*Advocacy * Prenatal Class Update * Digital Mammography * Safety and Quality Assurance * Clinical Information System * Teletrauma * Parish Nursing Program * Key West Night *Family Health & Safety Fair *Scholarships
Scholarships for local students who are pursuing careers in medically related fields are being offered by the Sierra Vista Regional Helath Center Auxiliary. The scholarships are valued at $1000.00 each and will be awarded in September 2008. Applications are available at the SVRHC Human Resource Office and the Auxiliary Gift Shop. Deadline to submit completed applications is August 1, 2008.
Sierra Vista Regional Health Center (SVRHC) partners with The Mall at Sierra Vista to sponsor a Family Health and Safety Fair open to the public. This new and exciting event will be held on Saturday, June 21, 2008 from 10:00 a.m. to 5:00 p.m. at The Mall at Sierra Vista.
Several exhibitors will be available with helpful health care information, exhibits, and or non-invasive health testing for you and your family. SVRHC will have several booths with items of interest for everyone. There will be nutritious food samples, give-aways and many fun activities such as a jumping castle and LifeNet’s helicopter landing outside the Mall. Come by and visit the booths to learn about the health, fitness and safety resources available in our community.
Current exhibitors are SVRHC Hospice Casa de la Paz, SVRHC Maternal/ Child Department, Sierra Vista Fire Department, Sierra Vista Police Department, LifeNet, American Lung Association, American Red Cross, SVRHC Rehabilitation Services Department, and TOPS.
For more information or if you are interested in having a booth, please contact Alicia Brusini at the Mall at (520) 452-0011 or Christy Haden at SVRHC Wellness Depot at (520) 459-8210.
Advocacy – Avoiding the Hidden Tax
Today, hospitals have an enormous responsibility in maintaining high levels of patient care, technological advancements, retention of quality staff, in addition to all the regulatory compliance issues they face. There is one additional issue that hospitals nationwide are now facing, one that could have a detrimental impact on the future of healthcare. While a community may focus on care and services received by a hospital, many do not realize the political side of maintaining a facility and how it can financially impact the care given and services that SVRHC is able to provide to you and the community.
With the Presidential race culminating this year, healthcare advocacy remains a top issue within hospital leadership and boardrooms across America. Sierra Vista Regional Health Center (SVRHC) is no exception; it is in a fight to maintain and campaign against a drastic cut in national funding so it can continue to provide high levels of patient care. The White House has proposed an unheard of $200 billion in budget cuts to Medicaid and Medicare, of which $135 billion would come directly from hospitals and impact millions across the country.
More importantly, at the state level, budget shortfalls and cuts would have a very negative impact on SVRHC by reducing and delaying reimbursements, eliminating vital programs critical to rural hospitals, and impede the process of placing eligible children and their parents on plans such as AHCCCS. “Our goal as the Board’s government relations committee at SVRHC, is to work with our elected officials to preserve and improve the quality of care necessary for our community,” says Lanny A. Kope EdD, SVRHC Board of Trustee member and Government Relations Committee chair.
What is an Advocate?
Advocacy is essentially educating our elected leaders. The Board of Trustees created a Government Relations Committee to make the healthcare needs of Sierra Vista known to our elected representatives. “Silence denotes consent, and when there are healthcare issues that need to be heard, our committee and its community partners serve as the forum,” says Kope. SVRHC’s government relations committee is chaired by Kope and includes members of the Board of Trustees, the Board Chair, the President & CEO, senior staff members, and members from the hospital Foundation and Auxiliary. “The Board of Trustees approved our 2008 political advocacy agenda that includes issues that are necessary to meet the healthcare needs of our community and county,” explained Kope. The two biggest concerns in the state of Arizona are malpractice reform since it has a direct impact on the physician shortage and Medicaid reimbursement disparities issues that affect the hospital’s financial viability. For some reason, he added, there is an erroneous belief that hospitals are immune from the basic laws of economics. Some of the 2008 advocacy agenda issues are:
Members of a board of trustees are natural advocates. They do not lobby for any personal or financial gain, but do so because they believe in an institution that is vital to a community. SVRHC’s board of trustees are community leaders who have a bipartisan view on many of the issues challenging healthcare facilities today, enabling the trustees to advocate effectively for our community and county by helping legislators understand the various health issues with which they have to deal.
