Steven H Shaha
Center for Public Policy & Administration, USA
In 2016, Steve Shaha was introduced internationally as “premier healthcare outcomes researcher globally in breadth and depth.” With 35+ years of studies, teaching, speaking and advisory work, Steve has addressed the needs of a long list of recognized organizations on four continents, including 11 foreign governments. He has 250+ conference presentations, 125+ peer-reviewed publications, three invited chapters internationally in 2015, and four books. Steve is a full Professor with 4 graduate degrees and has taught or lectured at 30+ universities in 6 countries, among them Harvard, Cambridge (UK), the King’s College, UCLA, Columbia and Cornell.
Background: The acquisition and use of electronic medical records (EMRs) has grown remarkably. Of yet statistically valid verification of beneficial clinical, cost and efficiency outcomes is rare or absent. The vacuum seems largest for bedside caregivers, mainly the hourto- hour vigilant Nurses with critical roles in patient outcomes. Healthcare needs EMRs that favourably impact bedside clinicians.
Methodology/Process: Five healthcare organizations rigorously undertook six projects to improve Nursing impacts through EMR programmable and adaptable solutions. Nurse, physican and IT-professional teams defined crucial Nurse-related documentation impratives that contributed to internal-EMR computations for vigilance, alerting and protection. The IT-proffesional then programmed/adapted the EMR to better value and incorporate Nursing decimation, better alert beside Nurses for key activates, and enable improved physician actions on Nurse-provided documentation.
Safety and Medication Errors
Pharmacy data and Nurse surveys corroborated (all p<0.01):
• 83.2% of Nurses rated 4 or 5 (1-5 scale) – 38.5% higher versus vbaseline - for improved safety, clinical management, documentation,
communication and “the 5 rigthts”
• 71.7% reduced medication administration errors.
• 83.6% decreased Falls with injuries
• 69.2% fewer acquired level 3&4 pressure ulcers
Nurse Efficiency & Efficacy
• 44-minute decrease in documentation time away from patients
• 21-minute decrease in overall documentation time
• 29.3% increased patient-direct time, shifting from 35% patient-direct to 52%
Conclusion: Programming and adapting the EMR for sensitivity for Nursing needs substantively and significantly improved Nursing efficiency and efficacy. Such adaptability through in-house teams maximizes role importance and recognized criticality. When Nurses
win, everyone wins.