Summary Tab in Electronic Medical Record Improves Pretransplant Patient Workup Coordination

ANAHEIM, CA — An easy to view page within patients’ electronic medical records (EMRs) that consolidates all the pertinent information gathered in pretransplant patient workups improves the efficiency of the stem cell transplantation coordination process for both nurses and patients, according to a presentation at the Oncology Nursing Society (ONS) 44th Annual Congress.

Extensive work-ups are required for patients prior to undergoing stem cell transplantation, including multiple tests, consultations, and patient education. Clinical nurse coordinators (CNCs) are usually charged with managing this process at large cancer institutions.

Each year more than 400 stem cell transplants are performed at Memorial Sloan Kettering Cancer Center; pretransplant documentation and the results are recorded in multiple areas within the electronic medical record (EMR). As a result, locating this information is challenging and time-consuming.

A baseline survey revealed that CNCs had to search through 5 different locations within the EMR for pertinent patient information, which can take at least 1 to 1.5 hours. Furthermore, most covering clinicians (87.5%) also reported difficulty in locating needed patient information.

Therefore, Faye Inumerables, MSN, RN, ACNS-BC, OCN^®, of Memorial Sloan-Kettering Cancer Center in New York, New York, and colleagues determined that an electronic tool to consolidate the complex pretransplant evaluations of these patients could improve the coordination of care. The team sought to create the clinical summary tab, a specialized view that consolidated all pertinent transplant patient information onto 1 page within the current EMR.

A task force consisting of CNCs, the nurse manager, clinical nurse specialist, health informatics, and nursing informatics was formed to develop the tab using the plan-do-study-act quality improvement approach. CNCs created a list of patient information obtained during the pretransplant work-up and the informatics team designed a template.

Surveys conducted before and after implementation indicated a significant increase in ease of locating data. Prior to implementing the clinical summary tab, locating patient data was rated as “somewhat difficult” by almost 90% of respondents. In the postimplementation survey, less than 30% of respondents rated locating patient data as “somewhat difficult,” with more than 50% rating it as “easy” and approximately 25% rating it as “very easy.”

Technological advancement/functionality can help improve coordination of nursing care for pretransplant patients. “A strong partnership with nursing informatics and health information systems teams helped build the clinical summary tab,” said Ms Inumerables. “Nurses play an essential role in driving the development of technology that improves the efficiency and safety of their practice. Our relationship with the informatics teams allowed us to develop an easily accessible electronic tool that improved patient care,” she concluded.

Reference

Inumerables F, Dunn E, Chan J, Rosa M, Fernandez I. Utilizing technology to streamline coordination of care for pre-transplant patients. Oral presentation at: ONS 44th Annual Congress; April 11-14, 2019; Anaheim, CA.