The Issues
According to the Arizona Hospital and Healthcare Association (AzHHA), the Appropriations Committee chairmen have selected several budget options that would significantly harm Arizona hospitals, which face ongoing challenges of their own as they strive to provide high quality, cost efficient care to our state’s growing population. The two major issues facing healthcare organizations within our state especially in rural areas are reimbursement disparities to programs like AHCCCS and Physician Malpractice Reform.
“Currently, rural hospitals such as SVRHC are reimbursed at 75% of cost for AHCCCS patients while at the same time, urban hospitals are reimbursed at 95% of costs for these same patients,” explains Kope. The need is great to reform the AHCCCS payment system to ensure AHCCCS payments for inpatient and outpatient services cover a greater percentage of hospitals’ costs. Kope continues, “We need an AHCCCS payment system that makes no differentiation between reimbursement for rural and urban hospitals, minimizes cost-shifting to commercial payers, and provides a standard claim submission process.” A new bill, SB 1376 is currently being reviewed by the state senate which effectively addresses and can potentially correct these issues. This bill will establish a hospital reimbursement advisory council consisting of AHCCCS, hospital representatives, independent contractors, and a health economist that will evaluate payments made by AHCCCS to inpatient and outpatient care.
As with any rural community, the ability to attract and retain quality physicians has become very difficult, especially in Arizona due to the excessively high liability premiums for our state. “The escalating cost of professional liability insurance premiums has resulted in SVRHC being the only hospital within the county where babies are delivered. OB/GYN physicians are not practicing in any other city within the county because the annual cost of professional liability insurance premium for an OB/GYN can range from $75,000 to $100,000 per year,” says Kope. These excessive malpractice premiums not only target the OB/GYN doctors, but other specialties as well. “Recently, an orthopedic surgeon from Sierra Vista moved to Wisconsin where he reportedly saved $80,000 per year in malpractice insurance.”
Get Involved
Hospitals not only need to avoid any cut in budgets, but they need increased federal payments so that they can continue to provide high quality health care in their communities. Kope concludes, “These issues are critical to our community, and we are asking that a leadership role be taken by our senators and representatives in the state legislature to address and solve these major problems.” You can help lobby by contacting your local senators/representatives and urge them to send a clear message to reevaluate these already compromised issues. These are community organizations that have agreed to join the hospital’s advocacy efforts: The City of Sierra Vista; Cochise County Board of Supervisors; United Veteran’s Council; and the Greater Sierra Vista Chamber of Commerce. If you would like SVRHC’s Government Relations committee to present to your group, please call Jo Nell Milligan, Executive Assistant to the CEO at 417-3003.
Senator John McCain
241 Russell Senate Office Bldg.,
Washington, D.C. 20510
(202) 224-2235 FAX (202) 224-2207
Congresswomen Gabrielle Giffords
502 Cannon House Office Building
Washington, D.C. 20515
(202) 225-2542 FAX (202) 225-0378
www.giffords.house.gov
Senator Jon Kyle
730 Hart Senate Bldg.,
Washington, D.C. 20510
(202) 224-4251 FAX (202) 224-2207
Senator Timothy S. Bee
1700 W. Washington, Rm 204
Phoenix, AZ 85007
(602) 926-5683 FAX (602) 417-3247
Senator Marsha Arzberger
1700 W. Washington, Rm 213
Phoenix, AZ 85007
(602) 926-4321 FAX (602) 417-3146
Representative Jennifer Burns
Representative Manny Alvarez
Representative Marian McClure
Representative Jonathan Paton
Nothing says happiness like a brand new baby. We at Sierra Vista Regional Health Center want to give you the tools to start out successful with your new bundle of joy. That's why at SVRHC, we have updated our Prenatal Classes to better suit our moms and dads. We have added another day for your convenience and a new interactive program to our sessions.
SVRHC's child birthing classes are tailored to your childbirth experience here at our hospital. Our specialized classes are taught by experienced Registered Nurses that are on staff in our Maternal-Child Department. Your childbirth educator will provide you with information about pregnancy, childbirth, newborn care, breastfeeding, and Dr. Harvey Karp's Happiest Baby on the Block Class. You will also receive a tour of the Maternal Child Unit.
Books are provided to each participant. Here are some frequently asked questions:
.
