Congress Abstracts 2005

70

INTERDISCIPLINARY COLLABORATION: MAKING ALLERGY HISTORIES PRESENT. Cynthia Murphy, RN, MS, Fran Zandstra, RN, MBA, and Carol Causton, RN, OCN^®, M.D. Anderson Cancer Center, Houston, TX.

Since the Institute of Medicine Report in 2000, “To Err is Human: Building A Safer Health System,” much emphasis by regulatory and health care agencies has been cited to promote patient safety initiatives within organizations. In a strategy to continue real time electronic documentation by nursing staff, and promote patient safety initiatives, executives at our Comprehensive Cancer Center approved the initiation and phased implementation of electronic allergy documentation within the organization in preparation for Clinician Provider Order Entry (CPOE) and Electronic Medication Administration (eMAR).

With approval and administrative support to move forward, an interdisciplinary team was organized including key clinical stakeholders who needed access to allergy history at the point of care. Our task was to provide allergy information to all healthcare professionals using coded values for future drug-drug and drug-food interaction checking at the point of care. Content user experts were solicited for team membership. The working team included: pharmacists, clinical dieticians, clinical nurses from both the hospital, ambulatory operations and ancillary services, such as Diagnostic Imaging. In addition, we found opportunities to leverage our initial pilot project using the electronic documentation of vital signs, pain level, height, weight and calculated BSA with the allergy documentation in the Electronic Medical Record, and deliver this data to the pharmacy department via electronic means for timely institutional data review.

The area of focus includes: the processes used to evaluate pre-implementation work practices, identify gaps and opportunities for improvement; formulate the design of allergen categories for data collection and reassessment by users; streamline policies; and review the techniques used to educate staff.

The specific methods used to evaluate the impact of this change in our environment will be described using pre and post implementation data.

We have found that in our large academic cancer center, that having the right team and the commitment of the executive leadership, improvements to patient care and patient safety is promising through electronic documentation of allergies and symptoms. The allergy history is present for all clinical staff when needed with no reliance on paper medical records to retrieve the data.