Baton Rouge General Makes Most Wired List on Louisiana Medical News

Baton Rouge General Makes Most Wired List

By: TED GRIGGS

Posted: Wednesday, September 7, 2011 2:18 pm

Baton Rouge General Makes Most Wired List | Most Wired, American Hospital Association, Baton Rouge General Medical Center, information technology, ventilator-assisted pneumonia, outcomes, quality

One might think that Baton Rouge General Medical Center’s selection to the American Hospital Association’s “Most Wired” list resulted largely from huge investments in information technology.

While the hospital has invested millions in creating one of the country’s most advanced health IT systems, Dr. Flip Roberts, the General’s chief medical officer, said slowing down the introduction of new infrastructure has been a key to improving clinical processes.

Instead the General has focused on redesigning processes around the IT infrastructure, Roberts said.

“I think that is where the gains have been really made in the last two years,” Roberts said.

Roberts said incorporating IT into an industry that has been notoriously resistant while working simultaneously to improve patient safety has been a long journey, one which is far from over.

The General is constantly redesigning its IT use to help ensure treatments are carried out in a reliable and safe manner, Roberts said.

“One of my roles is to constantly remind folks that IT needs to be a clinical tool,” Roberts said.

The hospital can’t force new technology on the clinical staff purely for the sake of saying the hospital has adopted information technology, he said.

The idea is to make the staff aware that a new tool is available and to get the medical staff to find the answers to some important questions:

How can the hospital best use this tool to take care of patients? To improve the patient experience and the work experience of the medical and nursing staff? The reliability of outcomes?

Bennett Cheramie, the General’s manager of clinical informatics, said each initiative, such as the treatment protocols for ventilator-associated pneumonia or tracking boards in the Emergency Department, was driven by key leaders on the medical staff and clinical community.

Without the staff’s assistance and development, none of these processes would have been adopted, Cheramie said.

“We’re trying to be very careful here not to put the cart before the horse. The clinical processes have to drive the IT,” he said. “And I think that’s how we’ve improved a number of gains in the last couple of years.”

For example, the ED tracking boards provide a real-time notification of where patients are in their emergency room experience, Cheramie said. A doctor or nurse can tell at a glance whether the patient’s labs have been drawn and if the results are back, rather than having to make a phone call.

The tracking boards have allowed the General to move patients through the Emergency Department more quickly, with better outcomes, he said. And the ER doctors were integral to the boards’ development.

“We need to be careful to make sure we’re not throwing IT at bad processes, but rather we’re correcting the processes and integrating IT into it,” Cheramie said.

With ventilator-associated pneumonia, that meant using the medical staff to redesign the process to improve the way the General identifies, treats and evaluates those patients, Cheramie said. The result is that the hospital was able to reduce the number of days patients spend on ventilators and the number of patients that develop ventilator-associated pneumonia.

Check lists in various industries help to improve safety, and there is sort of an evidence-based checklist, that if we can follow it 100 percent of the time on patients on ventilators, has been proven in other institutions to decrease the number of patients who develop pneumonia.

That was our journey, to try and take this checklist and find a way to ensure that we do it 100 percent of the time. And the end result we’re looking for is no ventilator-associated pneumonias.

The General had to figure out how to use IT to build in reliability so that the protocol went from being used most of the time to almost all of the time, he said.

Hospitals get a lot of things right 80 percent of the time because there are a lot of individuals working very hard to make that happen, Roberts said.

But it doesn’t take much for a treatment protocol to fall short of perfection. The physician who writes an order leaves out one of seven elements. An order for respiratory therapy is delayed from late afternoon until the next morning.

Information technology can be a key to making sure those things don’t happen, he said.

The General’s goal was to reduce the number of patients who came down with pneumonia, Roberts said. Reducing the number of days patients spend on ventilators was a wonderful added benefit.

The General was the only Louisiana hospital named to the 2011 Most Wired list. In 2008, Baton Rouge General was named one of the “Top 25 Most Connected Healthcare Facilities” by Health Imaging & IT magazine.

The hospital credits its comprehensive, interdisciplinary approach for reducing costs, improving workflow and efficiencies, enhancing quality and outcomes, and increasing patient satisfaction.