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Moving to Electronic Systems. Implementing Iatrics PDI for Medication Reconciliation. Veronica Breadner RN Marie Descent BSc.Phm., RPh. Our Hospitals.

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moving to electronic systems

Moving to Electronic Systems

Implementing Iatrics PDI for Medication Reconciliation

Veronica Breadner RN

Marie Descent BSc.Phm., RPh.

our hospitals
Our Hospitals
  • Halton Healthcare Services (HHS) is comprised of 3 acute care community hospitals - Oakville-Trafalgar Memorial, Milton District and Georgetown Hospital
    • 420 beds (314 acute/67 CCC/39 Rehab)
    • 34,401 surgical procedures
    • 20,519 admissions
    • 157,793 Ambulatory visits
    • 3,519 Deliveries
    • 128,873 ED visits
    • 3000 staff
    • 325 physicians
paper vs electronic
Paper vs Electronic
  • Standardized process across organization
    • Patient D/C Instructions
    • Electronic documentation
  • Promote enhanced utilization of electronic record system
  • Enhancement of Med history in EMR across continuum of care
  • Increased efficiency of data collection methods and auditing ability
  • Med history easily updated
  • Improved legibility
  • Utilize existing pharmacy dictionary
criteria for software evaluation
Criteria for Software Evaluation
  • Screen Appearance
  • Ease of use and access
  • Implementation time
  • Ongoing support & consultation
  • Training materials
  • Cost
  • Extent of experience
  • Standardized drug names
  • D/C Prescription
  • Standardized discharge instructions
why iatrics
Why Iatrics
  • Met more of evaluation criteria than other two vendors
  • Physicians could use the tool in place of CPOE
  • Generates order sets and DC Rx
  • Partnered with Micromedex – we were already familiar with.
  • Utilizes Meditech programming – HCIS platform – simplify report writing and dictionary build
  • Design screens familiar to staff
  • Lower cost alternative
  • Opportunity for Discharge Instructions
training and support
Training and Support
  • eLearning
  • Hands on training
  • MedRec Champion training
  • Go-Live support for 2 weeks/unit
    • Ongoing pager support
  • Huddles
  • MedRec Resource Binder
  • Biweekly Newsletter/Updates
implementation
Implementation
  • Pilot Areas:
    • Pre-Admission Clinic
    • Surgical unit
    • Renal Medicine Unit
  • Software Installs handled by Tech team
  • Testing
  • Go-Live with Admission, then month later Transfer and 2 weeks after that Discharge
    • Form issues – completed by vendor
  • Team available days/evenings for end-user support
    • PDSA Improvement Cycles
forms
Forms
  • Admission
  • Pre-Admission
  • Transfer
  • Discharge Rx
  • Patient Discharge Instructions
  • Patient Discharge Instructions for LTC
  • Patient Recorded Home Medications
lessons learned
Lessons Learned
  • Corporate support and communication
  • Use of Champions is key
  • Early engagement of pilot units
  • Increased communication with Physician groups
  • Differentiate between personal preferences and global needs
  • Impact on other departments
  • Contracts with Unit Managers
  • Never under-estimate impact of change process on affected units/departments
future roll out
Future roll-out
  • Project plan to roll out to remaining OTMH inpatient units by December 2010
  • Big Bang rollouts at Georgetown and Milton sites
  • Consider concurrent rollout in identified Outpatient units
future challenges
Future Challenges
  • Maintain momentum
  • Raise profile corporately
thank you
Thank You
  • vbreadner@haltonhealthcare.on.ca
  • mdescent@haltonhealthcare.on.ca