cerner women's health newsletter_april 2013
DESCRIPTION
Cerner Women's Health Newsletter_April 2013TRANSCRIPT
Women’s Health Newsletter April 2013
In This Edition What We’re Doing
End of Support for FetaLink on iBus 1.3
FAQ Adding a Pregnancy
Maintaining Industry Awareness Critical Congenital Heart Disease
AWHONN
Client Spotlight Sinai Hospital of Baltimore
In The News Truman Medical Center Methodist Women’s Hospital
Content Releases
Women’s Health Newsletter
What We’re Doing
End of Support for FetaLink on iBus 1.3
This is an important message to our FetaLink clients who are currently on a version of
iBus up to and including version 1.3.
Cerner has set June 30, 2014 as the end‐of‐support date for CareAware iBus 1.3. This is
detailed in Flash PR13‐0040‐0.
The latest FetaLink release, version 1.9.4, became available in February of 2013. It is
supported on both iBus 1.3 and iBus 2.1. However, this is the last FetaLink release that
will be supported on iBus 1.3. Details are available via the technical flash T12‐0028‐0.
If your produc on FetaLink system is running a version of iBus up to and including
version 1.3, contact your CernerWorks produc on owner or client results execu ve to
begin planning an upgrade to iBus 2.1. Upcoming FetaLink releases will be supported
on iBus 2.1 un l further no ce.
Wenger Awards
The Women’s Health team was a
proud sponsor of the Wenger
Awards for the 3rd year in a row.
In support of Women’s Heart Health,
this event took place on April 8th in
Washington DC and was focused on
celebrating those who are making
extraordinary contributions in the
field.
FAQ
How to Add a Pregnancy on 4.x Platform
On the 4.x pla orm, the Add, Modify, Close, and Cancel Pregnancy op ons on the
pregnancy summary are now located in the overview component drop‐down menu.
To add a pregnancy, click the drop‐down menu of the Overview component and
select ‘Add Pregnancy’. The same Add Pregnancy window will then display and the
remaining process is s ll the same.
April 2013
Best Practice
Finalize and Disassociate
The Cerner recommended workflow is to finalize a strip at least once per shi or once
every 24 hours when monitoring antepartum pa ents. In doing this, it will reduce
me of loading the fetal monitoring episode, memory used and blank space seen
when scrolling. This is also recommended so that fetal strips can be more easily
reviewed and compared with previous strips. This is especially important with the long
term antepartum pa ents who are being con nuously and intermi ently monitored.
When reviewing a strip for a long term antepartum pa ent it may be difficult to scroll
along the extended view if the strips have been running for extended periods of
me. Once the strip is finalized it become an archived strip and may be accessed via
the pa ent archives. This will put the archived strip at the bo om of the screen while
the current strip is s ll running and viewable for comparison. This workflow also
makes it easier to access mul ple archived strips at the same me the current strip is
running.
For those antepartum pa ents that are being intermi ently monitored the episode
should be finalized at the conclusion of the monitoring episode.
We have seen several of our clients choose specific mes for finalizing episodes, but
please keep the following in mind:
o Midnight is the me when other “backend” reports (such as ADT updates) may be
running. This would be a possible increase in the load to the system based on the
number of strips being finalized and the number or Ops Jobs running.
o First thing in the morning is generally when physicians are on the unit to do
rounds, so you would want to have the strips archived prior to all of the clinicians
arriving on the floor so they are available for them to view from the archives.
o Some clients have chosen to finalize the strips with bed side report given at shi
change. This will end the documenta on and observa on of the nurse going off shi
and begin the episode fresh with the oncoming nurse.
o Ac vely laboring pa ents may need to be excluded from the shi change report
me based on workflow and pa ent laboring status.
Did You Know
Client Conversions
Since 2009, the Women’s Health
Team has been busy with client
conversions.
As of the end of Q1 2013, we had
78 live client sites with 150 live
facilities!
Our current international clients are
located in the United Arab Emirates
and the United Kingdom.
Women’s Health Newsletter
Community Involvement
March of Dimes
On Sunday, April 28th, the Women’s
Health team is participating in the
March of Dimes March for Babies 1
mile walk .
The March of Dimes has led the way
to discover the genetic causes of
birth defects, to promote newborn
screening, and to educate medical
professionals and the public about
best practices for healthy pregnancy.
