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Maternity Clinical Information System (MCIS)
The challenge of moving from paper to fully electronic CIS
Jane BrosnahanDirector of Nursing & Midwifery
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Our Place - Primary & Secondary Maternity Unit – 11 Beds
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Background to MCIS
• Fully electronic• Supports maternity journey from confirmation
of pregnancy through to 6 weeks post partum– Conception to six weeks postnatal– DHB and community care– All clinical staff involved with care of mother and
baby
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What does MCIS look like?Thanks to Tairawhiti DHB for sharing this slide
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Pregnancy CareThanks to Tairawhiti DHB for sharing this slide
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The Warm Up
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Implementation of Trendcare 2013
• Midwives were fearful/ mistrusting of new technology and reliability of the data
• Variable IT literacy in the workforce• Slow to uptake system• Once implemented good users
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Implementation MCIS October 2014
• Small DHB not used to being early adopter – best at being a fast follower adopter
• Never anticipated that SCDHB would be the first DHB to utilise the entire system – originally selected to commence in 2nd tranche
• Externally managed system so constantly evolving (currently on version 8 – version 9 coming soon)
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Implementation MCIS October 2014• Much bigger change process than anticipated –
training , training , training communication, communication, communication
• Success required individual level practice changes – clinical notes , increased use of partograms
• Need to purchase new tools of the trade – laptops (cows), secure bags, mobile printers, i phones
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Training and utilisation
• All midwives (Core, Continuity of Care, LMC)– Some resistant staff with extra training and
involvement in the implementation they are now some of the best users
– LMC Midwives (non-employees) some now prefer MCIS as there preferred method for recording clinical notes
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Training and utilisation cont’d
• Senior Medical Officers– Obstetricians (ongoing training required to increase
utilisation)
– Paediatricians (more involvement in version 9 release)
– Anaesthetists (training planned)
– Locums
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Equipment
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And then came
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Membership• SCDHB General Manager, Clinical
Governance • SCDHB Director of Nursing &
Midwifery • SCDHB Falls Lead • SCDHB Strategy, Planning and
Funding • Home Based Support Services • Aged Residential Care Provider
• Sport Canterbury • ACC• Timaru District Council• Community Physiotherapist• Primary Care Chief Medical
Officer (as required)• Co-opted representatives (as
required)
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Learnings (post implementation and from Tairawhiti DHB)
• Undercooked project management• Better preparation• More involvement of end users• Probably should have implemented part
rather than entire system• Greater consideration of Health and Safety
issues related to equipment
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Benefits to come
• Automated triple enrolment – National Immunisation Register– Tamariki Ora Well Child providers– Oral Health– General Practice
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Benefits to come
• Hearing screening module (implications for Public Health Nursing, General Practice)
• LMC Midwives MMPO notes to be linked to MCIS
• National Maternity dataset through Health Information Standards Organisation process
• Link to Health Connect South for lab results etc.