I have found this to be true also.  Coming from an ED environment, where 
there is considerably less documentation than in an ICU, we constantly had 
folks staying after the end of their shift to finish their "stack 'o 
charts".  At first (prior to Meditech) overtime was a real issue, then 
when they were told no more overtime for chart completion, we started 
experiencing missing  charting, "hidden" charts, and the like.  While this 
particular crew was leery about documenting on-line, going into it with a 
"you will only document something once, and it will be electronic" made 
things a lot easier.  We really tried to not have folks writing things 
down on paper napkins, only to transcribe it later into the system. Strong 
nursing involvement in the build of the CDS screens and the flow of the 
system to enhance the charting is paramount.  About three weeks after our 
go live, we had a downtime.......and those nurses never looked back after 
that.  They were glad the paper was gone.  Now....the trauma form....that 
was a little more hideous, but after about 4 months of working on it, we 
did come up with an electronic form that was able to be used bedside by a 
scribe (as usually the trauma nurse was too busy!!).  After things settled 
down, the trauma nurse would take over from there on the charting (signing 
on as herself, of course).

Sheral Graham
Senior Consultant
Healthlink, a Division of IBM
IBM Global Business Services
cell: 541-680-3239
[EMAIL PROTECTED]



"Davis Daniel - Southern Hills" <[EMAIL PROTECTED]> 
Sent by: [EMAIL PROTECTED]
11/20/2006 05:44 AM

To
"Mueller, Madge" <[EMAIL PROTECTED]>, <[email protected]>
cc

Subject
RE: [MEDITECH-L] Real Time Documentation






Madge,
It has never been good practice for staff to work all day taking notes and 
then find a magically quiet time near the end of their shift to document 
everything that happened.  But, with the paper chart we have felt that at 
least we could tell anyone who started looking at the chart that 
information not yet documented in it verbally.  Of course, we still could 
have memory lapses and other issues could have impaired our ability to 
document so late.
 
But, now in the computer world, anyone can be looking at the chart from 
anywhere in our facility, or even by dialing in from home.  So, we no 
longer have that safety thing where we could see someone coming to read 
the chart and tell them what we haven’t entered in it yet.  We expect 
staff to do something for the patient and then find a computer and 
document what they did.  You will likely find that those staff who do that 
will not have overtime trying to document.  Characteristically, those 
staff who save up all their documentation for the end of the shift are 
those who stay after their scheduled shift to get their documentation 
finished.
 
Critical care units can be especially resistant to getting into the 
computer because it is nearly impossible to duplicate their tri-fold 
spreadsheets where the transcribe tons of information.  But, with strong 
CNO support and a responsive PCM building efficient screens, you soon have 
CCU staff that would not want to go back to paper – for the most part.
 
Daniel Davis, RN

From: [EMAIL PROTECTED] 
[mailto:[EMAIL PROTECTED] On Behalf Of Mueller, Madge
Sent: Tuesday, November 14, 2006 4:08 PM
To: [email protected]
Subject: [MEDITECH-L] Real Time Documentation
 
Help! 
We are in the process of building our NUR documentation.  We are wireless 
and have mobile computers and our expectation is that the staff will 
document in "real time".  Our User Group feels we are being totally 
unrealistic and that there is no way nurses can document in "real time". 
They also feel that critical care units cannot document on line and should 
stay manual with a flowsheet.  Are we being unrealistic?  Are there any 
sites that actually have their staff documenting in "real time" and 
critical areas documenting on line?  If so, what secrets do you have to 
get staff to accept?
Thanks in advance for any assistance. 
Madge 
Madge Mueller  RN, MSN 
Trihealth Information Systems 
Sr Applications Programmer/Analyst 
(513) 569-6814 
[EMAIL PROTECTED] 

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