We have not had any of these issues with EDM, our staff really like it, both Nursing and Medical Staff.
I can relate to your issues with the core team building EDM, we had a smaller team than you mentioned. In reality 3-4 people did all the work, with the Nursing Educator (Rose) and myself doing the majority of the building. Now the ED nursing director and her assistant were on the team, but their understanding of Meditech, the process for building dictionaries,cds's, reports, etc were non-existent. They did bring with them their knowledge of ED and what they wanted out of the system (it didn't hurt that I was an ER nurse for 12 yrs before moving to IS). I have installed other ED systems and none of them I like as much as EDM. When we trained 100% of the ED staff before GO-LIVE, any concerns or issues we brought to the ED Director/Assistant Director and if they wanted these changes we did them, if not we did not. No requests that were valid and needed were turned down... Now we are not documenting meds on-line yet, we are just going LIVE with writing scripts in EDM/RXM. We do full documentation (from day 1), discharge instructions with Meditech's PIC, the physicians assign themselves to their patients (we have double coverage in ER and a PA/NP in Fast Track), also for any ER admits, the doctors enter their bed requests on-line, and of course they use PCI and EPS for chart/results review. Were you documenting allergies and home meds in RXM Historical Meds or in EDM queries? If the allergies were in RXM and your staff could verify them (code them) or if PHA coded them, the drugs would go thru allergy checking (I think....). Our doctors use T system forms also, the paper form, but or ER Medical Director is willing to try the on-line documentation (and even anxious to try it). It will not be perfect (nothing is), but he knows that just like with nursing in EDM, any issues that come up, I can usually figure out a way to resolve them. When we take a drug/med out of the dispensing machine, we document that med administration on the er encounter record next to the written order. Now when we do POE/POM in the ED, we will document on-line (EMAR). The meds we take of the the machine show up now in our EDM records in EPS/Daily Review and in BAR reports for charges, in custom EDM reports that list meds. We have not had these complaints of med errors. Again we are not ordering meds in Meditech in EDM or inhouse.... I do not see any reason not to go forward with EDM...It would help to have more staff input (from the ER staff). Good Luck, let me know if you need anything, I will be happy to help you. ________________________________ From: [email protected] [mailto:[EMAIL PROTECTED] On Behalf Of Cindy Snyder Sent: Friday, February 23, 2007 10:00 AM To: Romona E. CS/Smith; Jackie Welch; Deborah Pelaia; [email protected]; Glenn A Gregersen; _SISU - Clinical Systems Users Group Subject: [MEDITECH-L] RE: EDM Rallying the troops! Hello Everyone: I wish you all the luck, with all sincerity.....Our system is down....The nursing staff was so disgruntled and blamed it for medication errors that Administration chose to suspend use until we get things resolved.... Now, let me explain some of our issues and just for good measure, my opinions.... : ) We had an implementation team with only one staff nurse, the ED director, myself (clinical analyst) another clinical analyst, two pharmacists and two unit secretaries. So, nearly all the building and decisions on what was to be answered by the nursing staff was decided by the director of the ED, which is good from a policy change and compliance with the change perspective. The draw back to this is that the nursing staff did not like a great deal of what was done and tried to go in the 'back door' to myself or the other analyst to have things changed. So, we always ask if they asked Mom first when they make a request of us. At the point the system was taken down, we were LIVE with the tracker, care area staff documentation, and POM was being used by the nurses/secretaries. The physicians were not using the system for anything other than to view the tracker. We have had some issues with the MAR, due in part to the fact that we have chosen to do a 'phased implementation'. At this point, the nursing staff removes a drug from Pyxis, which generates an order that populates the MAR. So, no allergy checking is done when medications are ordered. We have had ongoing issues with allergy checking in the PHA module and of course those have carried over to the EDM module now. For instance, to check for any Codeine allergy, it is necessary for the