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Nurses are at the heart of two-year project that will transform patient care

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Yvonne Wilson, front row, centre, and Ann Mitchell, directly to Wilson's left, were part of a talented group of nurses

Yvonne Wilson, front row, centre, and Ann Mitchell, directly to Wilson’s left, were part of a talented group of nurses who showed clinical expertise and leadership as The Ottawa Hospital prepares for the launch of Epic, the digital health network on June 1.

Hundreds of nurses across six health-care partners are leading the charge towards the launch of the Epic digital health network. Many more are supporting the effort as their colleagues and the larger hospital family of over 18,000 people receive training, learn new policies and understand new practices.

Hundreds of nurses across six health-care partners are leading the charge towards the launch of the Epic digital health network. Many more are supporting the effort as their colleagues and the larger hospital family of over 18,000 people receive training, learn new policies and understand new practices.

Hospital and project leadership recognized from early on the value of involving nurses in all facets of this effort to transform care. Their insights are integral to making the vision of seamless care in a digital age come true.

“Nursing has been involved from adoption of Epic to validation to testing,” said Ann Mitchell, Director of Nursing Professional Practice. “That input has been essential to making this system work well for us and other providers. We spent hundreds of hours in build and design meetings, and we were able to add or change some functions to support how we work and to make the system practical.”

Ann Mitchell
Ann Mitchell is the Director of Nursing Professional Practice.

Clinical expertise and perspective from nurses are setting the entire effort up for success.

“We’re going to be able to provide more holistic care by having patient information available in real time to the patient’s care team across our partner network,“ said Yvonne Wilson, an experienced nurse and Clinical Director at The Ottawa Hospital, who is also the clinical lead for the project.

The launch of Epic across six partners in Eastern Ontario will usher in 21st-century health care for patients in Eastern Ontario. Those six partners include The Ottawa Hospital, the University of Ottawa Heart Institute, The Ottawa Hospital Academic Family Health Team, Hawkesbury and District General Hospital, Renfrew Victoria Hospital, and St. Francis Memorial Hospital.

Nurses offer valuable insight and leadership

A project of this size and importance needed world-class teamwork. Clinicians and physicians worked closely together from the start in order to develop a seamless system that will enhance patient care. The dedicated staff of the Project Fusion team, a talented group of Information Technology and clinical professionals, have worked for two years to build and test the system.

Nurses were among the professionals on that team.

Vidhya Veeraragavan became the first Epic-certified analyst at The Ottawa Hospital in 2017. She is a registered nurse with a Master of Science in Nursing.

As an analyst, Veeraragavan offered expertise in the areas of rehabilitation, mental health and security related to documenting information for patients in hospital. She met with clinical managers to collect data on workflows to help build the system so that it is standardized across the partner organizations.

Veeraragavan recognized that it might take some time for staff to adapt to the new system, but that doing so has many benefits.

“It will be so handy – click and go. We’ll save time and energy, so care providers have more time for patient care,” she explained.

Indeed, many nurses became project analysts and reviewed current workflows to customize the system. Peggy Guilbeault, who has worked in the NICU and in infection control over her 30-year career, was in charge of inpatient clinical documentation. She and her team spearheaded the process of standardizing hundreds of workflows, a process which reduced order sets from 560 to 311. This represents an unprecedented level of standardization compared to other Canadian builds.

“I think the biggest win for nurses is that there is a strong element of patient safety.”

Nurses have not only been an essential part of building the new system but also in teaching others how to use it. Dozens of nurse educators have spent months creating tools to help colleagues understand and use the new system.

Front-line nurses were engaged to become Credentialed Trainers, who were responsible for delivering training to over 4,000 nurses. Leading the training presented a great opportunity for nurses to develop new skills and to try a different aspect of nursing. When these Credentialed Trainers return to their unit, they bring with them an in-depth knowledge of the system and become imbedded resources who can provide further support to their peers.  

In so many ways, nurses have worked hard to educate and prepare staff for Epic – all to support high-quality patient care.

“I think we have infinite possibilities for how we can enrich patient care once the system is live,“ said Wilson.

Yvonne Wilson is a registered nurse and the clinical lead for the implementation of the Epic digital health network.

A new era in patient safety

 “I think the biggest win for nurses is that there is a strong element of patient safety,“ said Mitchell.

For example, beginning in June, nurses at the bedside will scan the medication and the patient’s ID bracelet before administering the medication to the patient. The Epic system helps ensure the right person is getting the right medication at the right time.

“Epic will help the hospital further reduce the risk of medication errors,” said Lisa Mishak, a nurse with 19 years of experience in the ICU. “In addition, some of our patients have thick medical binders given our long-standing care relationship with them. In Epic, we won’t be looking through hundreds of sheets of paper. We’ll actually be able to look up what we need to know on the patient quickly and easily, leaving more time for care.”

“We know that what we see ahead of us isn’t the finish line, but rather the start line of a new era in care, safety and quality improvement.”

The enhanced security features in Epic ensure that members of a patient’s care team have access to the right information while keeping patient health information secure.

 “Epic will absolutely give all our other staff access to information in a timely, secure and need-to-know-only fashion,” added Wilson.

Patients as partners through MyChart

Starting June 1, patients can sign up for MyChart, a secure portal that keeps all your health records in one place. MyChart is connected to Epic, so once signed up, patients need only to tell their story once, including their current medications and allergies, and wherever they go in the network, their health-care team will be ready to help.

MyChart is a powerful tool to help patients feel empowered as an active and valued partner in their health-care journey.

“MyChart will give patients another way to play a central role in their care team by engaging them in their care and planning, and having easy access to their patient information,” said Wilson.

Patients can use MyChart to access their health records from their mobile device or desktop. Information and test results are updated in real time, so their health information is always at their fingertips.

Together we strive to Improve care in our community and abroad

While The Ottawa Hospital and its partners have been driving towards the launch of the new system, we know that what we see ahead of us isn’t the finish line, but rather the start line of a new era in care, safety, and quality improvement.

“We are leaving our mark on health care and potentially changing the lives of patients who live thousands of miles away.”

The hospital has a long-standing culture of quality improvement, and Epic will help deepen and enhance our commitment to it.

As an Epic hospital, The Ottawa Hospital will have access to the vast knowledge of hospitals throughout Canada and the United States that also use Epic. In addition, The Ottawa Hospital can contribute to that well of knowledge by sharing its expertise through Epic’s world-class best practice functionality.

In fact, some of the hospital’s world-renowned best practices are already available to members of the larger Epic community, which includes renowned health institutions like the Mayo Clinic and Johns Hopkins Hospital.

“We are innovators,” said Wilson. “Our work and research to improve care will be available to hundreds of health-care organizations across North America. We are leaving our mark on health care and potentially changing the lives of patients who live thousands of miles away.”

 
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