CLIENT OVERVIEW

Washington Health SystemWASHINGTON, PENNSYLVANIA, U.S.A.

Client Profile

• 2 hospitals

• Over 2,000 medical professionals at more than 40 off-site locations

• Physician group with 20 practices and 79 providers in

12 specialties

• Family Medicine Residency Program with 3 locations and 41 providers

• Pharmacy processed 1.8 million orders in FY 2015

Allscripts Solutions

• Allscripts Sunrise™ platform (Hosted by Allscripts)

Sunrise™ Acute Care

Sunrise™ Emergency Care

Sunrise™ Clinical Performance Manager

Sunrise™ Pharmacy

Sunrise™ Surgical Care (not yet implemented)

• Integration with Orchard Software Laboratory Information Systems

• Allscripts CareInMotion™

Allscripts Care Management™

Allscripts FollowMyHealth®

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CASE STUDY

Washington Health System is leading in healthcare quality, safety and valueSince the early 1980s, Washington Health System has used technology to automate processes to provide great patient care. By customizing its technology solutions to user workflows, the organization enables clinicians to deliver the highest quality, safety and value for patients. Targeted initiatives have achieved notable positive outcomes, including efficiencies with lab information systems, reducing medication errors and decreasing the total patient harm rate by 25%.

25%PATIENT HARM RATE DECREASEfrom 0.0073 in FY 2012 to 0.0050 in FY 2016

LOWER HEALTHCARE ASSOCIATED INFECTIONSthan average Pennsylvania hospitals

EXCELLENCE AWARD“Safety Across the Board” Excellence Award from The Hospital Association of Pennsylvania

ZERO MEDICATION ERRORSin FY 2016 that resulted in patient harm

32%

Case Study

Experience

Since 1897, Washington Health System has provided high-quality care to patients in southwestern Pennsylvania. With locations throughout Washington and Greene counties, its services and specialties include cardiovascular diagnostics and surgery, orthopedics, neurosciences, women’s health, cancer care, children’s therapy, rehabilitation and advanced imaging and more. To support the many quality and safety initiatives, Washington Health System uses advanced technology systems.

“We’ve been automated since the early 1980s and updated our system to Allscripts Sunrise in 2009,” Manager of Hospital Systems Lynn Bular said. “Because it has many products and is an integrated platform, it’s a great benefit to have much less interface work.”

MORE EFFICIENT LAB ORDER SETS AND RESULTS VERIFICATION

Washington Health System uses its rules-based lab information system (LIS) to improve lab ordering and results verification. “One of the biggest plusses of our LIS is that it is a rules-based system,” said LIS Coordinator Chuck Kulla. “So, we don’t have to wait for the company to update or pay for services. We can write new rules and solve the problem ourselves.”

With order entry, Washington Health System has created personal and universal profiles for common orders from physicians. “This process, along with the customizable order-entry screens, has made order entry quicker, more accurate and helps eliminate missed tests,” Kulla said.

“We’ve been automated since the early 1980s and updated our system to Allscripts Sunrise in 2009…Because it has many products and is an integrated platform, it’s a great benefit to have much less interface work.”

Lynn Bular, Manager of Hospital Systems

When results become available, auto-verification can share the information more quickly. “Rules-based auto-verification enables lab technicians to focus on the samples that need attention,” Kulla said. Washington Health System is currently auto-verifying approximately 80% of its hematology results, and is performing limited auto-verification in Chemistry and Urinalysis departments.

“The rules also enable us to help the technologist address abnormal results. For example, the use of pop-ups can restrict them from releasing invalid results,” he said.

SAFER MEDICATIONS WITH STANDARDIZED PROCESS

Washington Health System pharmacy processed more than 1.8 million medication orders in Fiscal Year 2015. Bular credits an interdisciplinary approach—involving pharmacy, nursing and physicians—with enabling standardized, safer medications.

The organization has standardized its medication reconciliation procedure. “The pharmacy is involved with the collection of home medications and allergies, which makes the process much cleaner,” Bular said. “All of our admissions through the emergency department or outpatient surgical area—they all have the same method now.”

Washington Health System implemented a computerized physician order entry (CPOE) system to eliminate potential mistakes in drug name and dosage that could be associated with handwritten orders. The hospital also uses locked, automated dispensing units, bar-coding and smart IV pumps to protect patients from inadvertent errors.

Washington Health System reduced medication errors with harm between fiscal years 2014 and 2015 due primarily to its hospital-wide implementation of CPOE. In fiscal year 2016, the organization had zero medication errors that resulted in patient harm.