staff to enter an ingredient allergy, and a drug allergy. So, we want to get this resolved prior to taking them LIVE again. Do I think it's a good system? Yes. Do I think we will get it back up? Yes. Will it be acceptable to everyone? Eventually. But those old ER nurses (yes, I am one of them) like things their own way and do NOT like change, because they feel they are out of their comfort zone. I am happy to talk more if you would like. Have a great day and best of luck. Cindy How am I doing? Please take a minute to fill out this survey to let us know. Thank you. http://www.hrhs.int/survey/MIS_Survey.htm Cindy Snyder RN Clinical Systems Analyst Howard Regional Health System Kokomo, IN 46901 (765) 453-8321 The opinions expressed in this e-mail message are those of the author and may not be representative of Howard Regional Health System or affiliates. This e-mail message and attachments, if any, may contain confidential or privileged information. If you are not the addressee or authorized to receive this message for the addressee, you must not use, copy, disclose, or take any action based on this message, any attachments to this message, or any information herein. If you have received this message in error, please advise the sender immediately by reply e-mail and delete this message in its entirety. >>> "Pelaia, Deborah" <[EMAIL PROTECTED]> 2/3/2007 8:23 AM >>> Agree 100%. Our physicians currently document on the paper version of the T-system. Family physicians have actually complained stating the documentation the ED physicians do on paper means nothing to them. They cannot figure out what happened with the patient while in the ED. We are currently using the tracker through EDM.we are doing a site visit this week to look at Mount Nittany's EDM nursing documentation. Hoping I get buy-in from ED nursing staff. Deb Pelaia, RN Clinical Informatics Analyst Hanover Hospital Hanover, Pa. (717)633-8887 -----Original Message----- From: Jackie Welch [mailto:[EMAIL PROTECTED] Sent: Friday, February 02, 2007 9:12 AM To: Gregersen, Glenn A; CS/Smith, Romona E.; _SISU - Clinical Systems Users Group; [email protected] Subject: RE: EDM Rallying the troops! Oh, they all love the T. You can build your T templates into Meditech, not really that difficult as I see it. We've used the paper T for a long time and I personally see that the documentation done by these ER docs is horrendous. We've been live with EDM for over two years now, they really like what they have so far, including ePrescribing. But, the culture change to get the docs to enter their orders and documentation is going to have to be pushed by more than me. I see us probably another year or so before we take on that battle, make them the first docs to go live after implementation of PCM. - Jackie Great River -----Original Message----- From: Gregersen, Glenn A [mailto:[EMAIL PROTECTED] Sent: Thursday, February 01, 2007 6:35 PM To: CS/Smith, Romona E.; _SISU - Clinical Systems Users Group; [email protected] Subject: RE: EDM Rallying the troops! Please post as we are also fighting this battle - ER docs wanted T sheets... ________________________________ From: Romona E. Smith [mailto:[EMAIL PROTECTED] Sent: Thursday, February 01, 2007 3:32 PM To: _SISU - Clinical Systems Users Group; [email protected] Subject: EDM Rallying the troops! We are just beginning EDM implementation (CS 5.5 SR2). I am looking for creative ways to encourage and interest the ED staff in this project. You know they love their paper charts! I plan to make monthly flyers to keep them updated on the progress of the Core Team. PCS is used house wide but the ED nurses have never documented in Meditech nor do they look at the EMR. I thought of having a drawing for the staff members that document set assessments on a TEST pt that I set up. This would at least get them looking at the system. I'm hoping you all have more creative thoughts than I - any suggestions? Romona E. Smith, RN Clinical Analyst Anderson Hospital Maryville, IL 62062 618-288-5711 ext. 278 [EMAIL PROTECTED] CONFIDENTIALITY NOTICE: This e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipients named above. If you are not the intended recipient, you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited. If you have received this communication in error, please respond immediately by returning this e-mail to the sender and destroying all copies of this communication including any attachments. ********************************************************************** This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. 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