Maintaining Industry Awareness
CCHD (Critical Congenital Heart Disease)
Newborn screening using pulse oximetry can iden fy some infants with cri cal
congenital heart defects (CCHDs, which also are known as cri cal congenital heart
disease). CCHDs represent about 25% of all congenital heart defects. CCHDs are
structural heart defects that o en are associated with hypoxemia among infants
during the newborn period and typically require some type of interven on – usually
surgical – early in life. Without screening, some newborns with CCHDs might be missed
because the signs of CCHD might not be evident before an infant is discharged from
the hospital a er birth. Infants with CCHDs are at risk for significant morbidity or
mortality early in life because of closing of the ductus arteriosus or other physiologic
changes.
Current published recommenda ons focus on screening infants in the well‐baby
nursery and in intermediate care nurseries or other units in which discharge from the
hospital is common during an infant’s first week of life. A pulse oximeter is used to
measure the percentage of hemoglobin in the blood that is saturated with oxygen.
PowerChart Maternity (US): Inpa ent (Jan 2013) # 64071 contains the CCHD
algorithm.
Source: Centers for Disease Control and Preven on
h p://www.cdc.gov/ncbddd/pediatricgene cs/pulse.html
April 2013
AWHONN
The Women’s Health team is expanding our presence at the Associa on of Women's
Health, Obstetric and Neonatal Nurses, (AWHONN) conference, June 15th‐19th in
Nashville, TN. By teaming up with DeviceWorks and Clairvia, for the first me we are
able to feature the breadth of Cerner solu ons available that focus on improving
efficiencies in a hospital’s maternity unit. AWHONN’s nursing focused a endees will
have the opportunity to experience FetaLink, PowerChart Maternity and FetaLink+ as
well as Care Connect, Infusion Pumps, MySta on and Breast Milk Tracking. Based on
survey results at last years’ conference, one of the biggest pain points for L&D nurses
and units was the lack of an L&D acuity‐based workforce management tool. We are
very excited to be able to share a solu on to this problem in our booth this year. Stop
by and visit us at booth #129.
Open House Event during AWHONN
We’re very excited this year to have
St. Thomas Health, a member of
Ascension Health, host an Open
House during AWHONN. This will
allow a endees to see first hand
how our solu ons are used at
Bap st Hospital ‐‐ a facility that
delivers 7,000 babies per year,
making it the busiest birth center in
the state of Tennessee.
If you plan on a ending AWHONN, are interested in joining this open house event and
want to ensure you receive updated informa on about it, please email Women‐
Fascinating Facts
A baby cannot taste salt until it
is 4 months old. The delay may
be related to the development
of kidneys, which start to
process sodium at about that
age.
The protein that keeps a baby’s
skull from fusing is called
“noggin.”
A baby’s eyes are 75% of their
adult size, but its vision is
around 20/400. By six months,
a baby’s vision should reach
20/20.
Newborns are more likely to turn
their head to the right than to
the left.
Women’s Health Newsletter
Client Spotlight
Sinai Hospital of Baltimore
Overview
Sinai Hospital of Bal more is a
467 bed community teaching
hospital and is part of the Life‐
Bridge Health system.
2200 deliveries were performed
in FY 2012. Perinatal Services
features a 12 bed L&D unit with 2
OR’s and 3 PACU beds, a 30
bed/35 Bassinet Mother Baby
unit, a high risk Antepartum
tes ng unit, and a 20 bed level IIIb NICU.
There are 150 Nurses with 1 Perinatal CNS and 1 Pediatric CNS. The medical staff
includes 4 Perinatologists, 2 Cer fied Nurse Midwives, 14 OB Residents, 3 Neonatolo‐
gists, 1 Neonatal Nurse prac oner, and 6 Pediatric Residents. There is 24 hour cover‐
age in‐house for OB, Neonatology and Anesthesia.
The ins tu on became a Cerner partner in 1998, going live with documenta on late in
1999. OBTV, a Phillips® product for electronic fetal monitoring and surveillance in L&D
was purchased in 2005. The L&D team became Alpha partners with the yet to be
named Cerner maternity solu on at this same me. In November 2010 the unit began
using Powerchart Maternity, with a FetaLink go live in May 2011.
The ins tu on is in Stage 1, Year 3 of Meaningful Use and at Stage 6 in the HIMSS EMR
Adop on Model.
