A Roadmap for Change

Since we admitted our first patient in 1890, Englewood Hospital and Medical Center (EHMC) has been driven by a vision to provide compassionate care in a humanistic environment. The advent of healthcare reform compelled us to find meaningful ways to advance this mission of clinical excellence while tackling the transition to value-based reimbursement.

We turned to health IT to help us create a roadmap for change. Our most pressing challenge was a dramatic overhaul of our clinical information systems to help our physicians and staff continue to provide the state-of-the-art, high-quality care our community had come to expect. Goals included:

  • Improved patient safety and satisfaction
  • Fewer medication and transcription errors
  • Widespread adoption of computerized physician order entry (CPOE)
  • Enhanced communication
  • Increased efficiencies

A True Team Effort

From day one, we set the expectation that everyone must “own the change” to ensure a successful result. Front-line staff, physicians and hospital leadership all stepped up. Every part of the hospital was involved. Interdisciplinary teams from all clinical areas, the medical staff, IT, business and finance studied the impact of technology on medication management, documentation, communication and care delivery.

After months of preparation, we launched the most comprehensive process improvement initiative in EHMC’s history: the implementation of a fully integrated clinical information system to improve safety, satisfaction and efficiencies. The “big bang” go-live of 14 clinical and business applications took place in a single day. It included CPOE, point-of-care, bar-code medication administration and interdisciplinary clinical documentation for nurses and physicians.

Significant Impact, Exceptional Results

We’ve realized exceptional results in all our target areas:

Patient Safety. Within a few weeks of go-live, CPOE adoption and compliance was more than 80% (exceeding Leapfrog standards and meaningful use requirements). Adoption has increased further to 92%. We achieved a high adoption rate by teaming seasoned physicians with tech-savvy physicians, and we offered a physician “cyber lounge” along with a 24/7 support desk. Strong engagement with our physician champions helps us sustain this remarkable rate, which contributed to a 90% drop in transcription errors in the first year as well as a 40% reduction in medication errors.

Patient safety is further enhanced with better medication management. Medication administration bar-code scanning compliance is 90%. Medication verification and reconciliation is 98% at admission and 99% at discharge, which helps ensure the patient is on the right medication regimen while they are with us in the hospital as well as when they leave.

Patient Care. The new systems support EHMC clinicians with the right information at the right time, helping them to make more informed clinical decisions at the point of care and adhere to standardized care processes. With caregiver collaboration, we built easy-to-use electronic order sets to target specific high-risk patient populations.

Our best-practice efforts have led to greater care efficiencies and improved outcomes, especially for preventable hospital-acquired conditions. Most significantly, our rate of venous thrombo embolism (VTE) has dropped 67%. Soon we will implement our clinical decision support-driven order sets that we built to apply best practices for high-risk perinatal and congestive heart failure patients.

Patient Satisfaction. We have incorporated patient advocates into our care delivery. In addition to providing patients and families with education and information on their condition, they are oriented to the enterprise patient visibility white boards where they can further monitor their loved one’s status.

Now patients can review their summary of care and discharge summary electronically. As a result, our Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores have improved steadily, with 82% of patients reporting they are satisfied with the discharge information we provide. Plans are in the works to roll out an online self-service kiosk for patients where they can register, schedule and view appointments and tests, view lab results, review account information.

Moving Forward with Confidence

Integrating health IT with our improvement efforts has empowered EHMC with advanced capabilities to address rapidly evolving demands for improved clinical, operational and financial outcomes. We’ve used it in myriad ways to help us hard-wire our policies and processes, streamline clinical and administrative workflows, support and coordinate quality care, and inform decision-making at the point of care. As we prepare to mark 125 years as the regional leader in providing high-quality care to our community, we know we have the tools we need to move forward with confidence in a complex, changing healthcare environment.

Englewood Hospital and Medical Center was a finalist for Distinguished Achievement Award for Clinical Excellence. The annual awards program recognizes customers that have achieved notable results in improving healthcare quality and patient safety through the effective deployment of Horizon Clinicals® and Paragon® clinical solutions.

Healthgrades’ Distinguished Hospital Award for Clinical Excellence™ 2013 ranks Englewood Hospital among the Top 5% of hospitals in the US for clinical performance. In addition, it has been recognized as a BEST REGIONAL HOSPITAL by U.S. News & World Report, which ranked the medical center fifth in the New York metro area. In addition, it received a Hospital Safety Score of “A” by The Leapfrog Group for upholding stringent standards in the critical areas of safety, quality and efficiency.

Clinical IT Assists Englewood Hospital and Medical Center in Process Improvement

Implementation of a comprehensive clinical information system has helped Englewood Hospital and Medical Center improve decision-making, reduce errors and enhance outcomes:

  • 92% CPOE adoption
  • 40% drop in medication errors
  • 90% drop in transcription errors
  • 67% drop in VTE cases
  • 82% patient satisfaction with discharge information
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About the author

Ronald J. Fuschillo, Jr., joined EHMC as vice president and chief information officer (CIO) in the summer of 2010. He is responsible for overseeing the medical center’s information systems, infrastructure, security and applications, and for leading the implementation of McKesson clinical and business applications. Mr. Fuschillo came to EHMC from Rutland Regional Medical Center in Vermont, where he served as VP and CIO.

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About the author

Cio Dela Riva joined EHMC in 2000. After 10 years as the administrative director of Cardiac Services, she joined the IT Department as the clinical informatics director responsible for managing the implementation of McKesson clinical systems and the initiation of a formalized informatics team. Ms. Dela Riva came to EHMC from The Mount Sinai Hospital and Medical Center, New York City, where she served as Clinical Manager for the Cardiac Surgery and Cardiac Cath Lab departments.