Cooper University Hospital is progressive in its approach to both technology and care. Located in Mt. Laurel, New Jersey, it is home to more than 700 physicians, 75 specialties, 550 beds, and the Cooper Medical School of Rowan University. As an academic medical center committed to world-class patient care, education, and research, Cooper University Hospital was, and remains, committed to the advancement of electronic records.
But in 2010, just three months from the rollout of its EpicCare EMR, clinical staff at Cooper University Hospital raised a red flag—one that had the potential to stop its EMR launch. That’s because in addition to being a world-class academic hospital, Cooper University Hospital is also the only Level 1 trauma center in southern New Jersey; it serves as the regional transfer center for critical care. It was for this reason that the red flag was raised.
A CRITICAL ROADBLOCK
The transition to electronic charting in low-acuity environments is one thing; the transition in high-acuity departments is quite another. In critical care and ICUs, nurses spend an astounding amount of time checking — and rechecking — each patient’s status. Physiologic functions such as vital signs, the functions of the life support equipment and invasive monitoring devices, and head-to-toe physical assessments are all recorded. Furthermore, these measurements and assessments are made repeatedly; they are often recorded as frequently as every 15 minutes.
Prior to its EMR rollout, Cooper University Hospital’s paper chart system for high-acuity documentation worked very well for its critical care nurses; for each patient, nurses completed a paper flow sheet. Nurses could quickly go down each line item in this sheet and mark physical observations and vital signs as well as information from medical monitoring devices. Implementing the EpicCare EMR would change all that. Instead of a quick run through with a chart and a pen, nurses would be subjected to a considerable amount of data entry, clicking through screens and typing in data.
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