Designing interdisciplinary documentation for the continuum of care

The Benefits of Standardized Nursing Languages in Complex Adaptive Systems Such as Hospitals

Paperwork is a major source of frustration for hospital nurses and takes valuable time away from patient care. Studies indicate that nurses spend an estimated 13% to 28% of total shift time documenting. The growth in documentation requirements for nurses can, in part, be attributed to an exponential rise in health system complexity. Authors explore the documentation of nursing care plans from a complex adaptive system perspective and then analyze the utility of adopting a standardized nursing language. An actual case history of a nursing unit's attempt to reduce complexity, improve completion time, and increase staff satisfaction in care planning by adopting a standardized nursing language is provided to emphasize a practical application.

Quantitative evaluation of regular morning meetings aimed at improving work practices associated with effective interdisciplinary communication

In 2000, an interdisciplinary surgical morning meeting (SMM) was introduced into the infants' and toddlers' ward of a major paediatric hospital to help overcome a number of communication and work process problems among the health professionals providing care to children/families. The objective of this study was to evaluate the impact of the SMM on a range of work practices. Comparative design including pre- and postintervention data collection was used. Data were collected on 100 patient records. Twenty children, from each of the five diagnostic-related groups most commonly admitted to the ward, were included. Demographic, medical review, documentation, critical incidents and complaint variables were obtained from three sources: the hospital clinical information system, the children's medical records and the hospital reporting systems for complaints and critical incidents. Children in the postintervention group were significantly more likely to be reviewed regularly by medical staff, to be reviewed in the morning, to have plans for discharge documented regularly throughout their admission and to have admission summary sheets completed at the time of discharge. The findings of the quantitative evaluation add some weight to the arguments for the purposely structured introduction of interdisciplinary teams into acute-care environments.

Development and implementation of an interdisciplinary plan of care

In January 2002 Aurora Health Care Metro Region chartered an interdisciplinary team to develop a process and structure for patient-centered interdisciplinary care planning. This unique endeavor created a process that includes the patient, family, and all clinical disciplines involved in planning and providing care to patients from system point of entry throughout the entire acute care episode. The interdisciplinary plan of care (IPOC) demonstrates the integration of prioritized problems, outcomes, and measurement toward goal attainment. This article focuses on the journey of this team to the successful implementation of an IPOC.

An interdisciplinary documentation performance improvement project

An Interdisciplinary Documentation Performance Improvement Task Force was created to evaluate and revise the documentation system at an academic medical center. The primary goal of the documentation project was to establish a standardized documentation system that reflected interdisciplinary planning of care for all of the organization's inpatient populations. This article identifies the process used to revise and implement an interdisciplinary documentation system. Project implementation and outcomes as well as recommendations and future initiatives are included.

Implementing a new model of integrated women's health in academic health centers: lessons learned from the National Centers of Excellence in Women's Health

The National Centers of Excellence in Women's Health Program (CoE) represents a new model for women's health in academic health centers that unites women's health research, teaching, clinical care, public education and outreach, and career advancement for women in the health sciences. Lessons learned from the first 3 years of implementation indicate that this type of model requires a transformation from the traditionally fragmented set of activities in academic health centers to an integrated system united around the goal of advancing women's health. The transformation requires institutional commitment, dedicated players, and an ability to build on existing resources and bring added value to the institution. Challenges and strategies to link women's health activities and increase collaboration are also discussed.

Lessons Learned: Developing Education for a System-Wide Documentation Project

BACKGROUND

As Summa Health System implemented an integrated interdisciplinary documentation system, educational sessions for staff had to be developed and presented.

METHOD

Structure of classes, scheduling of sessions, ongoing revisions and refinements, and key elements of success are shared.

RESULTS

Staff members incorporated the documentation changes into practice.

CONCLUSION

Other organizations may benefit and learn from the experiences of our two-hospital system in developing and scheduling education for a system-wide change project.