Are the classes open to anyone?
The mom and one coach (support person) may attend the series of classes.
.
Is there a cost to attend the class?
The cost of the class is $40.00, due at the first class.
.
When should I sign up for the classes?
We encourage calling and signing up for classes as soon as possible, because
our space is limited. We encourage you to register for classes around the
time of your 20th - 22nd week.
.
How many classes are in the series, and when do they meet?
There are six classes in the series that meet on Monday and Thursday nights
at the Education Outreach Center located at 1840 S. Paso San Luis. You will
be asked to select a series on one of those nights. When you sign up
you will be told what time the class starts. We also offer an all day
Saturday class, held in the Jenney Room at the hospital which runs from 10:00
a.m. to 6:00 p.m.
.
What topics are covered in the classes?
Late pregnancy discomforts
Breathing & relaxation
What to do and who to call when labor starts
Information about epidurals and medications used for childbirth
Caesarean birth
Newborn care
Breastfeeding
How to soothe a fussy baby (Dr. Harvey Karp's Happiest Baby on the Block Class)
To register for classes, please contact Jolene Vega, Registration Coordinator at 417-3079 or by email to jolene.vega@svrhc.org.
Place a photograph taken by a traditional camera that was processed with film next to a photograph taken with a digital camera. What do you see? The traditional camera, although innovative in its own time, produces clear photos with nice color. However, the digital photo shows a crystal clear image with bright colors, typically not seen with traditional photo processing. Why is this important? Breast cancer will affect an average of one in eight women sometime in their lifetime. It is the second most common cause of cancer related deaths in women. Numerous studies prove that early detection is a vital component in the successful treatment of breast cancer and that early detection begins with digital mammography.
With advancements in technology, we find ourselves comparing old and new technologies in everything that we do. Just as consumers strive for the best picture when they decide between traditional or digital cameras, physicians as well have the choice between digital or analog mammography equipment.
Sierra Vista Regional Health Center (SVRHC) has collaborated closely with the SVRHC Foundation to raise money for thedigital mammography system which will provide Radiologists with clear digital images in the fight against breast cancer. Through generous donations raised and annual events such as the Carter Golf Classic, The Festival of Trees and Key West Night, Sierra Vista Regional Health Center's Foundation has contributed monies towards the purchase of this state-of the-art technology.
Mammograms
Mammography plays a central part in early detection of breast cancers because it can show changes in the breast up to two years before a patient or physician can feel them. Current guidelines from the U.S. Department of Health and Human Services (HHS), the American Cancer Society (ACS), the American Medical Association (AMA) and the American College of Radiology (ACR) recommend screening mammography every year for women, beginning at age 40. Research has shown that annual mammograms lead to early detection of breast cancers, when they are most curable and breast-conservation therapies are available. The National Cancer Institute (NCI) adds that women who have had breast cancer and those who are at increased risk due to a genetic history of breast cancer should seek expert medical advice about whether they should begin screening before age 40 and about the frequency of screening.
Digital vs Analog Mammography
There are several obvious differences between analog mammography systems and the new digital systems. Some of those differences include quality of images, time differences and amounts of radiation.
Analog Mammography, Analog mammography uses x-ray to record images on film using an x-ray cassette. Films are then 'developed', produced, and put on a light box to be read by the Radiologist. Some disadvantages of analog mammography include:
• More exposure to radiation
• Blurry or unclear images
• Wait time for processing
• Increased need to retake films
Digital mammography, also called full-field digital mammography (FFDM), is a mammography system in which the x-ray film is replaced by solid-state detectors that convert x-rays into electrical signals. These detectors are similar to those found in digital cameras. The electrical signals are used to produce images of the breast that can be seen on a computer screen or printed on special film similar to conventional mammograms. From the patient's point of view, digital mammography is essentially the same as the screen-film system.
Digital mammography takes an electronic image of the breast and stores it directly in a computer, allowing the recorded data to be enhanced, magnified, or manipulated for further evaluation. The electronic image also can be printed on film. Film mammography units use film to both capture and display the image. The sensitivity of film mammography is somewhat limited in women with dense breasts, a population at higher risk for breast cancer.
