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 Wenger Awards
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.
The Women’s Health team was a proud sponsor of the Wenger
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.
Awards for the 3rd year in a row.
FAQ 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.
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
Did You Know
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.
Client Conversions Since 2009, the Women’s Health
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.
As of the end of Q1 2013, we had
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.
Team has been busy with client conversions.
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
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.
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.
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
Fascinating Facts
A baby cannot taste salt until it is 4 months old. The delay may
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.
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.”
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‐ sHeatlh@Cerner.com
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 What We’re Doing
Client Spotlight
Physician Playbook The OB/GYN physician playbook is a
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.
set of established standards and recommendations based on the best practices observed by Cerner across
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
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.
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.
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.
Just For Fun In Which Month Are the Most Babies Born?
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?
The summer has been the top
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
season for births in the United States, according to records kept by the Centers for Disease Control and
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
Prevention, and August often wins the title as the month during which the most babies are born.
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
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
In the News
Quick Disassociate 1. From the Census View, click on
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 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
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.
continued documentation on the
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.”
current patient.
Source: Becker’s Hospital Review
another patient and also allowing for
April 2013
In the News continued Nebraska Methodist Women’s Hospital
National Women’s Health Week May 12-18, 2013
Methodist Women's Hospital delivers 10,000th baby
National Women's Health Week is
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!
a weeklong health observance
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.
of Health and Human Services’
World Health Congress
coordinated by the U.S. Department
Office on Women's Health. It brings together communities, businesses, government, health organizations,
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.
and other groups in an effort to promote women's health and its importance. Find out more by visiting: h p://womenshealth.gov/nwhw/
Women’s Health Newsletter Content Releases
April 2013
Social Media
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:
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 developments 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!
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.
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
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.
If you are interested in printing this newsletter, you can download a printable PDF on our Women’s Health Collaboration uCern page.