Maturity Models

Improving Neonatal Outcomes with Streamlined Documentation: A Stage 7 Success Story

Improving Neonatal Outcomes with Streamlined Documentation: A Stage 7 Success Story

UMass Memorial Health Care, the largest not-for-profit healthcare system in central Massachusetts, ensures it delivers safe, high-quality and compassionate care to all patients, starting right at birth. UMass Memorial had a need for change to its data collection process in the Neonatal Intensive Care Unit (NICU), where providers were not able to efficiently collect and use data, thus delaying timely decision-making when caring for for critically ill newborns.

NICU providers previously collected data from multiple sources. This required time spent logging in to multiple, non-integrated electronic systems. This daily data transfer was time-intensive and often required manual extraction, increasing the risk of transcription errors. This also meant that any quality improvement project involving data collection took weeks to collect, and any discoveries that would help with clinical decision-making would be delayed.

Improving Speed and Accuracy of Data to Clinical Outcome

To address this issue, Neonatology Division Chief Lawrence Rhein, MD, gathered a workgroup of neonatology physicians and nurses, respiratory therapists, pharmacy staff, quality informaticists and application analysts. The versatile group combined their clinical and technical expertise to streamline integrated documentation processes and utilization of integrated tools and devices.

This workgroup identified methods to display trended data, implemented electronic tools necessary for quality documentation and provided training and support to providers on these tools. This new process is error-proofed, as data automatically flows into the daily documentation system. Today, as care team members round on patients, they can review a patient’s current and integrated care summary (orders, test and progress results, clinical and device documentation). All rounding tasks (including new orders and documentation) are completed real-time. Graphically displayed, trended data allows providers to make immediate clinical decisions. Providers now have significantly more time to spend with their patients and explain care plans with families.

Having easy access to discrete and integrated data has resulted in a substantial clinical outcome: the rate of infants discharged with growth failure decreased drastically. Prior to these improvements, it was difficult for the NICU to look at interval rates of weight gain or loss for multiple infants, and growth failure in very-low birthweight infants born appropriate for gestational age occurred over 24 percent of the time. Now, the NICU team can analyze the effects of interventions much more efficiently, directly resulting in a decrease of growth failure rate to less than 4 percent in the first quarter of 2018.

Percent of infants born appropriate for gestational age discharge with growth failure
Source: UMass Memorial Health Care 

Improved analytics, physician adoption of tools and integration of patient data has made it possible for physicians to quickly gain insights from patient populations, dramatically improve care coordination and rounding efficiencies, and make clinical decisions real-time. The NICU strives to continue its use of data in every aspect of care, including nutritional, respiratory, and developmental outcomes.

HIMSS Analytics Stage 7 Validation

HIMSS Analytics is proud to recognize UMass Memorial for its validation as a Stage 7 healthcare system, as tracked by both the EMRAM and the O-EMRAM. UMass Memorial Health Care is in the top 2 percent of organizations that have achieved Stage 7 for both the acute and outpatient settings.

“Data that took a month to collate now takes minutes,” stated Lawrence Rhein, MD, MPH, Chief, Division of Neonatology and Associate Professor of Pediatrics. “Utilizing similar data collection tools and strategies, we have also greatly reduced the need for parenteral nutrition and central lines.”

“HIMSS Analytics congratulates UMass Memorial Health Care for achieving Stage 7 for both the acute care setting (EMRAM) and the ambulatory setting (O-EMRAM). Stage 7 represents a culture of continuous improvement and care throughout the UMass organization and to the residents of Central Massachusetts,” said Philip W. Bradley, FHIMSS, HIMSS Analytics regional director, North America.

Learn More

Learn more about how to empower your organization with the HIMSS Analytics EMRAM and OEMRAM.

Contact Kyle Munderville for more information on the healthcare provider maturity models and Stage 7 award.