Training— Successes, lessons learned, and how got to where we are today
The Powerchart Maternity and FetaLink ini al training (4 hour class) was mandatory
for all nursing staff. One unforeseeable lesson learned was that there was a delay with
go‐live so the classes were farther from the go‐live date than planned. Encouraging
“playing” in mock mode on a computer in the back of unit helped to remember
processes.
What We’re Doing
Physician Playbook
The OB/GYN physician playbook is a
set of established standards and
recommendations based on the best
practices observed by Cerner across
our client base and established to
improve the productivity & user
experience satisfaction level.
Recommendations are broken out
by specialty and include preferences
and privileges, content, workflow,
and training.
The playbook is scheduled to be
released at the end of June 2013.
April 2013
Client Spotlight continued
With new addi ons to the documenta on, screen shots highligh ng new features are
shared in huddles and staff mee ngs.
The most difficult concept to grasp seemed to be the P2DA process.
The week of go‐live, super users, Cerner reps, and Cerner coaches were scheduled for
24‐7 for first few days and then trated down throughout the week. Daily turnout
around mee ngs were helpful to make adjustments in the system, as well as to
communicate and educate.
How to con nue to remain successful?
Ins tu on wide—
There is an increased level of communica on and rela onships with I.S. teams
The addi on of Women & Children’s I.T. Analyst: one person who facilitates the system has helped to coordinate projects
Cerner—
We con nue to build and maintain communica on and rela onships
The addi on of the Client Service Manager has increased sa sfac on
Site visits with other customers to Sinai has increased energy with team
Plans for the Future
Revise documenta on to be be er aligned with work processes
Involve RNs in audits of documenta on
Get rid of paper log book ASAP
Power notes for MDs— engage the residents w/development/training
Interdisciplinary IPOCs—going house wide as well as in maternity
Lacta on Documenta on— to include outcome data for the Joint Commission’s Perinatal Core Measures
Just For Fun
In Which Month Are the Most Babies Born?
The summer has been the top
season for births in the United
States, according to records kept by
the Centers for Disease Control and
Prevention, and August often wins
the title as the month during which
the most babies are born.
In 2006, the most recent year for
which statistics are available, August
had the most U.S. births, just as it
did in 10 of the previous 16 years,
with the CDC estimating that 9
percent of all births occurred then.
February had the least.
Women’s Health Newsletter
Tips & Tricks
Quick Disassociate
1. From the Census View, click on
the patient name you wish to
disassociate.
2. A transfer conversation dialog
box will pop up. Assure “patient only”
is selected and select a HOLD bed.
This automatically disassociates the
patient from the current monitor,
enabling that device to be used for
another patient and also allowing for
continued documentation on the
current patient.
In the News
Truman Medical Center
TMC, a two‐hospital system based in Kansas City, Mo., recently completed a transfer
of land from the city of Kansas City, where they will build a $11.5 million, 35,000‐
square‐foot grocery store.
The store, which is expected to open in the middle of 2014, will offer produce, meats,
dairy items and ethnic foods from an array of local businesses, urban farmers and
community gardens. TMC will become one of the only hospitals in the country to oper‐
ate its own grocery store, and there is a clear goal in mind: Eliminate the food desert
within the hospital's service area, and fight chronic condi ons by ins lling a culture of
good nutri on.
For John Bluford, president and CEO of TMC, the grocery store concept was a no‐
brainer. “ It's an extension of our farmer's market. We've been running a farmer's
market for three years, and it's in a nice pa o environment on the campus of the hos‐
pital, almost literally under my office. So we started this farmer's market because the
hospital is adjacent to the tradi onal food desert environment that everyone is talking
about now. There is a big lack of grocery stores in a two‐ to three‐mile radius.
The farmer's market has been a resounding
success. It takes place once a week on
Wednesdays, from April to late November,
and we get up to 600 customers on that
day. We sell from 3,000 to 4,000 pounds of
fruits. It's pre y awesome, and it's well‐
a ended. Sixty percent of the people who
come are staff, 20 percent are pa ents and
20 percent are community members. Over
the years, the community and pa ent
volume has been picking up, and I expect this year, the community volume will be in
25 to 30 percent range.
Some of our physicians are actually wri ng prescrip ons for our pa ents to go to the
farmer's market. That led us to say, "If this is such a great idea, why not have a full‐
service grocery store?" There was a lot of buy‐in from the physicians and board
members, and the business community supported it as well. [The grocery store] really
supports our mission — to create a healthier community.”
