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Preprinted forms gone; data flow is enhanced
Embosser cards, bulky machine also gone
Palmetto Health Baptist Hospital in Columbia, SC, has replaced its old embosser card technology with a Patient Link Up Enterprise (PLUE) system that has eliminated costly preprinted forms and increased the clarity and accuracy of the patient data flow, says Charlene Cathcart, director of admissions and registration.
The system, a product of Standard Register, went live at Palmetto Health Baptist in May 2002, and is scheduled to be in place at Palmetto Health System’s two other hospitals by early spring, Cathcart says.
The PLUE system "gives us the ability to print any piece or the entire admission kit directly to a printer located at the nursing station," she adds. Cathcart notes that while many hospitals choose to have those documents print in the admissions area, sending them straight to nursing is in line with a Sentinel Alert issued by the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO).
"Sentinel Alert No. 10 talks about nurses writing information by hand and the need for bar code identification," she says. As she was researching PLUE, Cathcart notes, she discovered that not only could the system send documents directly to the nursing station, it could print labels with bar codes.
Realizing she could get rid of the embosser cards and their accompanying technology — an expensive machine that broke down every two weeks or so — sold her on the Standard Register product, she says.
The bar code labels "allowed us to be a little more creative," Cathcart explains. "We do bedside glucoses here, and before clinicians had to manually type in a 10-digit account number for that patient. Now they can just take the glucose meter and scan it from the patient’s armband, and the bar code reader downloads the [account number] into the lab system."
Although there is no hard data available yet on the cost-effectiveness of the new system, Cathcart says her sense is that "the savings are pretty significant. One box of the old multipart admission forms costs $286, and we use about three boxes a week. The cost of a box of blank paper is virtually nothing."
In addition, "we no longer have to have a staff person go into the workroom, break down an admission packet and sort out the pieces for different places," she points out. "The only pieces that print in the admissions area are the admission, consent and assignment of benefits form."
Some ancillary departments at Palmetto Baptist also receive face sheets directly, Cathcart notes, and that practice will be more widespread at the Palmetto Richland campus, which is more decentralized. "There will be printers in more ancillary departments, and if they need another copy, we will let them print it."
Unlike at Palmetto Baptist, which has a very centralized operation, she says, a large number of patients at the Richland campus are sent directly to the appropriate ancillary department. "They would need to have [access to the system] where they are, so they can print and reprint as needed."
Patient safety enhanced
A major advantage of the PLUE system is that patients are identified more quickly and accurately because their identifying information is not written by hand or added with an embosser card, Cathcart says.
The system also provides the ability to fax physician orders directly to the pharmacy, she adds.
"The physician is on the unit, [the printer] spits out a blank form with the bar code [identifying the patient], and he writes the order on that form, which is faxed to the pharmacy," she explains.
In the past, Cathcart says, the second part of the multipart physician order — a smeared duplicate page — would have been sent by pneumatic tube to the pharmacist, who often would have had trouble reading the information and had to look up the patient in the computer system. With the new system, she adds, the process is enhanced because, in effect, every copy is an original.
The price of the system varies, she notes, "based on how you decide to roll it out. It can be done inexpensively, or you can choose to put printers on all the nursing units. Based on my last calculation, I should be able to cost-justify it in two to five years."
Implementation of the PLUE system went particularly smoothly at Palmetto Baptist, Cathcart adds, because nursing and the ancillary departments were an integral part of the process from the beginning.
It also helped that a multidisciplinary team drove the project, she says. "A lot of times information technology makes the decisions and you live with them, but this time we made the decisions together. We got input from the medical staff, did a lot of education of physicians, and it went extremely well."
[Editor’s note: Charlene Cathcart can be reached at (803) 296-5187 or by e-mail at email@example.com.]