QUALITY IMPROVEMENT INITIATIVES

Project Name: Brattleboro Memorial Hospital Quality Initiative:
The Electronic Medical Record

Time Frame: FY 2007 and ongoing

Aim Statement: Brattleboro Memorial Hospital endeavors to improve outcomes and ensure the quality of care for our patients. It is our goal to provide safe, quality evidence-based care to our patients along the continuum of care. Performance Improvement is a process that assists in identifying opportunities for improvement, developing action plans, implementing these action plans and positively impacting patient care. An opportunity to positively impact patient safety and quality of care is in the implementation of an Electronic Medical Record (EMR). Brattleboro Memorial Hospital’s goal in implementing a comprehensive integrated EMR is to positively impact patient outcomes.

Description: Brattleboro Memorial Hospital formed the Clinical Information Steering Committee (CIS) at the beginning of FY 2007 with the following mandates:

• To oversee the long term development of the BMH Electronic Medical Record.
• To review and prioritize all IS projects with any clinical impact and submit a comprehensive project plan to Senior Staff for approval.
• To oversee the execution of all approved projects to ensure continued progress towards comprehensive electronic medical record.
• To coordinate all communication with vendors.
• To coordinate upgrades or changes to existing software/hardware applications to insure availability of appropriate resources.
• To guide the formation of and progress of task forces convened for implementation projects.
• To act as conduit with Health Information Management in developing the definition of the electronic medical record
• To communicate progress to the Board of Directors, medical staff, senior leadership, and the leadership team @BMH

Interventions:
The following are the accomplishments achieved in FY 2007 towards an integrated, comprehensive electronic medical record at BMH:

• The integration of the pharmacy system with the Hospital Information System: this will assist in the seamless transfer of information between bed-side clinicians and pharmacy
• The implementation of a voice recognition radiology dictation system: this will expedite the availability of a final transcribed radiology report for medical treatment decisions
• The implementation of an electronic patient education software for easy access to evidence-based patient education material
• The acquisition of computer mobile carts and initiation of on-line nursing documentation for Vital Signs, daily nursing assessment and Intake & Output. Physicians trained in access of needed information. Reports developed for easy access by clinicians for quick reference.
• The implementation of electronic medication storage devices initiated: this not only impacts the safe storage of medications but is an important step towards the electronic medication administration record with the integration of electronic review of the medication order at the bed-side.

Evaluation and Next Steps:
Brattleboro Memorial Hospital has developed a three year timeline for the ongoing development and implementation of a comprehensive EMR. Audits are used to evaluate completeness of documentation and communication among the health care team, impact on efficiency of patient flow to include time of transfer between nursing units as well as impact on patient satisfaction scores. Baseline data is being collected to use for analysis and comparison to determine impact of the EMR.

BMH’s overall assessment for the inpatient as reported by our patient satisfaction scores

Q1 FY 2008 90.9%
Q2 FY 2008 91.4%

Contact

Quality Management Department
Brattleboro Memorial Hospital
17 Belmont Avenue
Brattleboro, VT 05301
Mary L. Morgan
VP Quality Patient/Safety
mmorgan@bmhvt.org
802-257-8355 (phone)
802-257-8813 (fax)