Automating Healthcare
Solving business problems with savvy automation
 


Nursing Audits

Business problem
Nurses audit medical records in every inpatient unit to ensure high-quality patient care and compliance with accreditation standards. We needed a tool to capture audit results for reporting and to ensure that the correct audits were done in each unit in the correct timeframe.

What it does
The nursing audit tracking tool provides:

  • overview of an inpatient unit's audit status for the current period
  • forms to create or edit a patient audit
  • forms to create or edit a hand hygiene audit
  • tools to manage the lists of units to audit and the audit schedule
Unit status
To determine which audits remain to be completed for any unit, a nurse selects the unit from the list of all inpatient units. An overview of all required audits for that unit during that period is displayed, with any audits due highlighted in red (shown below).


[Click the image above to see the full size image]


Selecting any link in the form brings the nurse to the patient selection form for that unit (the same form used when adding a new audit). A specific patient may be selected by inputting name or medical record number, or by searching with no criteria, which displays a list of all current patients (shown below).


[Click the image above to see the full size image]


Selecting a patient from the list (above) opens the audit tool with the selected audit already exposed (shown below).

Note: if the maximum number of audits for any category has already been performed, that category cannot be selected.


[Click the image above to see the full size image]


  • Answering "Yes" for any category completes that audit.
  • Answering "No" for the category exposes any additional items to be audited (shown below).


[Click the image above to see the full size image]


Most categories have a simple list of items to be audited (shown below).


[Click the image above to see the full size image]


Certain categories have multiple sub-categories (shown below)


[Click the image above to see the full size image]


Selecting a sub-category exposes the choices for that sub-category (shown below).


Modifying an audit
Completed audits for the current month may be modified by searching the database of audits. Any combination of criteria may be used; simply selecting a start date will list all completed audits for the unit (shown below).


[Click the image above to see the full size image]


Observational audits
Other types of audits are being added to the tracking tool. The first was a hand hygiene audit (shown below).


Audit schedule
Application administrators control the audit process by selecting the months when each type of audit must be performed (shown below).


[Click the image above to see the full size image]


Unit configuration
Application administrators also control the audit form used for each unit, selecting from a list of available forms (shown below).


[Click the image above to see the full size image]


Permissions
Application administrators also control access levels for each unit.

  • "User" permissions are granted for specific units by the manager of that unit; users may submit an audit for that unit.
  • "Manager" may submit audits, assign other managers/users, and receives monthly unit status report. Responsible manager is automatically assigned by automated process.
  • "Superuser" holds user privileges AND may enter/view observational audits.
  • "Admin" holds superuser privileges AND maintains quarterly audits and assigns permissions.

Reminders
Unit managers receive an automated e-mail reminder one week prior to the end of each month if there are any missing audits for that unit (shown below).


Reports
Monthly reports are automatically produced and published on the intranet for each audit category. A sample of one report is reproduced below.


[Click the image above to see the full size image]


Outcomes

  • Nursing audits are completed with the least possible effort and on a timely basis.
  • Excellent results from a recent Joint Commission accreditation survey.

Lessons learned

  • The operating department(s) must devote adequate resources to implement a new process. It took two tries to successfully implement nursing audits. A major reason for the failure of the first attempt was that adequate nursing resources were not assigned to auditing.
  • A significant amount of application development rework should be expected when a new process is designed and automated simultaneously. Changes in the underlying process are inevitable, and these will trigger revisions in the automated process. In the real world this cannot be avoided when the new process must be brought on line as quickly as possible.


Posted 26 November 2008

   


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Nursing Audits

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