Abstract 3888: Use of Electronic Triggers to Insure Compliance with Nursing Driven Stroke Measures
Background and Purpose: Our Lady of the Lake Regional Medical Center is the largest hospital in Louisiana with 734 Bed licensed beds. Patient care in the adult care units is delivered by over 1200 nurses in 20 acute care units and 5 intensive care units. There are over 25,000 Inpatient discharges from the medical center annually. Stroke discharges for the fiscal year 2010 were 867. The Medical Center utilizes an electronic medical record and is supported by a health system department that drives the development and oversight for the IT implementation in the 4 hospitals within our system. With only 5 Certified Stroke Centers in Louisiana, none in our geographic region; OLOL set a goal to become stroke center certified. With competing priorities and multiple quality initiatives in the medical center and across our health system, OLOL was challenged to develop processes to insure compliance in meeting the nursing driven stroke measures; dysphagia screen and stroke patient education. Our task was to develop electronic triggers to insure that screenings and education occurred at the appropriate time during the patient stay.
Methods: This effort required work across disciplines and the health system. Our caregivers (nurses, physicians, and pharmacists), quality leaders, technology team members, and process experts worked together to reach our collective goal. The team developed triggers, or tasks required to be completed, based on an admission diagnosis or suspected diagnosis of stroke. When completing either task, the electronic record would auto populate a specific form for the task to be completed. For stroke education, the electronic form navigates the nurse through the 5 required components of stroke education, allowing the nurse to print a hardcopy of the required education for patient review. For the dysphagia screen, the auto form directs the nurse how to complete the task and automatically implements orders based on a pass or fail of the screen.
Results: Data collected from Get with the Guidelines, Stroke at our organization pre and post implementation of the triggers were measured. Compliance with dysphagia screen increased from 59% to 87%. Stroke education increased from 0% to 94.9%.
Conclusion: Electronic triggers improved compliance with meeting nursing driven stroke measures for patient education and dysphagia screen. The need to provide quality stroke care and improvement efforts for documentation was identified as a need before the application for Stroke Center Certification. Stroke meaningful use requirements for stimulus dollars helped to provide the organizational focus of resources that otherwise might not have appropriated for Stroke.
- © 2012 by American Heart Association, Inc.