Physicians will experience the benefits of online nursing documentation when the Electronic Multidisciplinary Documentation (EMD) project launches on May 9, announced Kevin Tabb, M.D., SHC’s Chief Quality/Medical Information Officer.

Using new technology such as Computers on Wheels (COWs) — mobile carts armed with laptop computers, barcode medication readers and vital sign devices — EMD allows nurses to implement physician orders, as well as document vital signs, nursing assessments, medications and many other aspects of patient care that have previously been on more than 50 paper documents and forms. Tabb said EMD improves access to patient information, thereby reducing the chance for error and improving the quality of patient care.

Physicians will have access to the system to place orders and view patient information at any computer loaded with Carecast, the software enabling online documentation that was activated throughout SHC last December as a precursor to EMD. There will be no need to compete for binders or clipboards during rounds, Tabb said.

Conditional orders also become active on all units on May 9. Conditional orders allow each physician to input orders into CPOE (Computerized Physician Order Entry) well in advance of transfer from the PACU or ICU, but they are not activated until the patient actually has a bed assigned and is transferred (i.e., the “condition” is met). This will improve efficiency of the transfer process, Tabb noted.

The EMD rollout begins May 9 on the Surgical Admission Unit and the Ambulatory Surgery Center for Admission Assessment only. After stabilization, the entire documentation system will go live on three pilot units through May and June. Thereafter, EMD will roll out to the remaining inpatient nursing units every one to two weeks, with the final unit set to go live in October.

Following is the roll out schedule, effective as of mid-March:

May 9 ....... ASC/SAU (Admission Assessment only)
May 23 ..... C2 (pilot unit)
Jun 4 ........ D1 (pilot unit)
Jun 18 ...... D/E Ground (pilot unit)
July 2 ....... D2, D3
Jul 16 ....... B2, G2S
Jul 23 ....... B3, C1 (CIRU)
Jul 30 ....... C3, B1
Aug 6 ........ F3
Aug 13 ...... E3
Aug 20 ...... G2, H2
Aug 27 ...... F Ground, Dialysis
Sep 10 ...... E1
Sep 24 ...... North ICU
Oct 8 ........ E2

The conversion from paper to online nursing documentation will take place on the morning of the “go live” activation date in each nursing unit.

Physicians can get up-to-speed on Carecast and EMD by visiting the Carecast Learning Center on the Internet or on the SHC Intranet at:

www.emd-wbt.stanfordhospital.com

The training module on conditional orders was revised in late March and two new modules were added. “Viewing Charted Data” shows how to access nurse charted data, such as vital signs, I&O and medication administration. “Managing Inbox Alerts” shows how to recognize and resolve inbox alerts and how to get alerts when new results are available. Completing Web-based training is required for any physician who will enter conditional orders or needs to view patient information online.

Watch for EMD updates in the Medical Staff Update and on the EMD Web site:

https://shcintranet.stanfordmed.org/departments/EMD/default.