Livonia Outpatient Surgery Center

Situation

Livonia Outpatient Surgery Center in Livonia, MI (a suburb of Detroit) is a state-of-the-art surgery center specializing in cataract and other eye related surgeries. With a case volume of nearly 500 surgeries per month, Livonia faced challenges keeping up with its paper medical records. Administrators at the ambulatory surgery center (ASC) specifically noted the inefficiencies of paper records, including:

• The inability to quickly access records for information;
• The costs associated with paper; and
• Incomplete charts.

“At the end of the day, I would have staff standing around for one to two hours reviewing that day’s charts,” said Jennifer Bednarchik, Chief Operating Officer at Livonia. “When they were done, the charts would go on a chart cart and then over the next week to two or three weeks, we would hunt down the staff members that needed to complete their charts.”

Bednarchik added that staff also spent a significant amount of time looking for paper charts, and Clinical Director Laura Picano-Wilson, R.N., said buying, stocking, and “shuffling” paper was costly.

Solution

To solve their issues, the administrators turned to SIS Charts™, a cloud-based electronic clinical documentation solution from Surgical Information Systems (SIS). SIS Charts is integrated with Livonia’s AmkaiOffice™ business management system and SIS Analytics™ business intelligence tool, both of which are also from SIS, providing a complete solution to help Livonia Outpatient Surgery Center thrive.

Because SIS Charts is delivered as a subscription-based service, Bednarchik said it was appealing from a financial standpoint. “We didn’t have to spend the up-front capital necessary to purchase another server and didn’t have to hire IT staff to set it up, which saved thousands of dollars,” she said. “We just installed computers where we didn’t already have them, and then started using the system.

Livonia configured SIS Charts to match its existing workflows, which helped from both a usability and training perspective, according to Picano-Wilson. “The way we have SIS Charts set up, it is specific to what the nurse is doing at that moment, which makes it easy for them to chart,” she said. “As a manager, I’m very confident that I could show somebody – even with no computer knowledge – how to work the system and be up and running in one day.”

Tish Burke, R.N., a Preop nurse at Livonia, agreed: “It’s set up exactly how we intake and discharge our patients. It goes in a step-by-step order, so you really don’t even have to think about what your next [documentation] step is. SIS Charts is easy, it’s fast, and it makes it very easy to retrieve information as well as put information into the computer.”

Results

Livonia quickly transitioned from paper to electronic documentation, and all clinical staff – including the doctors and Certified Registered Nurse Anesthetists (CRNAs) – have rapidly adopted the system. Although the doctors aren’t currently charting their care (they -plan to do so in the future), they are using SIS Charts to view details about past surgical experiences, as well as allergy and medication information, which helps them prepare to see the patient. The CRNAs are charting their in and out times and ASA scores. “The staff absolutely loves the SIS Charts clinical documentation system,” Bednarchik commented.

The end of day process also has improved because multiple people can be documenting in a patient’s chart at the same time, enabling the nurses to review and complete their section of the chart for each of their patients. A completion percentage bar at the top of the record shows if the chart is complete or missing documentation, which speeds up the process.

“On a busy surgical day, each nurse has 10 to 12 charts to review,” Bednarchik said. "In the past, I would have multiple nurses huddling at the recovery desk fighting for the same chart to review. Now, with SIS Charts, they quickly go through what they are responsible for, review the documentation, sign off, and they are done for the day. As a result, we are not paying any more overtime, the staff is happy, and the charts are completed on the day of service.”