Facility penalty or not?

[NotMyProblem MSN]

I think it is absolutely ridiculous that a facility can profess to be paperless when the charts in the rack weigh more than the computer! Does management not realize that they have made things more complex by requiring nurses to document meds, care plans, and basic nursing care on the computer AND in the charts???? The computer documentation is EXCESSIVE but at least we can take the computer into the rooms with us and document, check orders, review labs, administer meds, etc. but why on Earth do we have to make sure that what's in the computer is also on the charts? We fill in the blanks online and then have to go fill out the ENDLESS forms at the desk too??!?!?!!?!! There is no wonder the families and visitors report on the satisfaction surveys that all they saw was the nurses sitting up at the desk. If we still have to fill out paper forms and do chart checks and compare the paper chart to the computer, what's the purpose of having an IT department? Is not it their job to design and update the electronic medical record whenever whoever decides there is just ONE MORE FORM that needs to be on the patients' medical record? I think they should be penalized for using excess paper. Millions are being spent on computers so why continue to spend all of this money on paper unless the budget is not as bad as they want us to believe. It is just so annoying when I bust my behind doing patient care which takes the entire 12-hour shift and then when I grab a chart to try to do the darn comparison and checks, here comes the darn doctors to get the ENTIRE chart rack to head down the hall to make rounds AND the oncoming nurses need the computers to begin their morning/evening meds, which leaves me standing there empty handed. But not for long!! I clock out and go home!!!!! No computer? No chart? No need for me to stay!

[NotMyProblem MSN, ASN, BSN, MSN, LPN, RN]

Are you having to run parallel systems while bringing your EHR up to speed? Although it's a horrible technique, it's not unusual. However, if this is a continuing thing rather than an interim solution --- YIKES.

Health Care Reform legislation in the US (ARRA) requires conversion to electronic health records. Organizations that meet the requirements can get significant $ reimbursed from the Federal gov. But there are specific metrics that have to be met in order to prove that you are achieving the required outcomes. FYI, one of those outcomes has to do with physicians interacting with the EHR to enter their own orders.. srsly. There are a bazillion other goals and metrics that increase each year. Hospitals have to meet them or the $ stops. If this is what the OP's organization is trying to accomplish, they need to fire their project managers. Running two systems (EHR & paper) on an unlimited basis is not accomplishing anything.

We are all having to deal with the same physician issues re: resistance to change. The only thing that makes a difference is leadership. Medical staff execs have to be engaged in order to make it happen. My organization is well on its way...and since we're a Catholic health system, I think we'd know if the Pope was converting, doncha think?

Actually, we are a teaching hospital with mainly residents giving orders, under the guidance of the physician, of course. As as such, these gifted and talented people are young and VERY intuned with the world-wide-web. They are loving the computerized physician order module. However, the progress notes are still on the physical chart that is EVER-GROWING. Absolutely EVERYTHING that is on that chart can be found on the computer and some things are ONLY on the computer, like labs, radiology reports, etc. Every shift, we have to complete 3 forms saying that we've done the computer work AND made sure all orders are dated, signed, and faxed for those who refuse to enter them into the computer. Then there is a form in each patient's room that we have to complete every hour, that we have to sometimes ask families and patients to please leave in place. THEN, at the beginning of the shift, she get to carry around a printout of every order and consult, as well as a paper MAR, and a charge sheet on each of our assigned patients. Some of those packets are a combined 20 pages long, depending on how long the patient has been there. Let's not forget the report sheet that we handoff from shift to shift per patient. My little thin, blue closeable clipboard that I often use to protect patient information is USELESS. (I need a backpack for all this stuff!)

As far as I know, there is no paralleling going on because some floors have less papers and others have more. But BY GOLLY, they have 'em!

[NotMyProblem MSN, ASN, BSN, MSN, LPN, RN]

What the what? The pope is resigning? Is it sad that I learn of many major news events from reading posts on Allnurses.com?

Yeah I know! Do like I do: turn the TV on and look up every once in a while.

[amygarside]

Sorry about your frustration about this process, it can really be frustrating.

[AnonRNC]

... AND made sure all orders are dated, signed, and faxed for those who refuse to enter them into the computer. ...

Excuse me? Your facility allows certain providers to just refuse? Do these providers bring in big-money cases or something? That's insane...and so sad that it all falls to the nurse to clean up the mess.

[Frenchyrn]

Then they wonder why do nurses go overtime and patient care satisfaction is down...

[Bortaz, MSN, RN]

Could be worse. I learned the pope was resigning from FB.

The Pope resigned from Facebook?!?

[NotMyProblem MSN, ASN, BSN, MSN, LPN, RN]

Excuse me? Your facility allows certain providers to just refuse? Do these providers bring in big-money cases or something? That's insane...and so sad that it all falls to the nurse to clean up the mess.

EXACTLY!!!! We have to confirm the orders online, and sign them off on the chart. CONSTANTLY! Somewhere in the process, the order needs to reach the patient. That IS the ultimate goal, or so I thought. The list of adversities of this process goes on. But I think everyone gets the gist of my disgust......

[kalevra, BSN, RN]

If they could get the MD's to become computer literate and savvy....this problem would be solved. They (the MD's) bring in the revenue it's their choice how they want to see/utilize the information for their purposes for rounds.

What blasphemy is this!!!! MDs taking their time to use the computer to make an RN's life easier!!!!Maddnesss!!!You sir live in a fantasy!!!! indubitably!!!!

lol

[xoemmylouox, ASN, RN]

Where I work EMR was transitioned in one dept at a time. That was a disaster! In the end it is worth it. I enjoy EMR. Docs refusing is nothing new. Those who are forced always find a way.. Believe me I have seen some ridiculous crap.