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Case Review of Ehr Implementation

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A Case Review of EHR Implementation in a Pediatric Emergency Department
Jennifer Juif
Southern New Hampshire University

A Case Review of EHR Implementation in a Pediatric Emergency Department Organizations face many challenges when implementing an electronic medical record (EHR) system. Quality, safety, and efficiency need to be maintained during implementation. The case study reviewed: Impact of electronic health record implementation on patient flow metrics in a pediatric emergency department (Kennebeck, Timm, Farrell, Sooner, 2012) attempted to quantify the effects of offloading low acuity patients and its impact on length of stay. Length of stay and volume of patients in an emergency department are correlated. The study was conducted in a pediatric emergency department (ER) in Cincinnati, Ohio. Prior to implementation, a plan was utilized to off load patients to a different area in the ER due to a surge from the H1N1 flu virus. This was successful in decreasing patient numbers and length of stay. The organization decided to use the same template for the EHR implementation. Despite its prior success, offloading patients did not improve efficiency or length of stay (LOS) during EHR implementation. The primary issue identified was the failure of offloading patients. The study stated, “During implementation only 5% of patients were diverted. During the H1N1 surge, 10-20% of patients were diverted.” (Kennebeck, Timm, Farrell, Spooner, 2012). The organization used the same criteria for both scenarios. Changing the criteria could be a simple solution. The organization could have added to the flu symptom criteria. For example: lacerations, simple orthopedic injuries, or anything that could be seen in an urgent care setting. This would decrease visits to the main ER and improve efficiency based on decreased number of patients seen.

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