P ALMS W EST H OSPITAL CPOE WITH ADVANCED CLINICALS IMPLEMENTATION

P HYSICIAN C HAMPIONS “W HAT I W ISH I H AD K NOWN B EFORE I S TARTED ”

R ESPONSIBILITIES HOURS PER WEEK AS P ILOT P HYSICIAN C HAMPION H OW DID YOU GET TO THIS NUMBER ? o M ONTHLY PAG MEETING o M ONTHLY S TEERING C OMMITTEE MEETING o C ONFERENCE C ALLS A SSIST CEO & CNO WITH IMPLEMENTATION EBOS BUILD AND APPROVAL PROCESS

T IME M ANAGEMENT N EED TO SET ASIDE TIME TO BE THE P HYSICIAN C HAMPION P RIORITIZE B UILDING AND A PPROVAL OF O RDER S ETS Y OUR P RACTICE L IGHT AT THE END OF THE TUNNEL

P HYSICIAN C HAMPION R OLE P HYSICIAN NEGOTIATOR “O NE OF THE TEAM ” C HEERLEADER L IAISON WITH ORDER SET BUILD TEAM L IAISON TO CEO, CNO, CFO L IAISON TO MED EXECUTIVE COMMITTEE E MOTIONAL INTELLIGENCE, PERSUASIVE SPEAKER DIPLOMAT R ESOURCE F OR YOU!

P HYSICIAN L EAD & DAC R ELATIONSHIP C OLLABORATIVE W ORKING R ELATIONSHIP F REQUENT C OMMUNICATION C ONSISTENT M ESSAGE O PEN A CCESS TO E ACH O THER

What does Physician Champion need from you? Partnership with Executive Sponsors, CEO and CNO Communication Support of decisions and implementations during the project

P ALMS W EST H OSPITAL S ERVICE L INES : 175 B ED /A CUTE CARE MEDICAL - SURGICAL FACILITY Breast Care Center Cath Lab Emergency Room Obstetrics Orthopedic and Spine Institute Outpatient Rehabilitation Services Pediatrics Radiology and Diagnostic Imaging T EACHING A FFILIATE OF NOVA SOUTHEASTERN MEDICAL SCHOOL WITH M EDICAL R ESIDENCY P ROGRAMS

C LINICAL S TAFF P ROVIDERS N URSING AND C LINICIANS 500+P HYSICIANS 100+ARNP’ S, PA’ S, CRNA’ S. M EDICAL S TUDENTS AND R ESIDENTS 350+ N URSES 35+ U NIT C LERKS 40+ T ECHS, N URSING A SSISTANTS A NCILLARY S TAFF, INCLUDING HIM, L AB, R AD, RT, P HARMACY

CPOE T EAM P HYSICIAN C HAMPION : D R L UIS R EGALADO D IRECTOR OF C LINICAL A PPLICATIONS : S TEPHANIE N OEL M ASTER T RAINERS EBOS S PECIALIST P HARMACY EBOS S PECIALIST S TEERING C OMMITTEE P HYSICIAN A DVISORY G ROUP C ORE T EAM S UPERUSERS

T EAM D EVELOPMENT I NTERACTIVE WORKING RELATIONSHIP C OMMUNICATE WITH ONE ANOTHER ABOUT REQUESTS S HARE IDEAS WITH ONE ANOTHER C ONSIDER THE RELATIONSHIPS EACH PERSON HAS WITH DIFFERENT P ROVIDERS S HARE PRESENTATIONS – FACILITY LEADERS OF THE PROJECT O FFER R EPRIEVE TO ONE ANOTHER

P REP W ORK SELECTION OF PHYSICIAN LEADER/CHAMPION AND CORE TEAM, PAG, STEERING COMMITTEE MASTER TRAINERS AND SUPERUSERS GAP ANALYSIS/WORKFLOW ASSESSMENT DEVICE ASSESSMENT TIER A AND B PHYSICIANS TRAINING

O PERATIONAL & P ROCESS I MPACT AreaFromTo NursingColor coded chart tags, paper copies, hourly chart checks Status board order acknowledgement Manual translation of orders to plan of care Orders integrated to plan of care automatically Current orders recorded on paper Kardex Current orders available in electronic form Faxing medication orders to pharmacy Pharmacy orders process automatically Manual paper chart checkElectronic chart checks Respiratory TherapyPaged by nursing for new ordersImmediate system paging for stat orders, status board notification of orders 13

O PERATIONAL & P ROCESS I MPACT AreaFromTo PharmacyReceives orders by fax queueOrders present on tracker for review Delays in processingReduced turn around time for medication availability LaboratoryDelay for manual order entryOrders process immediately Staff reconcile duplicates and corrections manually Reduced duplicates and time for reconciliation RadiologyDelay for manual order entryOrders process immediately Peak load hours after physician rounds Peak load hours shift 14

O PERATIONAL & P ROCESS I MPACT AreaFromTo HIMPage by page manual deficiency management Order signature deficiency management automated TherapiesManual plan approvalPlan electronically communicated and signed by physician 15

I MPACT O N P HYSICIANS AreaFromTo RoundingSingle paper chart required for reviewing data, ordering, and documenting Electronic result and patient data available to all, order and document from any computer Signing chartsWeekly visit to HIMSign all orders and documents from any computer Admitting patientsTelephone orders, faxing ordersAdmit orders electronically using evidence based order set 16

Y OUR B RAIN PRE -CPOE

I MPLEMENTATION O VERVIEW

CPOE I MPLEMENTATION T IMELINE Open House P HASE 1 G O L IVE P DOC I MPLEMENTATION F ULL FACILITY GO LIVE WITH N URSING AND P HYSICIAN TRANSITION TO C LINICAL R EVIEW P HASE 2 G O L IVE : S OFT G O L IVE I MPLEMENTATION S TAGED I MPLEMENTATION OF H OSPITALISTS H ARD G O L IVE : I MPLEMENTATION A LL R EMAINING H OSPITALISTS, S PECIALISTS, S URGEONS

L ESSONS L EARNED The Four Agreements By Don Miguel Ruiz

L ESSONS L EARNED C HANGE IS DIFFICULT AND SCARY R ESIDENTS AND M EDICAL S TUDENTS CAN BE YOUR BEST ASSET Y OUR IDEA IS GREAT, BUT IT ’ S NOT MY IDEA “C ULTURE EATS STRATEGY FOR LUNCH ” T RIAGE DIFFICULT PHYSICIANS M EANINGFUL U SE C RITERIA “W HY NOT 30%?” U SE C ERNER VS. E PIC VS. M EDITECH N OT E VERYONE K NOWS H OW TO T YPE N OT E VERYONE U SES A C OMPUTER B E F LEXIBLE C USTOMIZE TRAINING P ATIENCE IS TRULY A GIFT I MPORTANCE OF “P REP W ORK ”

CPOE S TATISTICS

G OOD L UCK !!! THANKS FOR COMING REMEMBER WE ARE HERE IF YOU HAVE QUESTIONS Please feel free to contact us