Date post: | 25-Dec-2015 |
Category: |
Documents |
Upload: | marjory-walters |
View: | 228 times |
Download: | 0 times |
The Omaha System Partnership: Nursing Informatics Research Network
Kay PoulsenHelp4U, New Zealand
Kia Ora fromNouvelle-Zélande
Omaha System in NZ
• HINZ November 2009“To ensure that correct decision making occurs at
the right time, at the right place, and that services provided are at the right level in a consistent, coordinated way, this clinical information must be valid, reliable, but most of all present”.
Brent McGrath (1960 – 2010)
Changing the way nurses and allied health professionals document and communicate care in community clinical practice : a community care clinical data set.
Omaha System• Holistic evaluation of problems in the setting of a
person’s life– Individual, family or community level – Potential problems & health promotion
• Multi-dimensional perspective using simple framework– Omaha System is the A, B, C that enables us to write War
and Peace
• Measure the impact of interventions on consumer awareness and consumer engagement as well as clinical outcomes. – Knowledge, Behaviour, Status outcome ratings
A Community Care Solution
• Omaha System• CADITM data dictionary• Project GAIN • PLAIN WORDSTM taxonomy• IT architecture• International partnerships
• HINZ, November 2010 – Sheree East
“The key thing is, understanding the landscape in which you are operating is constantly shifting. And when the ground shifts beneath you – systems need to be flexible and sustainable.
“We are now ready to embark upon the trial and implementation of the dataset using 21st century documentation and communication technology”
Transforming Clinical Practice through Terminology
Delivering the vision
Help4U
• A health navigation and consumer advocacy service• Linked student welfare division with existing agencies• Commenced coordinating suburban welfare
enquiries• Earthquake services A-Z• The lightbulb project / winter care parcels project
The Aftermath: impact on health services
Loss of:•100 tertiary care hospital beds (17%)•600 residential care beds •122 non-government community health groups
and counting…..
Entrer (enter)…Omaha System
• TotalCare service– Hospital in the Home
• Nurse Practitioner service– Older Persons’ Health
• Help4U service– Family health centre care coordination
• AESOP clinical documentation tool
• New Zealand Omaha System User Group
Preliminary Comparison:Nurse Practitioner Service and TotalCare Service
• The Nurse Practitioner Service served 11 patients (27% male, 36.4% living alone)
• Average age 86.6 years, with an average of 6.1 problems per patient (67 total problems)
• Have been referred by general practitioner for more frequent in-home visits
• The TotalCare service served 37 patients (27% male, 56.8% living alone)
• Average age 84.8 years, with an average of 10.0 problems per patient (371 total problems)
• Have been identified as requiring residential care, but there is no bed
Comparison of Problems (n > 20)
7
5
4
2
4
2
3
2
7
16
20
21
22
23
23
27
28
30
0 5 10 15 20 25 30 35
Skin
Vision
Medication regimen
Physical activity
Pain
Urinary function
Health care supervision
Personal care
Neuro-musculo-skeletal function
TC
NPS
Of the 9 top problems, 5 are physiological and 4 are health related behaviors.
Comparison of Baseline Knowledge, Behaviour, and Status Ratings
2.763.00 3.053.02
3.72
3.32
1
1.5
2
2.5
3
3.5
4
4.5
5
Knowledge Behaviour Status
NPS
TC
*Behavior is significantly higher for TC (differences for knowledge and status are not significant)
29
0
4
34
64
5
70
232
0 50 100 150 200 250
Missing
Community
Family
Individual
TC
NPS
Baseline assessments for all problems: Individual/Family/Community Level
Next Steps• Omaha System Partnership Care Plans
– Diabetes– Wound Management– Homecare
• Post discharge care coordination research• Streamlining and integration to care process• TotalCare Evaluation
– “The service appears to have achieved what it was set up for with only 25% of those eventually admitted to resthomes and only 1 to hospital. Six patients ended up dying in their own homes”.
Questions
Sheree East, RN, DoNNurse Maude, Christchurch NZKaren A. Monsen, PhD, RNUniversity Of Minnesota, Minneapolis, MN, USAAmy B. Lytton, MS, RNSt. Paul-Ramsey County Public Health, MN, USASara AveryMassey University, Nursing ProgrammeWellington, NZAshleigh PeckCPIT School of MidwiferyChristchurch, NZ
Acknowledgements