Washington Health System

Outcomes• Total Patient Harm Rate decreased 25% (from 0.0073 in FY

2012 to 0.0050 in FY 2016)

• Reduced medication errors with harm due to hospital-wide implementation of Computerized Physician Order Entry (CPOE). In FY 2016, had zero medication errors that resulted in patient harm.

• Achieved a reduction in healthcare associated infections (HAIs), to 1.65 HAIs per 1,000 patient days, which is 32% lower than the average for Pennsylvania hospitals.

• Decreased the number of patient falls, keeping the number

of falls that result in a major injury to 3%, which is better than the national average of 4%-6%.

• Prevented Stage III and Stage IV pressure ulcers, with zero cases in FY 2015 and FY 2016

• Received “Safety Across the Board” Excellence Award from The Hospital Association of Pennsylvania for exceptional performance in reducing preventable harm and readmissions

• Successfully attested for Meaningful Use Stage 1 in 2011, Stage 2 in 2014 and Stage 2 Year 2 2015

CLINICAL PATHWAYS TO CARE FOR PATIENTS WITH CONGESTIVE HEART FAILURE (CHF)

CHF means that the heart is weak and cannot pump enough blood throughout the body. Because it is a complex chronic condition, patients with CHF tend to have higher rates of readmission and have longer hospital stays.

Using medical logic modules (MLMs), an interdisciplinary team developed a clinical pathway for CHF patients. When these patients present in the emergency room, clinicians now use customized order sets that enable appropriate interventions. For example, if clinicians determine the patient needs to be admitted, the inpatient pathway presents order sets to get the appropriate consultations with cardiologists, pharmacists and, if needed, palliative specialists.

Once CHF patients leave Washington Health System, the organization recently began an outpatient care coordination program. “It’s a nice transition for patients when they go home to have a care coordinator who can help answer questions,” Bular said. “It saves them unnecessary trips to the emergency department.”

PATIENT ENGAGEMENT AND CARE MANAGEMENT FOR BETTER POPULATION HEALTH

To meet the requirements of the Meaningful Use incentive program, Washington Health System implemented the FollowMyHealth patient engagement platform in 2014. “Our medical records department has been leading the efforts to encourage adoption,” Bular said. “The team has a good process for identifying and enrolling people, getting patients signed up before they leave the organization.”

In the first three quarters of 2016, Washington Health System had achieved 5.34% of patients enrolled and using the portal. “We’ve been up as high as a 9% enrollment rate, and even though the Meaningful Use requirements have changed, we’re not backing off because we see the benefits for patients when they have an online portal to engage with providers.”

In 2016, Washington Health System also replaced a homegrown case management system with Allscripts Care Management. “At first clinicians were reluctant to leave the old worksheets. But once they saw this application, it was a smooth transition,” Bular said. “The communication that they can have with other facilities, sharing information…it makes a huge difference.”

Washington Health System case management staff is now able to communicate directly through the platform with insurance companies and post-acute providers. “We can send chart documents direction from Care Management, eliminating the need to print off documents and fax them separately,” Case Management Director Lynn Watson said. “We also can run real-time reports that assist in daily management.”

Outcomes

In 2014, Washington Health System was recognized by The Hospital Association of Pennsylvania (HAP) for exceptional performance. The organization received the “Safety Across the Board” Excellence Award to recognize participating hospitals’ achievement with the Partnership for Patients (PfP) program goals of reducing preventable harm and readmissions.

The American Hospital Association supports use of the total patient harm rate, a calculation to help organizations manage patient safety. The computation includes several events,

“One of the biggest plusses of our LIS [laboratory information system] is that it is a rules-based system…So, we don’t have to wait for the company to update or pay for services. We can write new rules and solve the problem ourselves.”

Chuck Kulla, LIS Coordinator

Visit us at www.allscripts.com or call us at 1.800.334.8534 for more information.

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including medication errors with harm, healthcare-associated infections, patient falls with injury, Stage III and IV pressure wounds (i.e., bedsores) and more. There have been no serious pressure ulcers in fiscal years 2015 and 2016.

Washington Health System has decreased its total patient harm rate by 25% over the past six years. The organization continues to achieve its vision to be a leader in healthcare quality, safety and value.

“We can send chart documents direction from Care Management, eliminating the need to print off documents and fax them separately…We also can run real-time reports that assist in daily management.”

Lynn Watson, Case Management Director