Linda Schiech, RN, MSN, AOCN, a clinical nurse specialist at Fox Chase Cancer Center, in Philadelphia, Pennsylvania, shared how the hospital overcame obstacles during a presentation titled Success and Failure: Strange Bedfellows, at the Oncology Nursing Society's 30th Annual Congress.
"We're in the early phases of going from a paper society to paperless," Schiech
"You have to do a few more clicks to find things, and that annoys physicians and other clinical people trying to do their work rapidly," Schiech
said."It's been an interesting journey." Schiech
referred to business management guru Peter Drucker's wisdom that 15 years of past successes can contribute to failure to help explain the difficulties the hospital experienced with the IT plan.
Fox Chase's successes date back more than a century.Founded in 1904, the hospital has obtained Magnet status, its scientists have won Nobel Prizes and it has pioneered modern approaches to cancer care.
"We've been successful as an institution and as a nursing department, yet it's difficult when trying to implement change, because people have a fear of failing," Schiech
"Many people said they hoped they would retire before we would do this," Schiech
said."We have nurses who do not know what a mouse is.There are a lot of different levels of people.We have new nurses that can whip through anything."While serving on the hospital's practice council, Schiech developed experience with policies and procedures and documentation.The hospital tapped her to move half time into the informational technology department to facilitate implementation of the electronic medical record (EMR) by bringing a clinical perspective to the team.
"It kind of goes backward from the way you would normally think of things," Schiech
Eight members of the IT
team testing the new system trained super users from each unit and hospital department.The staff returned to their floors and trained people working with them.
In addition, Schiech
and the IT
staff trained physicians on the system in their offices, one-on-one.
Now, almost a year after launch, "Everyone is getting used to it," Schiech
The software company has modified the product to accommodate some of Fox Chase's requests and will work with the hospital's team to develop an oncology module.
The hospital intentionally chose a phased implementation to build support and avoid major problems.Fox Chase
has begun working on the next phase, enabling nursing and allied health to document electronically.Schiech
plans more training with future phases.
"Eventually, with an electronic medical record, it's going to increase patient safety and help with communication," Schiech