April 2016News

Making instructions for patient care clearer, faster, safer

New digital Patient Order Sets are ready to use and customizable

Imagine that you’re a doctor and you want to issue comprehensive instructions for nurses, pharmacists, nutritionists and other members of healthcare staff who are providing care for your patient. Normally, you’d fill in a form by hand, relying on your experience and expertise to determine the measures that the healthcare team ought to implement.

Not a bad system, but hardly in step with the times.

Wouldn’t it make more sense—be faster, more accurate, more convenient and, in many instances, much safer for your patient—if you could simply open a computerized form whose predetermined, evidence-based orders cover various aspects of the ailment that your patient is being treated for? All you’d have to do is verify that the orders are appropriate; if needed, you could personalize some of them to suit your patient’s special needs.

That’s the revolutionary step the JGH is taking with the introduction of digitized Patient Order Sets. Since the project’s November launch in the 5Northwest unit, the system has steadily been expanding and will eventually include every unit and department in the hospital.

Where appropriate, this initiative will be spread out to the JGH’s partner-institutions in the Integrated Health and Social Services University Network for West-Central Montreal (West-Central Montreal Health). Working together, they will develop and implement standards of care that are built around patient safety and efficiency.

Technology upgraded through private support

Generous support from the estate of Betty Lewis enabled the JGH to acquire and implement the Patient Order Sets. This is a perfect example of how a well planned bequest can benefit today’s patients and those in generations to come.

Private support was also of key importance in the hospital’s major upgrade of its information technology infrastructure and systems. This allowed the JGH to improve current levels of access, quality and safety, while supporting the new Pavilion K and ensuring seamless connectivity with the rest of the hospital.   Major improvements included:

  • construction of the new and expanded Nan and William Lassner Data Centre
  • an upgrade of the new Perioperative Information Management System in the operating rooms
  • acquisition and implementation of e-pharmacy, as well as imaging and specialized decision-support software applications

For more information or to make a donation, please visit the JGH Foundation online or call the JGH Foundation at 514-340-8251.

Guiding this project is a core group consisting of Dr. Elizabeth MacNamara (Medical Leader and Chief of Diagnostic Medicine), Geneviève Beaudoin (Clinical Leader), Serge Cloutier (Nursing Leader), and Bob Lapointe (IT Leader).

Geneviève Beaudoin (seated), a Clinical Nurse Leader, reviews one of the new Patient Order Set with (standing, from left) Denise Bédard, a Nurse Consultant in Colorectal Surgery and Vascular Surgery; Justine De Monteiro, Interim Head Nurse on 5Northwest; and Kathryn Baldwin, a Nurse Clinician on 5Northwest.

Geneviève Beaudoin (seated), a Clinical Nurse Leader, reviews one of the new Patient Order Set with (standing, from left) Denise Bédard, a Nurse Consultant in Colorectal Surgery and Vascular Surgery; Justine De Monteiro, Interim Head Nurse on 5Northwest; and Kathryn Baldwin, a Nurse Clinician on 5Northwest.

Dr. Lawrence Rosenberg, President and CEO of West-Central Montreal Health, says that in introducing the Patient Order Sets, “we are standardizing our approach to common problems and by reducing the variation that sometimes creeps into the care of our patients. The problem with variation and a lack of standardization is that they can sometime lead us to do things that perhaps we shouldn’t be doing—or not to be doing things that perhaps we should be doing.”

Dr. Rosenberg adds that the Patient Order Sets “will make life easier for doctors, nurses and allied healthcare professionals, because we’ll know that for a particular medical condition, there is an agreed-upon approach, as documented in the Order Set. Thus, we eliminate the need to run around and try to find doctors to figure out exactly what they want done.”

The digital system that the JGH is installing comes fully equipped with a database of thousands of completed Patient Order Sets, covering a vast array of diseases, illnesses and medical conditions. This data represents best practices in the numerous hospitals and other institutions that subscribe to the service, with information supplied by a legion of physicians in every specialty.

“The Patient Order Sets require input from doctors in every area and specialty across our network,” says Dr. MacNamara, who is overseeing the project. “Their insights and in‑depth knowledge are pivotal in providing better treatment and care for our patients. By reviewing, validating and modifying the original forms, they and the hospital’s nurses and healthcare professionals are conforming to the practices and procedures that have been found to work best at the JGH.”

According to Ms. Beaudoin, the introduction of a digital system means that the new orders will be clearly printed and easy to follow—an improvement over handwritten orders that may sometimes be illegible or misread and, therefore, prone to potential errors. In addition, she says, the digital orders will be updated on a continual basis to reflect the latest practices and circumstances at the JGH.

While many hospitals and healthcare institutions in Canada and North America have already implemented the Patient Order Sets, the JGH will be the first to do so in Quebec. “It’s a major step forward for patients and staff alike,” Dr. MacNamara says.”


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