More Efficient Workdays
Case Study
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Business Problem
Ayisha Bradley, an MDS nurse at Care Centers in Johnson City, Tennessee, found that her facility’s team meetings were followed by hours and hours of putting in notes and writing orders
Solution
By moving her data to Experience Care’s electronic health records, Bradley was able to speed through meetings and teach nurses to update notes and document care plans on the spot, leaving them extra hours to care for residents.
Details
Team meetings in long-term care facilities are when a staff plans what needs to be done for the day. For those who rely on paper, that can mean bringing tens of charts along with you. And even then, there is not the opportunity to fill out charts until after meetings are over. “They’re just running through and having a conversation,” Bradley said. “So it might take an entire day to actually get everything done.”
Solving the Efficiency Problem in Long-Term Care
Electronic Health Records
When Bradley and her team started using Experience Care’s electronic health records, it was a bit of an adjustment. But they soon found that they had far more time in the day to care for residents. This is because they could get more done in meetings and had less paperwork to fill out when they dispersed.
“Our meetings are more efficient.”
The problem with paper is that it is nearly impossible to quickly access the vast amount of information about residents in the short time allotted to each item raised in a meeting. Experience Care’s KPI Dashboard made it possible for Bradley and her team to quickly scroll through their tasks. “It’s speeding up meetings,” she remarked. “Our meetings are more efficient. No longer do you have to grab 1,000 charts to take to the meeting. You can just pull up the KPI Dashboard in your EHR and see which residents have triggered a weight loss or supplemental order or have an indoor assessment open.”
One of the biggest reasons Bradley can work efficiently with her KPI Dashboard is that she has customized it in accordance with her facility’s needs. “You can create it how you want and include what you want to be on there,” she said. “We use it as a workflow. It’s used for morning meetings. It’s used for follow-up meetings. It’s used for behavior meetings. It’s used for nutrition at risk meetings. We set up dashboard sections just for those meetings.”
“Once you walk out of that room, everything’s done.”
Perhaps the greatest advantage of using Experience Care’s software in meetings is that nurses do not have to worry about missing assignments, as they can complete them right there as they are mentioned. “There’s no, ‘I forgot to put that note’ or ‘Now I have to go spend two hours at the nurse’s station and write orders for everything we talked about’.” Rather, she said, “Once you walk out of that room, everything’s done.”
“Now, when we’re finished talking about a resident, the DON has already entered a new order and has the note completed.”
Ayisha Bradley, Informatics Technician at Care Centers
Nurses Have More Hours in the Day
It is clear that Bradley, who is now the QA informatics technician at Care Centers, and the rest of the staff are working more efficiently. “Pretty much anybody involved in that meeting is saving time by working from the KPI Dashboard,” she said. But just how many hours are they saving?
DONs Save Two to Three Hours a Day
A director of nursing is responsible for managing and supervising all nursing personnel operations. That means he or she must make sure the facility is in compliance with federal regulations and state laws and review the progress of nurses. The DON must also keep nurses, the medical staff, department heads, and administrators on the same page. Those are some big responsibilities. So being able to save even an hour of time by documenting things electronically can have major implications for the performance of a DON.
Well, Bradley shared that she has found that her DON is not only saving one hour but two to three hours now that they’ve moved to Experience Care’s EHR. “Now, when we’re finished talking about a resident, the DON has already entered a new order and has the note completed,” she said. “The DON saves two to three hours.”
Dietitians Save One to Two Hours a Day
A long-term care dietitian is responsible for prescribing therapeutic diets, preventing and treating malnutrition, and managing individual nutrition preferences. That means he or she must enter the meal information for every resident on a daily basis. Bradley noted that the dietitian at her facility is now saving “a good hour or two” on account of using Experience Care’s EHR.
MDS Nurses Save Two to Three Hours a Day
An MDS nurse is responsible for conducting resident assessments, developing care plans, and monitoring Medicare and Medicaid coverage. By using EHR, the MDS nurse can make sure to fulfill all those duties. “The MDS nurse is saving time because they don’t have to set aside extra time to update their care plan,” said Bradley. “Rather, while the meeting was happening, they went ahead and updated their care plan with that new intervention. So they don’t have to go back and get that chart, write it out, and find the next resident.”
“As soon as your CNAs log in, they are alerted immediately if anything is wrong with a resident.”
Less Paperwork. A Higher Standard of Care.
