Children’s Hospital of Saskatchewan: Our Journey to Opening Day

It’s midnight. Your six-year-old has been running a high fever for a few days and you have been in emergency trying to determine what is happening. The decision has been made to admit your little one to pediatrics. When your child is registered, your child receives a wrist band and you notice a little box on it filled with tiny black squares. And this week, you will see that little box already making an appearance in some pediatric units at Royal University Hospital.

Sample arm band with new bar code

Sample wrist band with new bar code

You might not think much of it all, but that little box is the first step in fulfilling a vision of a digital hospital for Children’s Hospital of Saskatchewan.

“Basically, that box is a barcode and it will be key to tracking your child’s health information within Health Records and linking up with other health information systems,” explains Wes Hiebert, clinical lead for Saskatoon Health Region’s eHealth and Health Information department. Hiebert is part of a group working to implement forms on demand and scanning of health records for the new hospital. “When your child is registered, a specialized software application takes some of his or her information such as name and health number from our registration system and prints it automatically onto the forms used in their chart. The forms can be printed right on the unit when they are needed by clinicians. We will no longer need to print multiple patient identification labels and attach them to blank forms, reducing storage and paper on the units.”

Scanning of a patient’s chart upon discharge, and making it immediately available for viewing within the region’s electronic health record system (called ‘Sunrise Clinical Manager’) is one of the critical “must do” projects underway in support of the new Children’s Hospital of Saskatchewan (CHS). The new hospital was designed to support a future provincial electronic health record and as a result there is very little physical space on the CHS units for storage of clinical forms and historical patient charts. The ability to scan the paper chart is reliant upon having forms used in the patient’s chart that are barcoded with patient and form identification information.

Sample arm bands and corresponding labels with new bar code

Sample wrist bands and corresponding labels with new bar code

Over the past number of months, Hiebert and team members Julie Gerwing and Michelle McCulloch have been meeting with clinical areas that will be moving into the new hospital to review the forms they use today on the unit and how those can be standardized and put into an electronic format.

The project team members are also tasked with the plan to reduce form storage on each unit. Beyond reducing storage needs, pre-populating forms and having them accessible electronically for printing will help eliminate patient identification errors.

“This will also move us away from unit-specific forms based on individual preferences,” explains Julie Gerwing, the clinical lead with the Scanning and Forms on Demand Project, eHealth and Health Information. “Patient clinical forms will be created and designed centrally to ensure standardization. By doing this, it ensures forms are created consistently and used in the same way in every unit by all care providers.

Once in place, units will see cleaner-looking forms with barcodes in place. The project team will work with each unit moving to the new hospital to map out the right work flow in terms of printing forms and assembling charts, and providing training. The roles and responsibilities of each care provider for this new way of printing and preparing charts will be identified during this process.

New clinical forms with corresponding bar code

New clinical forms with corresponding bar code

“We are redeveloping all clinical forms with the new software application to enable printing the forms on demand with patient ID and barcode in place,” says Gerwing. “We will roll out this change unit by unit, and will work with each unit to create logical packages of forms often used together which should reduce the current time spent on assembling and labeling chart forms.”

The first unit to experience this new world of forms-on-demand are Acute Care Pediatrics, Neonatal Intensive Care (NICU), Pediatric Intensive Care (PICU), and Same Day Surgery (SDS). This week, these areas went live with the new forms.

“Once we are live, it doesn’t mean forms can’t be changed when clinically needed,” explains Michelle McCulloch, one of the Managers for Health Records and co-chair of the region’s Clinical Health Record Forms Committee. “When units need a form changed, they will submit it to the Clinical Health Record Forms Committee for approval. Once approved, the requested changes are given to a desktop publisher for development and implementation into Forms on Demand. This will ensure everyone has access to the same version of the form at the same time.”

“Having the barcode on these form will ensure that the patient’s health record can be automatically scanned after a patient is discharged and made immediately available within Sunrise Clinical Manager,” says McCulloch. “This will be a significant improvement in information flow and will positively impact the care we provide.”

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