Mobile Documentation: Optimizing Technology to Do More with Less

Another reason this approach was taken was the fact that this would be an interim solution. UMHS is planning to build a new patient care tower adjacent to University Hospital (its main campus location in Columbia) that will have vital sign machines (provided by the Skaneateles Falls, N.Y. -based Welch Allen) in all patient rooms that wirelessly feed the data into the EHR. “Instead of taking two to three years to [implement this project], we actually got to that point in two to three months knowing that two to three years down the line this technology would be replaced by something that was actually better,” says Karen Nickell, R.N., nursing architect, Tiger Institute, University of Missouri Health System.

Karen Nickell, R.N.

Nickell, a 14-year IT veteran, designed the build and worked with the device professional to build the workflows and develop special server configurations. The implementation team included IT services, nursing leadership, 12 unit nurse educators, and six staff members from the education and training department. “Just in time” training for an average of 30 to 60 minutes per person was provided to the nurses and nurse technicians on the units.

Compliance was continually measured post-implementation, says Dow. Tiger leadership followed up with nurse coordinators on floors where nurse techs were still using paper, and worked with them to ensure compliance. “I actually ran weekly reports and sent it to the management of the units so they could look on it and see which of their staff was using [mobile documentation] and getting the information in a timely manner,” says Nickell. “And if someone’s name was not on that report, they could go talk to them. Educators and managers were adamant that this would be used for patient safety and workflow.”

To measure success, a pre- and post-implementation time study was conducted, and significant improvements were found. The average length of time from point of collection to results documentation in the EHR decreased from 32 minutes to 2.2 minutes. This project has resulted in improved patient care and safety, efficient nursing workflow, and care team satisfaction, says Dow and Nickell. Documentation errors have been reduced, electronic health advisor rules now trigger in a timely manner and the care team workflow and satisfaction is improved.