SVRHC Installs Digital Mammography System
Dr. Jody Jenkins, a local surgeon specializing in women's health issues says, "I'm very excited to have digital mammography here in Sierra Vista . The images are clearer and the radiologists are equipped to manipulate the photos to detect early signs of cancer." Dr. Jenkins was a driving force in brining digital mammography to the community as her passion in the fight against breast cancer, as well as that of the staff and Radiologists, make early detection a number one priority.
Thrilled about the new digital mammography system now available at SVRHC, Kathy Carpenter says, "I'm excited to be a part of the newest technology available in mammography. The women of our community deserve the best in mammo care, and we now offer that service." Patients no longer need to travel to Tucson to receive digital mammography services. "In the last ten years, technology in the medical field has made leaps and bounds, I'm so proud that we are able to offer this cutting-edge service to our region," Carpenter indicates. SVRHC is privileged to provide the only digital mammography system in the county.
Michelle Nock, Interim Manager, SVRHC Diagnostic Imaging Department says, "Our department is accredited by the American College of Radiologists and abides by the stringent rules set forth by the MQSA (Mammography Quality Standards Act). We take these guidelines very seriously and ensure that we follow up with every patient." The Diagnostic Imaging department is inspected yearly by the MQSA and has passed every time. "The new digital mammography system is considered the gold standard in the mammography world, and I am so please to be a part of this program," says Robin Taylor, Mammography Technologist at SVRHC. In addition to MQSA's stringent inspections, the Radiologists also go though additional training which prepaes them to work with digital mammography technology.
SVRHC's new Digital Mammography system is a state-of-the-art machine called a Selenia, made by Hologic. The new digital mammography system still includes the CAD (Computer-assisted detection) capability. A CAD system uses a digitized mammographic image that can be obtained from either a conventional film mammogram or a digitally acquired mammogram. The computer software then searches for abnormal areas of density , mass, or calcification that may indicate the presence of cancer . The CAD system highlights these areas on the images, alerting the radiologist of the need for further analysis. Nock continues, "With the previous mammography equipment, patients would have to wait after their exam to see if the results were clear enough to read. Sometimes, a patient will move slightly or breathe, creating a fuzzy image. After taking the images, they would have to be developed, then inspected for clearness which could take up to ten additional minutes. With Digital Mammography, we can have the image up on the screen in ten seconds, and know instantly if the images need to be retaken or not."
SVRHC Radiologists are as excited as the staff with the new technology. "With digital mammography, I can review electronic images of the breast using special high-resolution monitors. I can then adjust the brightness, change contrast, and zoom in for close ups for specific areas of interest," says Dr. Gary Forsberg, Radiologist at SVRHC. Being able to manipulate images is one of the main benefits of digital technology. Forsberg continues, "Another convenience of digital mammography over film-based systems is it can greatly reduce the need for retakes due to over or under exposure. This saves additional time and reduces a patient's exposure to radiation."
SVRHC continues to expand its services to the community. The new Imaging Center will soon be built at the East Campus. It will be equipped with a 64 slice CT, bone density machine and a biopsy table. Jenkins concludes, "I currently have to rent a digital biopsy table whenever it is available. Having a table available at the new imaging center will help patients receive services in a timelier manner. Another great feature will be the capability of physicians to view uploaded digital images, which will eliminate the need for patients to carry their x-ray films to every appointment. Also, with the new imaging center, there will be a full radiology service providing breast MRI." For more information on Digital Mammography or to schedule an appt. at SVRHC, please contact the Diagnostic Imaging Department at 417-4536, 417-4588, or 417-4600.
Parish Nursing and Our Community
The need to connect with others is a basic human emotion. With today's fast paced world, we often put important things such as health to the side, in favor of just trying to get through the day. Within the last few years, a fairly new idea of pairing a nurse with a congregation has led to an innovative program called Parish Nursing. A Parish Nurse's main focus is on providing overall wellness, but it can extend to other needs within a congregation.
Parish Nursing is an idea born out of the understanding of the healing ministry in a church, with an emphasis on healing that is needed by its members. This is essential care that focuses on the whole person to emphasize physical wellness, disease prevention, and health promotion through a congregation. A Parish Nurse is an R.N. who has taken a Parish Nurse class to prepare for this service in their faith community. They are recommended by, and then work closely with, the leadership of the congregation .