Source: Becker’s Hospital Review
April 2013
National Women’s Health Week
May 12-18, 2013
National Women's Health Week is
a weeklong health observance
coordinated by the U.S. Department
of Health and Human Services’
Office on Women's Health. It brings
together communities, businesses,
government, health organizations,
and other groups in an effort to
promote women's health and its
importance.
Find out more by visiting:
h p://womenshealth.gov/nwhw/
In the News continued
Nebraska Methodist Women’s Hospital
Methodist Women's Hospital delivers 10,000th baby
Methodist Women's Hospital reached a milestone when the hospital's 10,000th baby
was delivered April 6th, 2013—and during their go‐live of PowerChart Maternity and
FetaLink!
Methodist Women's Hospital opened on June 21, 2010. That year, 1,779 babies were
born there. In 2011, 3,520 babies were delivered there and in 2012 the number grew
to 3,723. Since the first of this year, over 1000 babies have been born there.
World Health Congress
On April 9th in Washington DC, Shelly
Andrievk, from our Women’s Health
team joined forces with Dr. Morosky,
from the Hospital of Central
Connec cut and Candace Rouse from Lifebridge Health Center’s Sinai Hospital, to
present at the 10th Annual World Health Care Congress.
Their presenta on tled, “Improving Quality and Mi ga ng Risk Through the Use of an
HER” was part of the Women’s Health track. In their 3‐part presenta on, they
described how an EHR can go beyond simple order entry to transform departmental
quality, safety and educa on.
They also discussed maternal risk factors for preterm birth and recognizing the impact
that preterm birth has on infant morbidity and mortality. Lastly, they reviewed the
mul ‐site collabora on behind the crea on of Cerner’s Perinatal Risk Analyzer
solu on to aid in predic ng poor perinatal outcomes.
Women’s Health Newsletter April 2013
Social Media
Become a member of our Women’s Health Collaboration Community on uCern. uCern is a great way to stay up to date on the latest develop-ments around PowerChart Maternity and FetaLink, hear about upcoming events, network and share tips and tricks with your peers. If you are not already a member, we hope you’ll sign up soon!
Join Cerner on Facebook
Join the Women’s Health team on Facebook
Join Cerner on Twitter
Join the Women’s Health team on Twitter
Join us on uCern
If you are interested in printing this newsletter, you can download a printable PDF on our Women’s Health Collaboration uCern page.
Content Releases 4.5 Pregnancy Summary and Neonate Summary Generally Available April 2013
Packages:
64341 ‐‐ MPages: Pregnancy Summary Configura on 4.5 (March 2013)
64350 ‐‐ MPages: Neonate Summary Configura on 4.5 (March 2013)
Illumina ons link:
h ps://applica ons.cerner.com/members/illumina ons/IllumDetails.aspx?
illumid=4356
Highlights:
Pregnancy Summary Overview Customiza on
Maternal Weight Gain Graph was added within the Overview component giving the
clinician the ability to see the pa ent’s weights trended on a reference curve graph
and also in a table view that displays the weight change % (which is auto‐calculated).
The graph displayed is based off the pa ent’s BMI and one of four poten al graph
versions will be displayed.
Demographic Tab is now an op on within the Overview component. Demographic
informa on that was originally located on the Current Pregnancy Tab can be moved to
its own OPTONAL third tab. This tab can be configured be to displayed or not within
the Bedrock tool.
Race field now displays mul ple documented races for a pa ent mee ng a Meaningful
Use Stage 2 requirement.
Ability to Customize the 3rd & 4th columns of the Current Pregnancy Tab. The third
column allows configura on of any events under the Lab Results filter in Bedrock and
will display a er Blood Type event. The fourth column allows configura on of any
events under the Addi onal Informa on filter in Bedrock.
Neonate Summary
Hyperbilirubinemia Graph now has enhanced hover details and displays up to 3 Photo‐
therapy Start lines and Phototherapy Stop lines on graph.
Task Timeline now honors the primarily response for the Hearing Screening and
Circumcision tasks. The primarily response must be documented as completed before
either tasks will be “checked” off on the meline. Events defined as hover details for
the Hearing Screening and Circumcision tasks will not be used to mark the tasks as
complete, if documented.