Women’s Health Newsletter
December 2012
In This Edition Did You Know Breastmilk Tracking
What We’re Doing FetaLink UI Survey Results
Save the Date FetaLink 1.9.4 Illuminations Session
Maintaining Industry Awareness Cardiovascular Disease Risk
Client Spotlight Fort Healthcare
Women’s Health Newsletter Community Involvement
Did You Know We offer a Breastmilk management solution
Giving Back this Holiday Season The Women’s Health team decided to collect donations for a local women’s shelter this holiday season, and chose Synergy Services. Synergy Services, Inc. began in 1970 as Synergy House, the only shelter for runaway and homeless youth in western Missouri. Through the years, a series of both serendipitous and strategic mergers expanded the organization’s reach to include young children and women victimized by abuse. Today, Synergy provides a full continuum of care to assist individuals and families with immediate respite from violence, and services which empower clients to find and choose good options for future safety and success. In addition to their work to treat the effects of violence, they provide supportive services to families in crisis in an effort to prevent violence. Additionally, they focus on community education and social change in an effort to build a safer and more humane society.
Through bar-code scanning technology, Cerner Bridge® Breast Milk Management helps caregivers give the correct mother’s milk to the correct infant at the time of feeding. By ensuring positive patient identification, the solution increases patient safety and supports nursing workflow from receiving to administering. Clinicians use Cerner Bridge Breast Milk Management together with Cerner Millennium POC™ (point of care) solutions or as a standalone system to support all required documentation, including any comments associated with the feeding.
Solution at a Glance
Offers the ability to document the amount of milk given as well as any additives
Provides support for both donor milk and mother’s milk
Enables the tracking, storage, thawing, combining of products as well as expiration dates
Provides support for multiple births
Key Benefits
Positive patient identification of infants during feeding of expressed breast milk
Support of both donor milk and mother’s milk
Tracked storage, thawing, combining of products as well as expiration date
If your site is interested, contact John.Folmnsbee@Cerner.com
December 2012
What We’re Doing FetaLink UI Survey Results A FetaLink survey link was recently made available to members of our Women’s Health Collaboration Community, to gather feedback on FetaLink design and use. 48 people participated in the survey. 50% were L&D nurses, 42% were IT personnel, and the remaining survey-takers represented a varied list of OB clinical areas. What were some common responses? Logging in and out of the application: 34.4% of users would like to be prompted in the application. 43.8% would like an auto logout. Census: 63% would like to see more clinical data on the FetaLink Census, such as physician name, EGA, G/P, or Reason for Visit. Alerting: 65.6% would like to see which rooms are alerting from the Census. Names to consider changing:
Charting mode (53.6% in favor of changing) Archive (59.3% in favor of changing) Patient archive (53.6% in favor of changing) Clinical link (60.6% in favor of changing) Device (64.3% in favor of changing)
Workflow tools that were not commonly used:
Change User (77.4% rarely or never used this) Help Files (74.2% rarely or never use this) Time scale options (58.1% rarely or never use these)
Workflow tools that were commonly used:
Retroactive association (64.3% use this most or all of the time)
A common theme noted throughout was the desire for more integration with PowerChart Maternity. In addition, it was common (67.8%) of users to select actions they did not intend to within the application. This survey will be utilized to provide insight and feedback into the needs of the FetaLink user. One of our key initiatives for upcoming FetaLink releases is to enhance usability. Thank you to all who provided input, and be on the lookout for new surveys coming soon!
FAQ How long can the fetal monitoring strips be stored, and does Cerner ever purge the data? The fetal monitoring strips are permanently stored in the CAMM (archive storage) and are not purged. If a baby has a different last name than mom - does related records functionality still work the same? Yes, related records functionality will allow the clinician to quickly access the related chart (mom to baby or baby to mom)– regardless of the baby having a different last name. When does the link for related records get broken between mom and baby? The related records link is not broken automatically. It is Cerner recommendation that the client create a policy as to when this link is to be manually broken. We have seen hospitals manually break the link when the baby is discharged and have also seen them leave the baby and mom linked for several years. In the case of adoption or surrogacy, Cerner recommends that each organization follow state guidelines. The baby can be registered independently of the birth mother (thus never creating a link), the link can be broken as soon as the baby is born, or the link can be broken after the delivery information has been result copied to the baby’s chart. (Note – when result copying delivery information to the baby’s chart, there are no personal identifiable markers to the birth mother.)
Women’s Health Newsletter Tips and Tricks
Save the Date!
Open Pregnancy by EGA/EDD Report
FetaLink 1.9.4 Illumination Session
The Open Pregnancy by EGA/EDD report gives providers the ability to quickly query for the patients that still have an open pregnancy, based on user prompt inputs.
A client session of this Illumination is scheduled for Tuesday, December 18, 2012 1:00 PM CT.
Description of Session Join Jill Meier for a session on FetaLink’s newest release, FetaLink 1.9.4. FetaLink is Cerner’s maternal and fetal monitoring system that facilitates the flow of data from fetal monitor devices to provide a graphical display of the relationship between fetal heart rates and contraction data. FetaLink also stores and displays waveforms and annotations- information clinicians can view on a display monitor at the bedside, throughout the hospital or clinic, and through remote access.
