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Hospice of the Florida Suncoast, based in Largo, has developed software tailored specifically to track end-of-life care by monitoring clinical and administrative tasks. The Suncoast is currently establishing direct on-line connections for some 850 clinicians - doctors, nurses, social workers, and physical, recreational, and occupational therapists. The system links clinical staff with billing staff, enabling the group to code and submit bills electronically. Employees use the system to submit time records and patient visits.
Three years in the making, the system was built around the ideas and recommendations of senior-level managers, clinicians, field and administrative staff, and end users. Fifteen care teams, each responsible for as many as 100 patients, now use the system to record services provided.
When admitting patients, a team member uses a laptop to key information. Teams report that the presence of the computer does not seem to intimidate or bother patients, especially when staff members explain how the system works and how it can tailor and improve care. Whenever staff members make home visits and enter data, they sit beside the patient or family, who can then see what is being written and ordered. The system is less labor-intensive for clinicians, who can update care plans in approximately seven minutes, far less than the time once required to return to the office and manually update records.
Flexibility is built into the computerized system. For example, its forms can be modified and tailored to each patient's particular needs or case. Clinicians rely on the system to get a patient "snapshot," taking a quick look at key issues such as pain scores and medications. This "snapshot" is especially useful for on-call staff who may not be familiar with specific issues for a patient.
When problems occur, the system prompts the clinician with solutions and flags the record. Clinicians use the system's prompts to define goals, interventions, and outcomes. This information is analyzed to assess how well different interventions work, with which patients, and under which circumstances. This information is then entered into the system so that clinicians can learn from experiences with other patients and can seek "best practices" for particular problems, symptoms, and diseases. The University of Central Florida is in the process of using these data for benchmarking studies.
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This online version of the book Improving Care for the End of Life: A Sourcebook for Health Care Managers and Clinicians is provided with permission of Americans for Better Care of the Dying [ www.abcd-caring.org ] and Oxford University Press. All rights reserved. For further information on quality improvement in end-of-life care visit The Palliative Care Policy Center [ www.medicaring.org ]. |
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