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GETTING STAFF TO USE TECHNOLOGY

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GETTING STAFF TO USE TECHNOLOGY

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    1. GETTING STAFF TO USE TECHNOLOGY Liisa Ortegon, CNO Horizon Medical Center

    2. Why? Why? Why? “How is this going to help me do my job better?” “Why is this necessary?” “I didn’t go to school to become a computer genius!” “I guess this keeps somebody employed!” “Just when I thought I had myself organized, they come up with something new!”

    3. WHY e-MAR? Leapfrog JCAHO NQF CMS IOM Public Reporting Management of Risk PATIENT SAFETY Staffing Issues Aging Population Customer Expectations Interdisciplinary Communication Checks and Balances

    4. HOW TO GET THE STAFF ON BOARD? Keep the team engaged. Be patient as many do not adapt to change readily Communication…e-MAR benefits vs. expectations Focus on patient knowledge and patient safety Ongoing involvement of core team Keep the team focused on Patient Safety as a priority goal

    5. ESSENTIAL CORE TEAM MEMBERS Pharmacy Nursing IT&S Respiratory Therapy Educators - “Super Users” Executive Leadership

    6. “Get it Right” Equipment Analysis Pilot FIRST!!!! Communication Training/Education Troubleshooting Plan Competency Ongoing unit based resources

    7. CHANGE ISN’T ALWAYS EASY “What do you mean I still have to do the five rights?” “I shouldn’t have to verify the order, pharmacy does when they enter it.” “I thought this was suppose to speed up medication administration.” “I’ll fix them. I will bypass the system all together. They won’t know.”

    8. GUESS WHO CAME TO VISIT? “What?! A non-punitive culture can have accountability???” “Are you crazy…the staff will leave!!!” “Are you sure you want to go there? Nobody ever has!” Admin team supportive of CNO plan.

    9. WHAT HAPPENED NEXT??? Staff Meetings PATIENT SAFETY STRESSED Expectations clearly communicated again Non-compliance outcomes discussed Accountability Mandatory Education Completed Policy Reviewed Director Sign Off on Competency Steering Committee

    10. SUCCESS…OWNERSHIP… REALLY!!! STATS improved within one week of implementing accountability plan. No punitive measures were required to date. Turnover rate at Horizon is the lowest in the division! Satisfaction scores improved!!!

    11. Novice Staff Rely on e-MAR! Pt. history - allergies etc… Lab link Reminder to document BP/HR/Pain Scale Portable carts at bedside can be used for immediate staff/pt education Checks and balances Look alike sound alike drugs… Unusual doses flagged Realistic expectations

    12. $$$ RISK INCENTIVE $$$ After Horizon’s impressive improvement, HCI communicated a $$$ incentive for facilities achieving high level scanning practices. Horizon openly assisted other facilities by sharing information as, the primary goal was PATIENT SAFETY not the $$$. Although the $$$ were an incentive for some to shift focus to e-MAR practices, the stats continue to reveal scanning has become a routine. Staff received praise from higher levels, even outside the facility. The staff are so proud of their success and want to continue to exceed expectations.

    13. REQUIREMENTS FOR e-MAR SUCCESS Senior Leadership Actively Involved Staff committed to patient safety Ongoing Communication Education Steering Committee Ongoing Evaluation of processes/reports

    14. HORIZON A YEAR LATER… Statistics continue to improve and remain in the 90’s! Turnover lowest ever! Staff continue to monitor process and compliance. 2005 Quarterly and Annual Award…staff are not aware of this yet!!! JCAHO ACCREDITED 2004 Successfully completed 3 state surveys without any recommendations!!!

    15. CREAT A CULTURE WHERE PATIENT SAFETY IS NEVER ENDING!!! Take ownership to lead your facility to success! BE INVOLVED NOT JUST INFORMED!!! Commitment must be ongoing. Any measures to reduce harm to patients must be supported! Remember, Staff do not come to work to intentionally make medication errors. Assess causes of errors. Team approach/review. Support a “Just Culture.” Look at processes…

    16. IT WAS WORTH IT!!! Per a recent communication from corporate quality, 119,000 medication errors could have occurred if e-MAR was not actively in use within 130 HCA facilities. Would you choose a facility for healthcare without this technology? Everyone has choices of where to seek healthcare.

    17. QUESTIONS/COMMENTS

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