Want to save $60,000? Try electronic system

Document nurse charts, triage notes, orders

By switching to electronic nurse charting, triage notes, and orders, the ED at Mary Washington Hospital in Fredericksburg, VA, saved $60,000 in a single year, according to Rosemary Brindle, RN, MSN, TNCC, director of emergency care services.

"This is due to the multiform paper charts and order sheets that we no longer need now that we are 100% computerized," she says.

The ED will see almost 90,000 patients this year, and the typical paper cost per visit is 75 cents, says Brindle. When the information system [Amelior ED] was implemented a year ago, a team of ED nurses worked to train other nurses, she reports.

"We identified superusers’ who helped with peer-to-peer training and were primary contacts," Brindle says. "Nurses built basic proficiency within a couple of shifts."

Nursing documentation is more consistent because of the prompt-based format of completing a chart, she notes. "I have also found that an electronic chart record significantly streamlines chart review as there is no longer the usual hunt for the chart, which is cumbersome in an ED that can see up to 300 patients a day," she says.

Physician charting also is streamlined, since redundant documentation steps are eliminated. "Our physicians can import a triage nurse’s notes into their chart in two mouse-clicks and can make subsequent changes without impacting the original triage notes," she says.

Often, physicians can find the information that they are seeking quickly and less often need to ask the nurse directly, adds Brindle.

There are communication checks and balances, such as physicians having to sign off on verbal orders before discharging the patient, she notes. "This protects both the physician and the nurse involved, while ensuring safety for the patient," Brindle says.

With charting, orders, and results information between the ED and the ancillary departments automatically updated on the electronic patient tracking board, it is much easier for nurses to monitor the status of care for each patient, says Brindle. "Time wasted pulling charts is also eliminated," she says. "The system pre-codes as we chart, capturing level of care and facility charges automatically."

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Source and Resource

For more information on electronic documentation systems, contact:

Rosemary Brindle, RN, MSN, TNCC, Director of Emergency Care Services, Emergency Department, Mary Washington Hospital, 1001 Sam Perry Blvd., Fredericksburg, VA 22401. Telephone: (540) 741-1100, ext. 1180. E-mail: rosemary.brindle@medicorp.org.

For more information about Amelior ED Complete ED Information Management with Clinical Support Intelligence, contact:

Patient Care Technology Systems, 32 Journey, Suite 250, Aliso Viejo, CA 92656. Telephone: (949) 349-9409. Fax: (949) 349-9408. E-mail: inquiry@pcts.com. Web: www.pcts.com.