Friday, October 7, 2016

Epic is Now Live Thanks to Everyone’s Hard Work

Early last Saturday morning we flipped the switch and Epic went live. While things are not perfect, Epic is running smoothly and patients now only have one record at GBMC. This has really been a big team effort.

Cindy Ellis, RN, the Epic Project Director shared a few facts with me:

Epic 'at-the-elbow' support--We had 200 Epic team members offering ‘at-the-elbow’ support during go-live;

- Care Everywhere patient data is flowing in over 1,000 patient transactions. Organizations across Maryland and as far away as Texas and Colorado are pulling records as we share information and better coordinate care;

- Our Epic Command Center is open 24/7 and has resolved 48.72% of support tickets.

- A few inpatients are now trialing MyChart Bedside to view health information, message with their medical team and better plan for the day during their hospital stay.

Dave Hynson, GBMC’s Chief Information Officer, told me that he thinks that overall the implementation has gone better than even he anticipated. None of the issues that have come up have surprised him. There have been some issues with system access and printing, but these are things encountered by all hospitals that have implemented Epic. Dave believes that when you look at the grand scheme of things, we are implementing simultaneously more modules than most other hospitals, and we have had tremendous success to date. Dave is pleased with the work of the users, their support, optimism and enthusiasm and how they’ve been patient in working to resolve issues that come along. He points out that the team members from Epic headquarters have been impressed with our problem solving skills and the low amount of frustration among all parties involved.

One of the areas where the rollout has gone very well is in the Emergency Department. Mike Santiago, MD, one of our ED physicians who has been very involved in building, testing and implementing Epic for the ED said that our Emergency Medicine team took this transition very seriously and as a result this monumental change has gone relatively smoothly. Mike points out that behind the smooth transition of the physicians and nurses however, was a lot of not so visible hard work and preparation. There was direct clinical input every step of the way as the GBMC analysts and Epic team customized our ED workflows and orders in the system. Without this direct collaboration we would not be experiencing this initial success. Every one of the providers came to a training class and were encouraged after this class to practice in the “Epic playground” environment to familiarize themselves with the program. They were also encouraged to come in during designated times to work with the Epic masters customizing their order sets, their smart phrases and their other documentation tools. Without the engagement of the providers in this process our transition would have been much more painful. On top of this preparation, providers in the group have eased the transition by coming in on their own time for 2 to 3 hours to decrease the overall department workload and practice their initial documentation on a handful of patients. This provider directed effort has decreased the burden and the stress during go-live. It has been a major factor in the ED’s ability as a department to get up to speed as quickly as they have.

Kimberly Vohrer, RN, the Nurse Manager of Unit 38 said that one of her biggest concerns, prior to go-live, was that the system would be turned on but then crash. Kim is happy that the system has stayed live so that her team could focus on all of the changes that were taking place. Kim points out that over the last few days, what’s been a major help has been the interdepartmental collaboration, with the physicians and pharmacy for example, and basically everyone coming together to tackle any issues that come up. Kim adds that the nurses have been “rolling with the punches” and learning. They’ve also had support ‘at-the-elbows’ which has been very helpful and the fact that various members of leadership, directors and managers, round constantly and are being visible has also been a huge help. All this has really allowed the nurses to focus on taking care of their patient and with their responsibility in completing their documentation.

All of our team at Gilchrist Services should be commended as well for their great work in implementing Epic. Since so many of our Gilchrist patients are in their homes or extended care facilities, this made the task of one patient - one record even more difficult. They have done a marvelous job at getting the system up including in our 3 inpatient units.

Our employed physician offices have done very well, too. They had the added challenge of not having all of the data from their previous electronic record move seamlessly into Epic. I am very grateful for their efforts in making the transition work.

There is clearly more work to be done in the “stabilization” phase and no one denies that the learning curve is steep. We have gotten over the early stress of the implementation and our patients and staff are already beginning to reap the benefits of this wonderful new tool. Stay tuned as we optimize the system over the months and years to come!

National Physician Assistant Week

Please join me in celebrating all GBMC physician assistants (PAs). This week is National PA week (Oct. 6-12) and is a time when we celebrate PAs and their profession and showcase the value they bring to today’s healthcare team.

A physician assistant (PA) is a nationally certified and state-licensed medical professional who first completes a bachelor’s degree and then an intensive three-year PA program with at least 2,000 hours of supervised clinical practice.  They then must pass the Physician Assistant National Certifying Exam (PANCE), which is administered by the National Commission on Certification of Physician Assistants (NCCPA).

The GBMC PA staff practice in many areas from the outpatient offices to the inpatient units in a wide variety of specialties. Please join me in thanking our PAs for their hard work and for their important role in moving GBMC towards our vision.

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