Inside Duke Medicine

Values of Excellence, Teamwork Drive Progress for Successful 2013, 2014 Go-lives

Excellence and teamwork are among the five values that support Duke University Health System’s core value of “Caring for Our Patients, Their Loved Ones and Each Other.

They also echo throughout physician champion Charles M. Hodges, M.D.’s assessment of the important progress being made in preparation for Duke Maestro Care’s July 2013 inpatient go-live and the February 2014 go-live at Duke Raleigh Hospital, where Hodges is Chief Medical Information Officer.

In fact, excellent effort and outstanding teamwork by inpatient champions have combined to put the work ahead of schedule in creating order sets and working on documentation including patient histories, physical and discharges summaries, and progress notes.

“Some of the champions are unbelievably productive despite that being just a part-time position,” Hodges said. “They are able to generate a lot of material. Some are even producing materials a couple of waves ahead.”

He credits a growing sense of shared mission among the champions representing DRAH, Duke University Hospital and Durham Regional Hospital who are collaborating to ensure that Maestro Care provides coordinated care that reflects DUHS’ core value.

“A feeling of teamwork doesn’t occur right away,” Hodges said. “When we first put these 20-some champions together, all were from different disciplines and different locations across the health system, and we only knew each other from occasional interactions. Now you get a sense in team meetings that people feel relaxed and enjoy a sense of achievement from working together.”

Many also are going the extra mile to further demonstrate teamwork.

“Some of the people who have gotten ahead are doing exactly things you’d want team members to do,” Hodges said. “They are reaching out to people who might be a little bit behind for whatever reason and helping them catch up. I think the team is gelling and that’s what’s allowing us to move ahead.” For example, one team member helps another with a particularly large number of order sets, creating them in Provation in order to allow the colleague to catch up.

The current progress and Wave 1’s successful go-live on July 18 provide positive momentum moving forward toward inpatient go-live.

“It was reassuring to see that Wave 1 went well,” Hodges said. “When the inpatient turn comes next July and Duke Raleigh goes live a few months later, we will have gone through a couple of waves, learning many things and getting through a few bugs, so that should make our implementation easier.”

Meanwhile, confidence continues to build as Maestro Care’s inpatient functionalities emerge in planned phases, allowing people to go to the playground to test the inpatient build and gain even more knowledge of and experience with the system.

With order sets the first phase to be completed, next steps include completing the patient histories, physical and discharges summaries, progress notes and other documents. Then comes sharing the build with specialists to see how they respond.

The goal is achieving uniformity in inpatient workflow while allowing room for specialists to tailor things to their individual needs.

“What we don’t know yet is what will happen when we show the product to the specialists,” Hodges said. “We’re trying to develop generic notes that are not overly specific and allow the specialists themselves to amend and customize to their liking.” The learning process will continue after Wave 2 on Oct. 10, when many specialty clinics go-live.

Hodges credits the Maestro Care leadership for hard work of its own in keeping everything on track.

“They’ve set the tone for the rest of us,” he said.