KRAs for 2017

ePrescribing

Anupam has mentioned ePrescribing to the hospitalist service line and the residency programs. Both groups are interested in looking at baseline data before making targets for 2017. The baseline data should be available by mid-January.

Copy & paste

When this KRA was presented to the VPMMs at a system-wide safety meeting, they suggested using 2017 as a year to educate end-users about the behavior and learn more about the "copy & paste" phenomenon. If the high rates of "copy & paste" behavior persist over the calendar year, they would support developing a system-wide policy with site-specific interventions.

The group suggested a two-pronged approach toward this behavior:
1. General communication about the fact that "copy & paste" behavior will be monitored, and
2. Site-specific processes to counsel those physicians with much higher than expected rates of "copy & paste" compared to their site peers.

Some directors would appreciate other technological changes including turning off "copy & paste" for the assessment and plan or turning off "copy & paste" by individuals.

The group also reiterated the need for high-quality data to reduce the risk of inappropriately identifying a user with high rates of "copy & paste" based on attesting to a resident's note.

The group was amenable to reducing the number of users with the average across all notes greater than 95% identical by 25%. For example, if a site had eight users every week with notes that were on-average, greater than 95% similar, the target would be to reduce the number of users at that site with high "copy & paste" rates to six.

Communicating with end-users about Clinical Systems changes

A few of the directors were interested in having a monthly communication from Anupam about changes planned in our Clinical Information systems. Instead of emails that are easily deleted, posting these communications in each hospital's physician lounge may help disseminate the news to additional users. The group believed face-to-face communication was the most effective, but other communication modalities (e.g., mailboxes, screensavers, department meetings, cybercafes) add value.

CareConnection work plans for 2017

The CareConnection team is expecting to be fully focused on the Sherman integration and Cerner registration implementation for most of 2017. The team is asking for most changes to be submitted by March of 2017. We should still be able to make some changes to PowerPlans, but most other changes will be severely restricted.

Issues from prior meetings

[] If the signature + specialty request (with changing the resident's specialty with each rotation) and SmartTemplate work are performed by separate teams, then we will proceed down both paths simultaneously. Otherwise, we will work on the SmartTemplate request first before adding troponin in the daily labs SmartTemplate.
[] Anupam is still waiting to hear back from the Advance Care Planning Council about changing the requirement for a physical signature for LET orders.
[ ] Anupam to present electrolyte management to the ED Clinical Excellence Council to determine if this protocol could be applied in that setting.

Next meeting either January 19th or February 9th (depending on medical director availability) 0730-0830 hours CST.

Click here to see minutes from earlier meetings.