1. eCareManager™ Daily Management Reports

2. Learning Objectives  Following completion of this PowerPoint, the learner will be able:  Describe Daily Management Reports (DMR)  Discuss clinical significance of DMRs  Describe the process for utilizing reports in the ICU and/or eICU® center  Print selected reports from eCareManager  Access DMR on-line help menu  State key data dependencies for each report

3. DMRs – What are they?  Set of daily reports focused on ICU best practices  Designed to be run frequently in the ICU as an aid to improving patient care and compliance with best practices  Pull together a broad range of data from eCareManager (eCM)  Available reports:  ICU-eICU: Ventilator Bundle, Glycemic Control, and MI Bundle  eICU: APACHE® Data Report

4. Clinical Importance of DMRs  Implementation of evidence-based interventions for critically ill patients improves patient outcomes  ICU clinicians are often pulled in many directions and recognition of gaps in best practices may be challenging to identify  DMRs provide real time audit, management, and tracking tools to improve compliance with best practices

5. Operational Importance of DMRs  Data synthesis  Support proactive care  Simplify clinician workload  Shorten MDR prep time  Fully leverage remote-onsite model of care through innovative “technology connectors”

6. Reports Overview  All DMRs – Current Census patients  MI Bundle – What are the risk factors and current therapies for patients with Acute Coronary Syndrome?  Blood Glucose Management – Is the Blood Glucose in control?  Vent Bundle: How is our compliance with the “Vent Bundle” set of 5 ventilator bundle components?  APACHE Data: What data in eCM are needed to optimize the APACHE reports and ensure that all patient stays receive an APACHE score?

7. Accessing Reports  Log into eCareManager™  Click Daily Management Reports

8. Steps to run reports  Select Unit(s)  Select Report  Select Output (PDF or Spreadsheet)  Run Report

9. Use the toolbar to save and print Click Home to return to Main Menu

10. Saving a report  Select Spreadsheet Output  Click Run Report  Click Save  Select folder destination (Save in:)  Type File name (e.g., Glucose 6-10-06)  Click Save

11. Sample report saved as an excel file

12. Accessing on-line help  Click Help

13. Selecting help content  Click links to select desired help information

14. Type of help files  There are 2 types of help files for each report type: Report and Glossary

15. Help file: “Report”  Displays a sample report  Hover over any column with your mouse to display a pop-up describing key data dependencies

16. Help file: “Glossary”  Provides a description of the column and key data dependencies  Click the Print this Page to print glossary

17. To exit the help menu  Click File and select Close or  Click X in the right hand corner of the screen

18. MI Report Data Report DataeCM Screen MI and MI with ST Elevation (STEMI) -Notes-Create  APACHE® Admission Diagnosis and Today’s Diagnosis -Care Plan  APACHE Admission Diagnosis Medications (Aspirin, beta blocker, ACE-I, ARB,Statin, Anticoagulant) -Medications Lipid Profile-Laboratory  Chemistry LV Function Testing-Notes-Create  Past Medical History  Cardiovascular testing  Echo -Notes-Create  Today’s Treatments  Cardiovascular|Non-Operative Procedure|Diagnostic Ultrasound of Heart, Cardiac nuclear study, Cardiac Angiography|Left Heart

20. Blood Glucose Report Data Report DataeCM Screen Blood Glucose  Current (within 6 hours)  Prior (within 36 hours) -Laboratory  Chemistry  Glucose -Laboratory  Miscellaneous  Bedside Glucose -Flowsheet  Bedside Glucose Medications (Insulin, oral agents) -Medications -Flowsheet (Continuous Insulin Infusion) Nutrition-Care Plan  Nutrition  Enteral, PPN, TPN, Oral, PO

22. Ventilator Bundle Report Data Report DataeCM Screen Ventilation (Ventilated/Not Ventilated) Care Plan  Ventilation Care Plan TodayCare Plan  Care Plan Validated DVT ProphylaxisCare Plan  DVT Prophylaxis (device) Medications  DVT drugs Stress Ulcer ProphylaxisCare Plan  Stress Ulcer Prophylaxis Sedation HolidayCare Plan  Sedation Spontaneous Breathing Trial Care Plan  Ventilation HOB > 30Flowsheet  Nursing Procedure  HOB 30 degrees (within 12 hours)

24. Additional Ventilator Bundle Data  A ventilation selection on Care Plan must be entered in order for a patient to display on the report  NA is displayed for Sedation Holiday and Spontaneous Breathing Trial if the following are selected in the Ventilation section of Care Plan:  Ventilated – Chronic Dependency  Not-Ventilated Selection  NA is displayed for HOB-30 if a Not Ventilated selection is made in the Ventilation section of Care Plan  No Data icon displays if Care Plan not validated within 24 hours of running report

25. APACHE® Report Data Report DataeCM Screen Admit SourceADT APACHE Admission Diagnosis -Notes-Create  APACHE® Admission Diagnosis -Care Plan  APACHE Admission Diagnosis GCS-Flowsheet -Notes-Create RR/Ventilation-RR = Interfaced Vital Signs, Flowsheet, ABG/Vent -Ventilation = Care Plan and Active Treatment ABG/FiO2Laboratory  ABG TemperatureFlowsheet PMH/TreatmentsNotes-Create; PMH and Today’s Treatments Ventilation/AirwayCare Plan

27. ICU Process Guidelines

28. Care Plan and Task List  ICU use of eCM Care Plan will significantly increase the accuracy of DMRs  Use Task List to support eICU-ICU communication to include contraindications and plan

29. Daily Management Reports Thank You!