Parish Nursing, or Faith Community Nursing, is recognized by the American Nurses Association as a specialty area, which shows that Parish Nursing is not a passing fad. There is a real need in this country to bring health and wellness to people where they are. Parish Nursing is one way to do this.
How Does A Parish Nurse Assist the Church?
A Parish Nurse Program provides a comprehensive approach to congregational health and assists pastors and members to carry out the traditional ministry of compassion and spiritual healing based on the church's faith. Parish Nurses can inform, with permission, their ministers of any potential issues such as health, social, mental, or financial issues that their congregation members face. In some rural settings and smaller communities, Parish Nurses sometimes serve in two or more congregations. The belief amongst Parish Nurses is maintaining good relationships with those of other faiths who may not share the same beliefs, but are concerned for the wholeness of individuals and communities. Many Parish Nurses serve in synagogues, mosques, and many other places of worship.
Convinced of the enormous potential that Parish nursing offers the churches, it can mean building strong bridges in our community with other congregations and those individuals searching for meaning and wholeness in their lives. They are generally chosen by the church leadership and report directly to the Pastor. A Parish Nurse must be an RN with a current license and is generally designated as the church's Parish Nurse program leader. An LPN or other RN's may assist the Parish Nurse leader, being the ideal situation for a larger congregation. Typically, the pastor will approach a nurse based on their qualifications and their individual involvement within the congregation.
SVRHC Collaborates On Parish Nursing
At S.V.R.H.C., they want to impact their community's health, not just by treating illness and injury, but also by doing anything possible to prevent them from occurring in the first place. Bringing together a network of nurses who support health and wellness in their faith communities is a great way to make an impact on the health of Sierra Vista and the surrounding area.
Sierra Vista Regional Health Center will be there as a resource for every Parish Nurse Program in the community. "We see that Parish Nursing is an extraordinary opportunity. Its an opportunity for the hospital, for nurses, for faith communities and all the people to whom they minister, to come together for support. We want to embrace this opportunity to focus on wellness, and healing for people's bodies, minds and spirits. We do not want to have people coming to our hospital with serious problems that could have been addressed with preventive care and education," says Gina Kruml, Community Benefit Coordinator for SVRHC. Kruml continues, " Our Parish Nurse Program will give Parish Nurses in our area the opportunity to meet and share ideas. For instance, I heard from one Parish Nurse in a large congregation that she and other nurses in her church take turns always sitting in a certain seat during services, so that if their help was needed they could be quickly found." Another Parish Nurse got positive feedback about a bulletin board she did suggesting ways to celebrate a holiday season more simply, with less stress and cost. Kruml continues, "There is always something new to learn from other Parish Nurses, and they will also be an encouragement to one another."
"We researched to find one of the very best preparation classes for Parish Nurses, one that is flexible for each nurse's schedule, and that nurses will enjoy taking together. The online class that SVRHC sponsored R.N.s will be taking this fall is a 45 contact hour class, offered online through the University of Louisiana at Monroe School of Nursing," says Kruml. The professor, Dr. Linda Sabin, will be available on a daily basis during the two-month class, to discuss the content with them, answer questions and provide feedback about their assignments. The class will educate them about all the aspects of Parish Nursing they might consider for use in their congregation. After they have completed this class, their next step will be to investigate what the health needs and concerns are with the people in their faith community.
Each place of worship and each Parish Nurse will be unique, and we know that what is right for one congregation may not be needed in another. We plan to offer basic forms of support that might be useful for all of the Parish Nurses. Kruml continues, "For instance, we are providing our Parish Nurses with books about Parish Nursing, and we will be offering educational events for them twice a year. One of our goals at S.V.R.H.C. is that we will offer assistance to the Parish Nurses in addressing the health needs of our larger community. The time that we spend behind the scenes at S.V.R.H.C. finding wonderful educational materials and other resources for Parish Nurses could save a lot of time for each of them."
All Parish Nurses are welcome to get involved with SVRHC's Parish Nurse Program. Any nurse, community member, or faith community leader who would like more information about Parish Nursing is welcome to call. If you believe your congregation could benefit from a Parish Nurse program, please call Gina Kruml at 417-3158.
Teletrauma - The New 'Eyes' of Emergency Medicine
The American Telemedicine Association defines telemedicine as 'the process of improving patient health status by exchanging medical information, from one site to another via electronic communications.' This modern way of medicine serves as a direct consultation link between health care organizations, utilizing innovative videoconferencing, telemetry, digital X-rays, and ultrasound.
