At 8am on the 11th of March, University Hospital Kerry (UHK) went live with the Maternity EHR (Electronic Health Record). UHK is the second hospital to go live with the Maternal & Newborn Clinical Management System (MN-CMS) and the first general hospital to be making use of this solution. The readiness activities undertaken by staff at UHK ensured a smooth go live.
The learning from December’s go live in Cork University Maternity Hospital (CUMH) has been applied well to UHK, All technology solutions were in place well ahead of cut over, in excess of 3,700 hours of formal training was delivered to staff and engagement throughout the hospital best described as ‘calm excitement’ by the UHK project manager Fiona Lawlor. By 13:00 there were four babies on the system, some retrospective work was conducted to ensure that a small number of babies born before the 08:00 am cutover had their information on the system.
The concepts of the shared record and the identified benefits of a national EHR can be seen in Kerry already. A baby born into the Neonatal Intensive Care Unit (NICU) in CUMH six weeks ago has been transferred to the Kerry NICU in the last week. Previously this would have required a great deal of paperwork to be sent and in some cases testing and re-testing of the patients in the new location. The clinicians in the NICU in Kerry were thrilled to have the ability to access the full clinical record. Additionally, as the PAS (Patient Administration System) is also a group wide solution the administrative information, patient consent and statistics relating to the business operations of the care are also immediately available to the new care team.
By Sunday morning Kerry had seven digital babies, newborn babies now with a full digital clinical record accessible by clinicians across the hospital in a safe, secure and auditable manner. As with the CUMH go live, maternity teams across the country pulled together to support the UHK go live. This involved collaboration from across maternity services with teams from the Rotunda Hospital, National Maternity Hospital, Cork University Maternity Hospital, the Office of the CIO, National project & technology teams and partners from Cerner.
Mary Godley a Staff Nurse and trainer in Kerry Special Care Baby Unit (SCBU) said
“before the introduction of the Maternity and Newborn system, significant time was spent writing and rewriting baby details. Now details are entered once and populate where required, thereby eliminating the need for duplication of data entry.”
The first baby born following the go-live on the Saturday lunch time was a very proud moment for the hospital and all the associated staff. Prior to the go-live, the administrative team in the hospital issued the last ever paper record in its usual efficient manner, this would be the final paper record ever to be issued like this in UHK for Maternity/ Neonatal services; a somewhat ceremonial destruction of the record and an audit of the first digital record took place and from that moment on maternity/ neonatal services in Kerry would be paperless. As a member of the medical records team said on the second day of being live:
“Eliminating the need to create mother and baby charts has already, on day two, created time savings making us more efficient and we feel able to deliver information that will assure safer care”
The NICU in Kerry now has Internet of Things (IoT) devices available to all cots, capturing vital signs and providing the information as a dashboard to NICU staff. This means that nursing staff can focus on care delivery as time spent on written data entry and statistical analysis is eliminated.
All the support in place meant that the one issue reported on day one, the medication chart showing a slightly different time at the top of the screen, was able to be clinically evaluated, a fix considered and testing started very quickly.
The way in which the site went live means that the project team now start to focus on The Rotunda Hospital and National Maternity Hospitals (NMH). Even by 10:30 on the Sunday the go live planning started to move to the next sites! The Maternity Digital challenge earlier in the year increased the awareness of MN-CMS going live and every maternity unit in Ireland has now started its journey in some way, for example, the bedside digitisation of services in the maternity unit in University Hospital Galway and the implementation of tablet devices across maternity in Letterkenny General Hospital. This all starts to increase maternity services' digital maturity and begins the journey towards an EHR for every new-born child and mother in Ireland.
MN-CMS go-live support team and University Hospital Kerry, on Saturday 11th March, after the system went live.