General Electric Company, by and through its GE Healthcare division. Healthcare Re-imagined GE is dedicated to helping you transform healthcare delivery by driving critical breakthroughs in biology and technology. Our expertise in medical imaging and information technologies, medical diagnostics, patient monitoring systems, drug discovery, and biopharmaceutical manufacturing technologies is enabling healthcare professionals around the world to discover new ways to predict, diagnose and treat disease earlier. We call this model of care Early Health. The goal: to help clinicians detect disease earlier, access more information and intervene earlier with more targeted treatments, so they can help their patients live their lives to the fullest. Re-think, Re-discover, Re-invent, Re-imagine. GE Healthcare Integrated IT Solutions 540 West Northwest Highway Barrington, IL U.S.A. imagination at work ITE EN-US
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