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The Catalyst

Labor & Delivery Unit eagerly expecting Epic

Go-live for integrated electronic health record planned for 2014

By Megan Fink
Epic Program

A day in the life of a labor and delivery nurse currently consists of documenting in a mix of electronic and paper charts in four different systems. This data entry into fragmented systems that don’t talk to each other is “painful,” according to labor and delivery/antepartum nurse manager Karen Stephenson, R.N.

Labor and Delivery/Antepartum nurse manager Karen Stephenson and Women Care Services nurse Taiwana Richardson spend some time reviewing their current workflow.
Labor and Delivery/Antepartum nurse manager Karen Stephenson and Women's Care Services nurse Taiwana Richardson spend some time reviewing their current workflow.

Stephenson looks forward to the seamless integration of all her systems into Epic, ultimately having one chart for each patient.

A staff nurse for more than 20 years before entering management, Stephenson has seen the evolution of technology firsthand.

She recalls hand delivered and telephoned orders. There also once was only one computer per nursing station, which was not conducive to bedside charting. Several systems have followed, but the current charting process is still complex and confusing.

“The current system just doesn’t work for us,” said Stephenson. “There are so many logins and software systems to document in that we feel sabotaged by the current process. We can’t possibly touch all the systems in one day as there is always something else to do. Epic has the capability to tighten up the process. We have lots of staff buy in now.”

Benefits of Epic for Women’s Care Services include real-time charting, documentation at the bedside, simplified recording, and better reporting elements translating into improved patient care and safety. Currently, it takes hours for a Labor and Delivery Unit nurse to extract discrete patient data by hand to show metrics such as their decision to incision times, elective delivery rates before 39 weeks, thresholds to pain, and breastfeeding measures.

Seeing the benefits of having an integrated electronic health record, Stephenson and her staff are on the front line gearing up for Epic Enterprise go-live July 1, 2014.

“It’s the ultimate package if populated well, so we have to help build it,” she said. “If you don’t get involved, you can’t complain after the fact. This is the time to make changes, and have the analysts customize the system so things are logical to your area.”

Epic Applications for Women's Services

• “Stork” (Labor and Delivery application)
• “Ambulatory” – (Outpatient care application — already live with Epic)
• “Willow” (Pharmacy application used for antepartum medications)
• “OpTime/Anesthesia” (Operating room application used for C-sections)
• “Cadence” (Scheduling application)
• “Orders” (CPOE application used for physician orders)
• “ClinDoc” (Clinical documentation application)

Assisting the Epic analysts who are putting the finishing touches on the Labor and Delivery Unit application for Enterprise go-live, Stephenson’s team is working hard on the front end so it pays off for them on the backend. They are sharing their input on workflows affecting their areas to make sure each line item flows into Epic as it should, they are participating in clinical preparedness committees and becoming “SuperUsers” or advanced users of Epic.

In addition to participation, Stephenson is regularly communicating to ensure a successful project implementation for her units. She encourages communication in every direction, on every level. Some tactics Stephenson uses to keep her staff informed on Epic news include regular staff meetings, emails and a newsletter-like document pushed out to staff on a consistent basis.

“We need to see messages multiple times for it to be effective,” Stephenson said. “We need to touch it several times before it’s absorbed.”

There is still time for all departments, divisions and units to get involved and ready for Epic. The Epic Enterprise Program encourages all employees and future system users to become engaged, go to supervisors with questions and join a SuperUser program.

For information, visit the Epic intranet site at Click on Training Resources on the left menu bar and select SuperUser Program from the same menu area. There you’ll find what’s expected and a tool box for SuperUsers.

August 7, 2013

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