Authorized hospital staff members now use the ER tracking board to track patients from the moment they walk into the ER until the time they are discharged. After a brief orientation, most of the ER staff – includ- ing physicians, nurses, clerical assistants and registration personnel – adopted the new technology. “The ER tracking board shows us everything from basic patient demographics, to high-level detail about their visits, to what diagnostic or lab tests are in progress and which results are available,” says Hope. “It gives ER personnel a real-time, up-to-date picture of what is happening in both the outpatient areas of the ER and the inpatient hold area.”
In addition to the ER team, several other users rely on the ER tracking board for utilization and bed man- agement. The executive team also uses it to keep an eye on ER patient volumes and the potential impact on diagnostic and inpatient services. “We always know who has been admitted, who is waiting for treatment, and key information such as the patients’ length of stay and their level of urgency,” adds Hope. “This helps the clinical teams make decisions faster. All the pertinent information is readily available on the electronic board.”
Nurses know what room a patient is in, for example, how long he or she has been there, what lab or diagnostic results are pending, and the severity of a patient’s condi- tion relative to other patients in the ER as measured by the Canadian Triage and Acuity Scale (CTAS) national guidelines. For example, CTAS Level 1 refers to patients that need to be seen by a physician immediately, while CTAS Level 5 refers to patients that need to be seen by a physician within 120 minutes. Displaying the CTAS levels helps the ER staff make appropriate judgment calls about where attention should be focused. Within the province of Ontario, hospitals must report on their compliance with standards governed by these CTAS metrics. The BI system lets them actively monitor the CTAS scores as both a real-time decision-making tool and a quality metric.
“Not only from the point of view of care, but also from the standpoint of effi ciency and reporting to the province, this has been an effective measure,” explains Norwich.
System expansion explored
As the IT team obtains feedback about how the staff is using the ER tracking board, they are pondering ways to make real-time patient information available to other domains throughout the hospital.
“Now that the ER tracking board is in production, we can customize the presentation for various departments to refl ect the specifi c types of information they need,” says Norwich. “While the pressing need was to provide
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a real-time look at what is going on in the ER, our long- term plans include creating a complete patient-tracking system.
“The key element for safety and patient care is that everyone in the hospital has the right information for the right patient in the right place and at the right time in order to drive the right decision,” he continues. “BI initiatives allow them to make those decisions, thereby supporting the business objectives of the hospital. The ER tracking board results in better patient care, more accurate decisions and better patient fl ow using real- time data.
“The ER tracking board shows us everything from basic patient demographics, to high-level detail about their visits, to what diagnostic or lab tests are in progress and which results are available.”
“The challenge is to fi nd a way to empower end-users to create their own customized information, without requiring them to become business intelligence experts,” adds Norwich. “Throughout the years, advancements in BI technology have made data access easier. Using a dashboard approach reduces the need to create and produce static reports.”
In collaboration with the business and clinical stake- holders, Norwich selected Information Builders’ WebFO- CUS business-intelligence environment for its “guided ad hoc technology,” which lets users create dynamic reports by selecting parameters from a drop-down menu. They can choose columns, sort criteria, measures and output formats to generate their own personal reports. Additionally, menu selections enable repeat delivery via e-mail in any preferred format, including Excel, PDF, HTML, Word or as an “active report” that permits offl ine analysis. A single guided ad hoc reporting template can generate thousands of different reports to meet many different business requirements. Built-in security keeps data protected at all times, granting access to authorized users based on their role within the organization. Ultimately, Cambridge Memorial plans to deploy a managed reporting portal that lets users organize and navigate through guided ad hoc reports, dashboards and archived report libraries.
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