Sierra Vista Regional Health Center 's Emergency Department embraces Arizona 's Telemedicine Program for trauma and critical care known as "Teletrauma." Collaboration with the trauma physicians at University Medical Center and Blue Cross Blue Shield of Arizona has enabled SVRHC to provide Teletrauma in our Emergency Department to those patients coming in for care. Teletrauma is designed to assist rural community emergency room physicians in diagnosing a patient's appropriateness for care in their hospital or the need for the patient to travel to a larger tertiary hospital for treatment.
What is Telemedicine?
The initial stage of Telemedicine dates to the early 1960's when NASA developed satellite technology to transmit their astronaut's physiological measurements from their space suits to the spacecraft. Since then, various pioneer telemedicine projects were conducted throughout the U.S. , including here in Arizona . According to the Telemedicine Research Center , one pioneer Telemedicine project began here in Arizona between 1972 and 1975. In this particular Telemedicine project, NASA developed a program to deliver health care to the Tohono O'odham Nation, formerly known as the Papago Indian Reservation, because of their isolated location. The program was staffed with 2 paramedics using a van carrying various medical instruments, an electrocardiogram (EKG), and x-ray machine. The van and equipment were linked to the Public Health Service, enabling the paramedics to transmit patient information as needed.
Michelle Ziemba, Director of UMC Trauma Service, Dan Judkins, UMC Trauma Educator, and Massood Izadpanah, VitelNet Technical Developer began implementation of the Teletrauma program in August at SVRHC. The Teletrauma equipment was developed by VitelNet and features a user friendly program. The computer workstation automatically measures and calculates patient data, videoconferences with a remote camera/medical device, uses image enhancement tools, and video playback tools. These components are vital for the quick and accurate diagnoses of patients and their injuries.
Advantages of Telemedicine:
• Enhanced health care delivery to medically underserved populations
• Establish statewide Arizona Telemedicine Network connection
• Increase access to medical specialty services while decreasing health care costs
• Provide ongoing training for preceptors, medical students, residents and staff
• Improve public health in rural communities by providing current information and training
• Increase and promote the use of telecommunications for distance learning in health care
• Provide healthcare systems throughout the state with information, training, and expertise
"In southern Arizona , UMC is the only Level 1 trauma facility. Utilizing VitelNet equipment and the Arizona Telemedicine Program (ATP) network, SVRHC staff can remotely consult with a UMC physician or specialist anytime, 24 hours 7 days a week," explains Judkins. In an emergency trauma such as a motor vehicle accident or gun shot wound, immediate treatment can mean a difference between life and death. "Generally in these situations, the patient is immediately transported to a facility with tertiary care," explains Judkins. Jen Ford, an RN in the Emergency Department at SVRHC adds, "Now with Teletrauma, we may not have to transport, are able to treat and better manage patients with life threatening injuries by reducing the time it takes to receive specialist trauma treatment, helping to save more patients."
According to UMC, the Teletrauma program that now exists in five of nine rural southern Arizona hospitals, is only the second Teletrauma program established anywhere in the world. This cutting-edge technology is real time - there are no delays, no phone calls, no waiting around for decisions. Specialists help guide ER physicians and staff through videoconferencing, using remote monitoring equipment right at the patient's bedside. The video equipment used is so precise and versatile, it can make a paper cut look like the Grand Canyon . Utilizing this technology, trauma physicians at UMC can look inside a patient's injuries and assist SVRHC's physicians and staff with diagnosis and care from 75 miles away.
Kimberly Riggs, ED Interim manager says, "We will not be able to care for all circumstances such as spinal or brain injuries, those will still have to be transported. However, Teletrauma will assist us in determining those patients that have borderline injuries, many of which can be treated in our hospital, thus, keeping care closer to home."
New Clinical Information System for SVRHC
"We call it Project ISIS," indicates Richard Turner project manager for the new integrated clinical system to be operational at Sierra Vista Regional Health Center in August. "It stands for Intra Stellar Information System - we liked the idea of a space theme -- and it was our way to breathe excitement into the project and have a catchy name for staff to remember."
