Palomar Pomerado Health – Going for Gold, One Technology at a Time

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Palomar Pomerado Health—

                        Going for Gold, One Technology at a Time

             

As the largest public hospital district in California covering more than 800 miles of San Diego’s inland north county, Palomar Pomerdo Health is big in both size and scope. The health system includes the 326-bed Palomar Medical Center, 115-bed Pomerado Hospital, two skilled nursing facilities, five health centers, a surgery center, home health program, physician referral service and wellness classes.

 

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When PPH set a goal to become nationally recognized for technology, they knew the undertaking would be massive. Yet they believed the payoff would be worth it. The vision was clear. Find and install world-class technology and use it to enhance their mission of offering the best in healing and comfort while promoting superior patient health. Although the effort is far from complete, it’s already having major impact.

 

Redefining Document Management

The search for a way to relieve their document management woes was identified as a priority early on. Most recently PPH managed documents manually. The process was fraught with complexity. Without a mainframe editor function, every time a document was updated or reviewed it had to be physically moved from the mainframe, converted to Word and then hand circulated. One person’s full time job included coordinating the movement of documents from person-to-person, department-to-department and to committees for review. This person also managed the edits, cross edits, preserved master copies and was supported by bevy of temps six months in advance of a JCAHO review when the demand increased exponentially. To keep pace with compliance mandates and reviews the process needed to be reformed. A request for proposal was drafted and included a broad list of expectations. The system they envisioned would not only automate their archaic system, it would make the growing burden of compliance, less burdensome.

 

Document management is a complex undertaking for many industries, especially healthcare. As Jo Ann Wiser, Manager of PPH Data Center Operations points out, “there are a lot of document management systems, but most are extremely limited in handling the unique needs of healthcare and compliance.” Wiser says most systems didn’t even offer an electronic signature capability, which is crucial in healthcare. Without that simple feature, a vice president could be required to sign hundreds of documents—by hand. This was simply not an option.

 

Managing the Issue—Enterprise-wide Compliance

Wiser assembled a team to collect the needs of opinion leaders throughout the organization. Julie Avila, executive secretary for nursing administration at Pomerado Hospital and Dionne Blaha, executive assistant for administration at Palomar Hospital were up to the task. Together they uncovered that executives and users at PPH needed a system that could centrally control documents and manage the document creation and updating process. Again, most systems came up short. Wiser says some provided centralized access, but didn’t deal with compliance-related idiosyncrasies such as making the review and feedback process less cumbersome. That’s when it dawned on PPH. They weren’t looking for a “document management” system, although managing documents was part of the problem. They were really searching for a way to manage compliance. Wiser says the team realized that if they could get their arms around compliance, then document management would also be resolved. Once the issue was reframed, their technology needs became clear.

 

Technology to Manage Compliance Complexities

Compliance issues have cross-departmental reach. Julia Avila says the comments that she was hearing reinforced this, “In a healthcare setting individuals and committees all have to review, update and collaborate on policies and procedures.” Nursing and pharmacy are a great example. It’s critical that nursing knows and follows pharmacy procedures. Therefore nursing needs an opportunity to provide feedback to the pharmacy policies. Avila says, “A document management system is great for documenting the results, but our team wanted to use technology to enable the interaction, document the results and distribute the information.” This meant that PPH needed a system that could offer more than centralized access. What PPH needed was software to centralize, coordinate and audit reviews before enabling centralized access to the documents. At this realization Wiser and the team hit a cross roads. They could either try to make a document management system fit, or they could stay true to the vision and keep searching.

 

Technology Designed for NASA/JPL Provides the Answer

Fortunately for PPH, they weren’t the only organization demanding more complex document management capabilities. In the late 1990’s scientists at NASA’s Jet Propulsion Laboratory (JPL) at the California Institute of Technology, couldn’t find a system to meet their needs. They wanted the ability to use a process-based management approach to re-engineering 300-400 processes while also integrating ISO 9000 guidelines and making sure that the 5-6,000 related documents were correctly updated. Not exactly the same as healthcare, but amazingly similar in complexity. After a careful search of the market JPL partnered with Lucidoc to create a new, customized system. The advanced solution managed the complete lifecycle of a document by capturing every footnote, idea and update in addition to creating centralized access, control and coordination. This created an unexpected breakthrough for private industry and healthcare. The technology evolved into the first-ever solution designed to manage compliance by integrating the lifecycle of a document into the process of compliance.

 

A Compliance System that Manages Documents

Wiser says it’s really quite simple—now. “Most organizations think they’re looking for a way to manage documents. The reality is quite different. Like PPH, most really want to manage compliance and one of their deliverables is a document that reflects and enables compliance.”