With so many tasks at a long-term care facility, it is quite common for some to remain incomplete. Part of the problem for Bradley’s staff was that they were “stuck in an office all day long trying to do the follow-up,” she said. But Bradley found that this issue is far less prevalent now that she and her team are using Experience Care’s EHR. “Before, they had to push aside some of their daily work,” she said. “But now they can focus on getting out there in the hall with the residents and the nurses and being a bit more hands-on.”
What does this more time with residents mean for the care provided? Plenty. “The resident gets better care, because now when a person’s losing weight, not only does the nurse know but so does dietary, the administrator, the assistant director of nursing, and the matrix clerk,” Bradley said. “Residents are getting more attention because now everybody’s alerted.”
The Advantage of an Electronic Physician’s Dashboard
By moving from paper charts and no longer requiring physicians to be physically present in facilities, Bradley and her team have found that they are able to communicate with physicians much more quickly and effectively. “Before, a nurse would enter information for the doctor on Monday, but the doctor didn’t come in until Thursday,” she said. “Now, with the physician’s dashboard, doctors have access to the system wherever they are. So we can call them and say, ‘Hey, can you check on so and so?’, and they can pull up their dashboard, see the resident is triggered for something, and give us a call back to place an order.”
An Electronic Kardex that Alerts CNAs Immediately
Experience Care’s Kardex system provides daily alerts for ADLs, a summary screen with residents’ most important information, and a summary form where preferences can be set. “It’s just great,” said Bradley. “As soon as your CNAs log in, they are alerted immediately if anything is wrong with a resident.” She also mentioned that she and her team would emerge from meetings with everything easily updated on their Kardex, which made the rest of their workdays easier.
"Before, they had to push aside some of their daily work. But now they can focus on getting out there in the hall with the residents and the nurses and being a bit more hands-on."
Why Experience Care?
While there are other EHRs out there, Bradley found that Experience Care was the most user-friendly. “I know people that work on other electronic health record systems, and they’re not as user friendly as far as the dashboard and ability to guide your workflow through that dashboard,” she said. “I have seen American Health Tech. I have seen Point Click Care. And honestly, I feel like overall, this system works better for me. I can easily get on Experience Care and feel like I have everything I need a little bit better.”
“They value our opinions.”
Experience Care’s user-friendly system, she says, is largely the result of strong communication with users. “If there’s something we want the software to do, we can usually have a conversation about it,” she said. “And they usually figure out a way to make that happen.” Bradley mentioned the Kardex itself as being something that was developed by way of user group meetings. “We had some suggestions for things that were not on the [Beta version of the] Kardex section,” she said. “We asked if it is possible to add this or take this out. And by the time of our next user group meeting that next week, they had made those changes.”
Bradley gave the example of the splint section. Thanks to her input, splinting and braces are now separate categories. She’s currently in conversation with the support team about updating the physician’s order screen. “Neal [Cox, the clinical product manager at Experience Care] reached out the other day, and he actually wants to talk to a nurse at each building, the line staff, those who place orders every day, to hear what they would like to see in it. And I think that’s awesome. They’re digging to know what changes they can make for the better, asking the people who actually use the software every day.”
The weekly user groups give clients a voice. “They value our opinions,” Bradley said. “They want to hear from their clients and make the software more useful for them. And that’s awesome for me, because most companies just say, ‘This is the way the system is’. But Experience Care tells you what they’re changing and why. And then we talk about it before the updates.”
Top-notch customer service
Bradley called the Experience Care support team “amazing” and “partners” for her staff. “It goes beyond corporate,” she said. “I know probably on paper, we have a contractual relationship and they’re the vendor, but the way we work hand in hand, I feel like it’s more of a team and a partnership.” In this regard, she mentioned responses from customer support, which are “immediate, I mean immediate.” Bradley recalled recently receiving a phone call in less than an hour for an issue that turned out to be related to clearing a computer’s browser history. “I’ve always gotten a great response,” she said. “Sometimes I might have problems putting in a CSR or don’t know a password. Before I even receive a phone call, I get an email telling me how to do that. They provide the steps, a manual, my login info, and tell me to call them.”
“It does everything I need it to do and then some.”
Bradley mentioned that, in user groups, the Experience Care team will mention new features that users had not even thought about previously. “There are some things you didn’t even realize you wanted or needed,” she said. “And then you see it, and you’re like, ‘Oh, I can do that’.” When combined with a KPI Dashboard that helps make meetings more productive and a Kardex system that keeps nurses alerted, Bradley has found that Experience Care’s EHR has more than exceeded her expectations. “It does everything I need it to do and then some,” she said. “Overall, it’s very user-friendly, and the people I’ve worked with at Experience Care have been awesome.”