A year ago, SVRHC committed to converting from paper medical records to an electronic medical record system for patients. Exploring options, the hospital contracted with Cerner Corporation, one of the country's leading developers of healthcare information technology systems. "This conversion will enhance our ability to provide quality care and provide our staff a user-friendly, comprehensive clinical information system," Turner explains.
Aiding Turner in the planning and development of such a large-scale project were 17 team leaders and a physician leading the planning and design of each "solution" comprising the total Electronic Medical Record (EMR). A common theme of consistent care and augmented patient safety resonates among the project's team leaders.
Emergency registered nurse, Michelle Bauldry, indicates she sought an opportunity to learn and participate in a bigger endeavor to increase the quality of care. Leading the emergency solution FirstNet, Bauldry explains patients will see benefits of the integrated system on subsequent visits to the emergency department as it retains their demographic and medical information. "Our patients in the Emergency Department are already stressed and having important data at the beginning will enhance the care we are able to give initially."
"Computers come naturally to me," registered nurse Wendy Bray says. "As a nurse, I wanted to affect nursing in a different way. I saw this integrated system as a wonderful benefit for the hospital and a great improvement in the continuity of patient care." Bray oversees the CareNet solution and sees the system as good for patients since doctors, nurses, and other patient care staff can access results of other parts of a patient's chart simultaneously. No longer will clinicians have to search for a chart or wait for another clinician to finish charting before they can look at the chart. "Results will not be lost," Bray explains. "When a test is completed the only place the result can go is in the electronic record." CareNet provides bedside test ordering allowing orders to be immediately sent to the performing department.
While registered nurse Laura Goethe volunteered for the clinical system project, she felt it was a big step for her. "If I could build it (the surgery solution SurgiNet) then anyone can chart on it," Goethe laughs. "This project was a good challenge for me and when I saw the benefits the system's efficiency would do in providing more time with the patient, I was sold." Goethe indicates one of the most visible things patients' families will see is a confidential electronic tracking board in the surgery waiting area. Families will be given a number and will be able to track their loved one's status.
Turner indicates the hospital will go live with the new clinical information system on August 7. "Getting the system designed has been one part of the preparation to 'launch'," Turner explains using the space terminology the team adopted for the project. "Planning for a smooth transition has been a major goal of the project team. There are 67 'super users' who received 40 hours of training on the system and will be our first line of assistance during go live." In addition there will be 30 Cerner representatives who will serve as on-site support for the week of go live. Preparation continued with an extensive training program that allowed for every nurse and ancillary staff member to receive training in his or her area of specialty. The team has thought of every possible scenario which will make this a smooth transition for everyone including signage, informational brochures for patients and visitors, and decreased patient/staff ratios.
The hospital's pharmacy is also involved in the implementation process, pharmacy technologist Laura Berresford, indicates. "Our PharmNet is designed around patient safety." According to Berresford system features will identify potential medication issues, prompt known allergies, alert to adverse reactions and duplications. "Our patients will get the most accurate care throughout our entire hospital system," she explains. "Pharmacists can see if a dose is given and send messages to nurses, which will get medications to patients more quickly."
Medical Technologist, Jodi Barsha's eyes shine when she talks about the solution for the laboratory. "We are replacing a 17-year-old system," she relates. "We have four solutions for the lab - blood bank, microbiology, general laboratory, and specimen management." The new order entry capability reduces chance of error as each specimen will have a bar coded label and be used at the patient's bedside. For the first time, blood bank will be completely automated making for faster and more accurate comparisons and increased patient safety.
Thousands of hours of planning, including four trips to the Cerner technology center in Kansas City , have gone into the planning, design, and testing portions of the clinical information system. "Our team leaders and super users have put aside personal time, nights and weekends recognizing the importance of the success of Project ISIS," Turner indicates. "They understand they are affecting the way patient care will be delivered in our region."
Turner's pride in Project ISIS shows when he describes the flawless coordination, which has taken place. The ISIS team began collecting data last fall and began reviewing system design decisions. "We collaborated on how process changes will reach across the hospital and the impact it would have on patient care," he says. In January hospital staff reviewed assorted devices and made a selection based on what was best for the facility. More recently they conducted patient care scenarios ensuring all elements communicated with each other. According to Turner, the Cerner associates who participated in the test were very impressed with the operation and complimented the SVRHC staff on a job very well done.
