Electronic Medical Record in Pediatric Intensive Care: Implementation Process Assessment
Marie-Pier Matton1,2, Baruch Toledano1,2, Catherine Litalien1,2
1Pediatric ICU, Sainte-Justine Hospital, Montreal, Québec, Canada.
Journal of Pediatric Intensive Care
|May 22, 2019
Summary
Implementing a stage 7 electronic medical record (EMR) in a pediatric intensive care unit showed a slight, non-significant decrease in medical incidents. While staff were comfortable, caregiver satisfaction did not significantly improve initially.
Area of Science:
- Health Informatics
- Pediatric Critical Care
- Electronic Medical Records
Background:
- Electronic Medical Record (EMR) adoption is a global priority, with the HIMSS Analytics EMR Adoption Model (EMRAM) tracking progress.
- Canada's EMR adoption lags, with most hospitals below Stage 3 and very few at Stage 7.
- A Quebec pediatric hospital, initially at EMRAM Stage 3, aimed to implement a Stage 7 paperless EMR.
Purpose of the Study:
- To evaluate the impact of a Stage 7 EMR implementation on patient safety and caregiver satisfaction in a pediatric intensive care unit (PICU).
- To assess the feasibility and initial outcomes of a customized, paperless EMR in a pediatric critical care setting.
Main Methods:
- A pilot, customized, paperless pediatric intensive care EMR was implemented over 20 months.
- Continuous monitoring and change management (living lab approach) were employed post-implementation.
- Outcomes measured included severe medical incidents and staff satisfaction at six months post-implementation.
Main Results:
- A non-significant decrease in severe medical incidents was observed six months after EMR implementation compared to the previous year.
- A majority of PICU staff reported high comfort levels with the new EMR system.
- Overall staff satisfaction with the EMR was 33.9%, and satisfaction among internal staff was 41.9%.
Conclusions:
- The pilot EMR implementation, supported by extensive preparation and change management, was successful.
- Despite high staff comfort, the EMR did not significantly enhance caregiver satisfaction within the initial six months.
- Further evaluation is needed to understand long-term impacts on satisfaction and safety.
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