 

The beauty of the system was clear to Wiser when she helped a surgical nurse solve an obscure, but important problem. Wiser says, “The Lucidoc system was relatively new and we were helping users understand how to use it.” A surgical nurse needed information fast. She wanted to find the procedure for ‘ted hose’(thigh-high hosed used after surgery to prevent clots). Coming from a technical background, Wiser says the request didn’t make much sense to her, but the powerful search capability of the Lucidoc system solved the riddle. “I walked the nurse through the simple click and search process. She logged into the system and entered ‘ted hose’ on her computer and up popped the post surgical procedure for stockings.” Wiser says the nurse was simply amazed that she didn’t have to hunt down a hard to find procedure manual and start searching alphabetically through the pages to try to find where the ‘ted hose’ procedure might be. In fact, Wiser says that once staff and users get used to the easy retrieval they can’t live without it and they want to put everything in the system. This is why PPH decided to add their Human Resources documents to the system and is considering forms as well.

 

Removing the Burden of Compliance

PPH remembers well the time when “compliance” was code for “fire drill”. Wiser says it used to take six months to get things ready for a JCAHO review. The labor intensive process was costly and never really instilled confidence that everything was properly updated and distributed. Even though significant effort was applied. It was a pins and needles-like experience.

 

Today, Wiser says, PPH is ready for the day JCAHO starts it’s spontaneous spot reviews. The organization is confident that policies, procedures and staff are in compliance. According to Wiser, “The burden of crunch-time preparation is gone because the responsibility is now spread out to all departments.” Dionne Blaha, who supported the Lucidoc training agrees, “No one is complaining about having more work to do—quite the contrary.” Part of the reason is that the Lucidoc system simplifies the process and integrates it into everyone’s schedule. Blaha explains, “Clinical policies and procedures have a department sponsor. The Lucidoc system sends an email reminder to the sponsor to update the information when a procedure changes. The sponsor makes the changes and distributes it to those that need to comment such as the head of the department, a doctor and a VP. The system then collects each of their comments so that they can be integrated and reviewed.”  Blaha adds that the system has provided critical flexibility for key managers. “Our VP of Operations, who is responsible for overseeing a significant number of policies and procedures, is now able to access the information from home vs. being tied to the office.”

 

No More Fear of Non-Compliance and Safer Care

“Since the process is cleaned up and so much more efficient, getting the information to staff to use is natural,” Wiser says. Across PPH, Wiser knows that employees simply need to click a mouse to find the information they need. Wiser adds, this is what compliance was supposed to be about. “In healthcare we genuinely care about doing things safe and right for our patients. But when there is so much information to manage, people need a way to make the process easier and the information more accessible.” Now PPH has found the technology to make compliance a near-seamless part of the delivery of healthcare. More importantly adds Wiser, “Our staff now has the ability to see the big picture which has created more team spirit. The Lucidoc solution does such a great job at enabling document authors to comment and provide feedback that this interaction and visibility has created a deeper sensitivity to the impact that a policy may have on another department.” Jo Ann Wiser is not alone when she says, “We’ve found an innovative technology to do even more than realize our organizational vision. It’s making our jobs easier, creating departmental continuity and helping us provide better care—this is exactly what we need to forge ahead to become one of the Top 100 Hospitals.”

 

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The PPH Situation—At a Glance

Problem

PPH, like many organizations, tried to manage compliance by managing documents. However, document management software doesn’t coordinate compliance. PPH discovered:

Mainframe and manual-based policies & procedures with intranet access didn’t work…

ü       Accuracy was at risk

ü       Searching for policies was difficult, time consuming

ü       Editing and cross-editing paper versions created confusion & errors

Compliance management was a costly, time-consuming and poorly coordinated fire drill

ü       Notification of a review started an intense, 6-month fire drill process

ü       1-person coordinated document flow and feedback from person-to-person, department-to-department and to committees

ü       Temps were hired to get documents from the mainframe to Word and then copied and distributed

 

Solution Requirements

Automate compliance coordination and integrate document management into the process

ü       Selected a system that integrates documents into the lifecycle of compliance

ü       Required sophisticated edit, review, audit and reminder capabilities to streamline compliance coordination

ü       Needed centralized access and advanced search features to enable enterprise-wide compliance and safer care

 

Results

ü       No more audit file drills—Ready for JCAHO spot audits

ü       Reduced costs—less reliance on paper, copies, storage & temps

ü       More time—fast, accurate & efficient document creation, edits, reviews & approvals

ü       Fast knowledge—Simple, centralized access to policies & procedures

ü       Safer care—up-to-date policies & procedures just a few clicks away

ü       Improved teamwork—by creating cross-department awareness and insights

ü       Using the Lucidoc solution to prepare to become a Top 100 Hospital

www.lucidoc.com

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