Key Facets of Inpatient Build To Be Completed by Year’s End
posted October 26th, 2012
Thomas Owens, M.D. (right), DUHS chief medical officer, talks with Mark N. Feinglos, M.D., CM, division chief, endocrinology, metabolism and nutrition, and Kathryn J. Evans, BSN, MSN, FNP-BC, during a visit to Duke Clinic 1A during Wave 2 go-live.
Though the inpatient phase of Duke Maestro Care doesn’t officially go live until July 2013, two vital components need to be completed by the end of October and December, respectively.
As part of a process that was initiated earlier this year, inpatient workflow and other operational elements are scheduled to be finalized by Oct. 31, with completion of clinical content — such as order sets, document templates and other provider-focused content — following by the end of December.
“Even though it seems that the inpatient implementation is many, many months away, we are now at a crucial point in the project where we will freeze work on the design and content build so that we can begin to test, review and validate the system,” said Jeffrey Ferranti, M.D., chief medical information officer, Duke Health Technology Solutions. “While it may feel to some that we have a considerable about of time, all this content has to be built in the next two to three months in a very regimented process of build, evaluation, and formal review. It’s very important that providers engage with us quickly so we can consider all their content advice.”
Much important work will also occur between December and July — testing, revisions, error corrections — with physician champions reaching out across all three Duke Hospitals to seek subject matter experts and soliciting comments from providers on order sets and other content elements.
“It’s vital that people take that very seriously,” Ferranti said. “That includes Durham Regional Hospital and Duke Raleigh Hospital, because the content we are building now is going to impact them, even though they don’t go live until 2014."
Clay Musser, M.D., a Maestro Care provider champion who works at Duke University Hospital, applauded the work of subject matter experts engaged in building clinical content, noting that much progress has been made, especially on order sets.
“That said, a lot remains to be done and the final months of the design process will be very busy,” Musser said. “We must continue to maintain the momentum we have created. Every day is important.”
A new member of the Maestro Care leadership team, Eugenia (Genie) McPeek Hinz, M.D., has been working closely with DHTS on inpatient and ambulatory clinical documentation build to ensure that Maestro Care content is being built to maximize efficiencies and provider usability.
"Maestro Care is going to provide Duke Medicine with a better platform to continue to provide the excellent care that Duke University is known for in a more cohesive patient centric fashion,” said McPeek Hinz. “Building the dynamic documentation tools takes time but ultimately supports clinicians in their cognitive processing of patients and, as a by-product, in creating better quality electronic notes in an efficient manner.”
Janet Apter, RN, DNP, nursing and ancillary champion for the inpatient and ambulatory Maestro Care projects, said a draft of the nursing and ancillary clinical build and content will be completed by the end of October, then move into testing. As part of that effort, standardized practices have been created for use across multiple areas in the health system.
Next comes the start of the change management process, in which more than 300 workflows will be evaluated to determine the impact of Maestro Care on clinicians at the floor level, followed by a rewriting of policies, procedures and standards of care to make sure they align with decisions made about Maestro Care content. Then comes a broad effort between now and next spring to educate nursing and ancillary staff about Maestro Care before formal training begins.
“We’ll prepare for the changes and show them the content they have contributed to, so that when they go to training it will not be new to them,” Apter said.
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