PLAYING FOR CHANGEDr Sanjeev Bhoi MD.FACEE

Additional Professor

Department of Emergency Medicine

AIIMS

Objective

• Gaps • Issues and hurdles• Games of Mind• Playing for Change

Gaps

•System- •Manpower•Equipment•Guidelines and protocols

•Heath care personnel•Training

Issues and hurdles

• Casualty:- • orphan child of the hospital

• Lack of Team • Coordination• Abused,miused by established disciplines

Issues and Hurdles

•CMO a traffic police•Nurse- injectionolgist.•MLC

• Computer facility

Game of Minds

• Lack of motivation

• Apathy• Callous attitude• Commonly Misused Oppressed by established specialty

• Victim of lack of ownership

VideoPlaying for Change

Championing Playing for Change• Leadership• Ownership• Making a Team• Connecting ideas into reality• Introspecting within

Ownership

Mine Ours

Leadership

Making a Team

Team- Team

Connecting Ideas into Reality

ED

• MLC• Emergency Medical

record• Nurse Monitoring Chart• Patient monitoring• Reviewing images

IT

• E-MLC• Computerized Medical

Record systems• E- vital sign monitoring• E-patient monitoring • PACS, KiosKs

Introspecting within

• Emergency Department

• E-Emergency Department

To assess the perception of Emergency care providers towards the implementation of Electronic Medical Record system in Emergency Department

of a level -1 trauma centre

Courtesy :Sonia Chauhan (Trauma Nurse Coordinator)

METHODOLOGY

• Study design- Qualitative survey • Performance centre - ED of JPN Apex Trauma Centre, AIIMS.

• Study duration-February to October 2010 (3 surveys)

• Study Group-22 Emergency Care ProvidersDoctors 8

Nurses 14

Total 22

Study Tool

Structured, closed ended questionnaire consisted of 12 questions based on:

UsabilityApplicability Security Helpful in research of EMR.

SURVEY ON CPRS IN ER (JPNATC, AIIMS) BY HEALTHCARE WORKERS Are you aware of CPRS (computerized patient record system)? a) Yes b) No If your answer to the above question is ‘Yes’ please proceed below:

Usability: 1. Do you have problem in logging into CPRS? a) Never b) Sometimes c) Very often d) Always 2. Overall, how easy is the computerized MLC form? a) Not at all b) To some extent c) easy d) Very useful

3. Overall, how easy is the computerized transfer notes? a) Not at all b) To some extent c) easy d) Very easy

4. Overall, how easy is the computerized discharge summary? a) Not at all b) To some extent c) easy d) Very easy

5. Overall, how easy is the computerized entry of patient vitals? a) Not at all b) To some extent c) easy d) Very easy

Applicability:

6. Do you think this system is helpful in overall patient care? a) Never b) Sometimes c) Very often d) Always

7. Do you feel demographics are more accurately entered in all forms (MLC form, transfer out forms, discharge summary) by using the computerized system? a) Never b) Sometimes c) Very often d) Always

8. Do you think computerized MLC form is helpful for police and judiciary (courts)? a) Never b) Sometimes c) Very often d) Always

Security:

10. Do you think data can be manipulated in system (after sign off)? a) Never b) Sometimes c) Very often d) Always

11. Do you think this system will help in improving transparency and accountability? a) Never b) Sometimes c) Very often d) Always

Research: 12. Do you feel this system can be helpful in research? a) Never b) Sometimes c) Very often d) Always

• Likert scale(LS) was used (Likert 1=wrost, likert 4=best).

• Surveys were done on day- 20 ,day- 45 day and 9 months of implementation of EMR.

• Response of emergency care providers(ECP) were compiled

• Data analyzed by SPSS version 16.

Result

log

in p

robl

em

ease

of c

ompu

teriz

ed M

LC

ease

of e

lect

roni

c tra

nsfe

r not

es

elec

troni

c di

scha

rge

sum

mer

ies

vita

l ent

ry

help

ful i

n pa

tient

car

e

dem

ogra

phics a

ccur

acy

appl

icabi

lity

of e

lect

roni

c MLC

form

man

ipul

atio

n of

dat

a

trans

pare

ncy

and

acco

unta

bilit

y

rese

arch

0

0.5

1

1.5

2

2.5

3

3.5

4

2.23

2.5 2.45 2.41

2.71 2.72

32.82

1.41

2.77

3.32

S1S2S3

Usability

S1S2

S3

2

2.1

2.2

2.3

2.4

2.5

2.6

Likert Scale

Application of EMR

S1 S2 S30

0.5

1

1.5

2

2.5

3

3.5

likert scale

likert scale

Mission with a vision

To

play for change

A journey from ED to e-ED