One of the uses for this report is to identify patient records needing to have the pregnancy instance closed with an Unknown outcome.
During this session you will get an overview and demonstration of the newest features that are a part of FetaLink 1.9.4.
This Illumination session will focus on the following new features: • Documentation Integration • Black Background Option
We recommend any pregnancy
• Snapshot • Enhanced gridlines in PDF
more than 44 weeks be closed. Registration To register for the session, click the link below. You will need a Cerner.com user name and password.
https://applications.cerner.com/members/illuminations/IllumDetails.aspx? illumid=4328
Once the registration is completed and approved, you will receive a meeting link to gain access to the session.
December 2012
Maintaining Industry Awareness: Cardiovascular Disease Risk According to the CDC, a correlation exists between pregnancy state, birth outcome and future risk of cardiovascular disease (CVD).
Tips and Tricks (continued) This is important if a patient does not return for delivery or if her pregnancy
8% of pregnant women have high blood pressure during pregnancy, putting them at three times greater risk for developing hypertension and two times greater risk for developing heart disease later in life.
was never closed and returns with a new pregnancy, then the former pregnancy will be historical and show in her
Women who deliver before 37 weeks or have a growth restricted infant are two times more likely to develop CVD later in life.
One in ten pregnancy-related deaths are attributable to CVD.
pregnancy history. For clients with Powerchart Maternity Acute only, we recommend the preg-
For more detailed information, refer to the CDC’s fact sheet, “Cardiovascular Disease (CVD) and Risk Factors for CVD Among Women of Reproductive Age.”
nancy be closed at discharge once all
http://www.cdc.gov/reproductivehealth/WomensRH/PDF/CVDFactsheet_508.pdf
documentation is complete. For clients with Powerchart Maternity Acute and Ambulatory, we recommend to close the pregnancy at the 6 week postpartum visit in the office.
Women’s Health Newsletter Happy Holidays!
Client Spotlight
Wishing you the warmest wishes of the Season, from our women’s health family to yours!
Fort Healthcare Fort HealthCare is an independent, 110 bed Level 1 hospital that went live with 55 Cerner solutions on August 1, 2011, including Powerchart Maternity and FetaLink. The OB department has approximately 500 deliveries a year with four obstetricians and four family practice physicians.
It is believed the first fruitcake was made in Roman times when Romans preserved fruits that were out of season. And they made cake out of the fruit.
Prior to the implementation of Powerchart Maternity we used computerized documentation in OB, but the prenatal information obtained at the office was a paper prenatal record. This prenatal information was relayed to the OB department via faxes, beginning at 20 weeks and continued with updates monthly until 36 weeks, when it changed to weekly updates. As one can imagine, we used a lot of paper to maintain pregnancy communication and this was not always a reliable method for accessing current and updated health information.
To prepare for the implementation of Cerner and Powerchart Maternity, we began training our nurses approximately six weeks before go-live in small, hands-on, four hour sessions for a total of 12 hours. The week before we went live we trained them in another hands-on class for FetaLink, and also used this session as a review of Powerchart Maternity basics.
In addition to the two nurses who worked with Cerner from the beginning, we trained five additional Super users to assist with go live support. For the first two weeks of go live we had a Super user present on each shift to assist staff with their documentation and build their confidence with the new system.
December 2012
Client Spotlight (continued)
Best Practice
We started auditing charts almost immediately after the implementation and offered feedback, both positive and constructive, to each nurse. We continue to do monthly documentation audits and provide staff with their individual audit percentages, helpful hints and suggestions for improving their documentation. In addition to this, we offer required quarterly Cerner Review Sessions to the nurses. We share changes with the system, and through the audits, we identify areas that need to be reviewed with staff to increase their documentation compliance. These are likely the biggest reasons we have been so successful with our implementation.
Ensuring Optimal Performance Before launching FetaLink from your desktop, double check to make sure there is not an instance of it already running, but minimized in the
The greatest advantage to having the prenatal record in Powerchart Maternity is that we no longer have to fax records on a daily basis, and that the most current pregnancy and health information is readily available 24/7. This had saved both the clinic nurses and OB nurses a tremendous amount of time. In addition, when a patient presents at the hospital at any gestational age or at any time when the clinic is closed, we have reliable information at our hands to enhance the care given to the patient.
toolbar. This is a common finding at our client sites. Running one instance of the application will help to ensure
FetaLink has been an asset to our implementation as well. The nurses easily adapted to this and feel this has improved their documentation and eliminated the need for double documentation since their annotations flow to IView. Our physicians can easily access FetaLink in the clinic or at home to view their patient’s monitor tracing and no longer have to search for the paper strip to sign.
optimal performance. In addition, when you are done using FetaLink at that workstation, don’t
As with any new change implemented, we had our share of problems, but we found that if we addressed these readily we were able to work through them fairly easily. Good communication with the nurses and physicians is still essential to continuously improve our workflow and processes. We’ve come a long way since August, 2011 but it was worth the trip as we are now at ITWorks Site!
forget to log out!