STAGE 7 SPOTLIGHT Nemours: Improving Patient Care Through Safe Blood Product Administration

HIMSS Analytics

Healthcare providers across the globe refer to the Electronic Medical Record Adoption Model (EMRAM) as a standard framework for the implementation and effective use of health information technology. Modern HIT systems have a proven impact on the quality of care, the overall cost of care delivery and can help with improving operational efficiency.

The positive results of EMR implementation are far reaching across healthcare organizations, impacting caregivers and patients through the use of innovative technology. Let’s discover how Nemours became validated as Stage 7 through the implementation of the BPAM project.

The Challenge

Nemours is among the country’s largest integrated pediatric health systems — and is the only one in the nation with two freestanding children’s hospitals (Nemours/ Alfred I. duPont Hospital for Children in Wilmington, Delaware, and Nemours Children’s Hospital in Orlando, Florida).

Patients travel to Nemours from across the nation and from over 50 countries worldwide. On average, Nemours sees more than 400,000 children, resulting in 1.4 million health encounters annually. Their 900 specialists, 6,000-plus associates, over 3,500 healthcare professionals, and 1,500 doctors in training provide premium care at 80 locations, across six states.

In 2011, Nemours/Alfred I. duPont Hospital for Children was among the elite 1% of U.S. hospitals to achieve Stage 7 designation. The hospital achieved Stage 7 once again on September 12, 2017, on both the Electronic Medical Record Adoption Model (EMRAM) and Outpatient Electronic Medical Record Adoption Model (O-EMRAM). As a leader in electronic medical record technology, Nemours received the HIMSS Davies Organizational Award of Excellence in 2011 for its effective use of health information technology to improve the safety and quality of patient care.

Given that all other requirements were already met, the only remaining step necessary for Stage 7 re-validation was the implementation of barcode scanning for administering blood products. Prior to the Blood Product Administration (BPAM) project, patient information and instructions were attached to the blood product via paper.

The EMRAM Implementation

As early adopters of clinical information technology, Nemours/Alfred I. duPont Hospital for Children needed to implement just one project for Stage 7 renewal — development of barcode scanning for blood products. The BPAM project team included nurses, physicians, blood bank associates and leadership, lab leadership, and IS clinical application analysts.

The group developed the workflow, built the EMR to support this new endeavor, and performed downstream and integrated testing. Caregivers received education via web-based training, and nurses were given opportunities to practice with the technology prior to implementation.

Once the project went live, nurses and providers received support for several weeks afterward to help resolve any issues. Due to the project’s success and the collaborative efforts of the interdisciplinary team members, the project team was nominated for a Nurses Week Award.

In the new process, the patient’s barcoded wrist ID is scanned and a barcode is attached to the blood product to match the patient. As Stephen Lawless, MD, MBA, Senior Vice President and Chief Clinical Officer for Nemours Children’s Health System conveys the importance of the program: “Given that blood products themselves, if given in error, can have a catastrophic negative impact, safe delivery is paramount. Merging the safe technology of error-reducing barcoding to blood product administration is a significant step toward safety at a time when urgency and care delivery is paramount, and safe practices could easily take a back step.”

Nemours is already live with its electronic medical record (EMR) and picture archiving and communication system (PACS). They implemented an inpatient EMR in 2009, effectively eliminating paper health records. This greatly improved the quality of care and established them as a leader and innovator in the field.

The Results

Nemours/Alfred I. duPont Hospital for Children has continued to maintain its Stage 7 status and the BPAM project continues to ensure patients receive the correct blood products. The interdisciplinary, collaborative work accomplished by the project managers created a streamlined process effective at improving blood product administration for patients to reduce the risk of medical errors.

The Takeaway

Nemours collaborated with a wide range of stakeholders in the project’s earliest stages. The project managers focused on the importance of education. They offered extensive educational opportunities for caregivers in order to drive adoption, reduce risk and improve patient care. Due to the project’s successful implementation process Nemours greatly reduced the amount of support typically needed during technology implementation. Completing the BPAM project enabled Nemours/Alfred I. duPont Hospital for Children to achieve Stage 7 re-validation.

Nemours is just one of many healthcare organizations who have experienced the benefits of the EMRAM Stage 7 validation process. Like the team at Nemours, healthcare organizations can use the EMRAM as a roadmap to make strategic technology investments that support their overarching goals of becoming more innovative healthcare systems and improving hospital operational efficiency.

case study