Two Cerner representatives have been on site at the hospital throughout the planning and implementation process, remaining there through conversion. In addition a transformation specialist and physician executive worked closely with staff, leadership, and physicians discussing changes they can expect to see with the new information system.
Warren Gluck, M.D., quickly embraced the concept of the clinical information system, volunteering to be the medical information officer for the project. Leading the design and implementation portion for how physicians will view patients' diagnostic results and inpatient charts, Gluck indicates he is pleased to be a part of this cutting-edge technology. "This is going to revolutionize patient care for physicians and patients, alike," Gluck explains. "A nurse will enter a physician's test order into the system and that doctor will be able to check that result electronically as soon as it is done. In a later phase of the project, physicians will enter orders directly to the appropriate service, such as pharmacy, lab or X-ray. This eliminates the middleman, freeing desk personnel to help more directly with patient care. CPOE also automatically track allergies, possible drug interactions, correct dosages and has been shown in major hospitals to drastically reduce errors all along the order chain from placement to completion of the task." Results may be viewed both from within the hospital or from the physician's secure remote location.
A benefit patients will notice is the ability for physicians to perform bedside charting and chart review with their patients. "Many times our patients may have several doctors such as their primary care provider and consulting specialists," Gluck relates. "With this new system we can forward test results to these other care providers simultaneously and conference on the patient's best options from wherever we have access to a computer, and know the information is protected and HIPAA compliant." With the inpatient record available to all users with permissible access, patient care will not only be safer but faster as information will be shared simultaneously among caregivers.
"When selecting Cerner for our clinical information system, security and privacy of patient information was paramount for the hospital," Turner says. Cerner's state-of-the-art technology centers will provide remote hosting of medical records. They provide levels of emergency backup and disaster protection ensuring their system is continuously secure. Each center is constructed of steel and concrete with raised flooring, secondary roofing, and water detection sensors.
Located in Missouri , additional Cerner security includes on-site facility engineers 24 hours a day, 365 days a year, a dedicated utility substation exclusively for their technology centers, and backup transformers and emergency generators. Access is strictly controlled using recording cameras, entry alarms, keycards, and biometrics systems.
Protecting information in transit between SVRHC and Cerner, is a Multi Protocol Label Switching (MPLS) and is as close to a direct connection as current technology allows. There is a backup between both facilities in case the primary network is not functional. They have firewalls on both ends of both circuits to allow only known connections between SVRHC and Cerner.
Staff member, Malea Stiner, volunteered to oversee the design of the scheduling portion of the hospital's clinical information system. "This portion of the new system schedules outpatient visits," Stiner explains. "The beauty of it is we can see other scheduled appointments so we can try to cluster appointments to help reduce the number of times someone has to return to the hospital for testing - this is truly a benefit for patients who travel long distances to receive care."
The new scheduling component will also have the ability to print a form providing preparation information patients will need to know, time of appointment, location of test appointment, and post-testing directions. "We will even have the ability to print a personal calendar formatted either daily, weekly or monthly for our customers with all their appointments indicated," Stiner says.
All team leaders agree that working on Project ISIS has provided the chance for them to walk in someone else's shoes. "We have learned so much more about the hospital than what our 'normal' jobs have provided," Stiner says. "While there have been many hours and lots of stress involved, it is an experience I would not have traded for anything."
From Turner's perspective the greatest benefit of the new system will be its flexibility and growth potential. "This system can be amended to create more system efficiency and allow for changes as needed and as new healthcare regulations mandate alterations. For more information about Cerner Corporation, please visit their website at www.cerner.com.
Safety and Quality Assurance - Joint Commission Accreditation
Sierra Vista Regional Health Center is accredited through The Joint Commission. This agency serves to help ensure and monitor the quality and safety of patient care. We are committed to providing safe and quality care to all patients served. If you feel the services provided have in any way compromised patient safety or not met accepted quality of care standards, please contact the Quality Department at (520) 417-4542 so your concerns can be addressed. If you do not feel these concerns have been adequately addressed after contacting Sierra Vista Regional Health Center, please feel free to contact Joint Commission by either calling them at (630) 792-5000 or writing to Joint Commission at:
The Joint Commission
One Renaissance Blvd.
Oakbrook Terrance, IL 60181
