Klinikum Salzgitter GmbH is treatment centre with a cross-regional attraction. The emergency room treats around 22,000 patients per year and receives many seriously-injured and severely ill. Therefore the ward is often under high pressure during peaks. At the same time a lot of attention is given to a high-quality medical care and short waiting and residence times for the patients.
In order to optimise the patient care a software application was searched for which can be adapted to the health care providers’ way of working and not the other way around, i.e. that the health care provider needs to conform to the software. At the same time the goal of the computerisation was to improve the quality of the documentation, the pressure on the staff, the good communication between the physicians and the nurses and the workflow.
We found what we were looking for in E.care ED. The implementation of E.care ED has not only met the expectations, but it has exceeded them.
Even before the implementation of E.care ED the emergency room of Salzgitter was paperless. Nevertheless, E.care has contributed to a quality improvement of the documentation while simultaneously reducing the pressure on the staff. The care process in the emergency room is noticeably quicker and safer with the same amount of workers. A good example of the improved workflow is the fact that tasks can be given clearly and unambiguously with just one click of the mouse. On every computer in the ward the nurses can see which tasks need to be done and this speeds up the whole process. The fact that the average residence time of the patient has dropped from 89 to 75 minutes and that the waiting times until the first contact with the nurse and the physician have also decreased is not a coincidence: these improvements were made possible thanks to E.care ED.
The implementation of E.care Ed was not simple however and took a bit longer than originally planned. There are two reasons for that: the difficult integration with the current HIS and the initial resistance of a number of physicians. We would therefore recommend a sufficient preparation time before actually implementing the software. We deem it useful to have the system tested by a number of key users until all the connections and links with the HIS are established and operate smoothly. But this requires a solid cooperation between the IT department and E.care support.
It did not take long before the nurses and physicians who work in the emergency room started to appreciate E.care. Some physicians who only work in the emergency room from time to time refused to work with the software especially implemented for the emergencies. But because of the extensive implementation of so many functionalities intuition alone did not suffice to fully use the application. Patient conviction and a helping hand of the colleagues offered the solution. In the meantime E.care has been implemented fully and it is highly appreciated.
The costs and the efforts are definitely worthwhile. E.care is a very intelligent documentation and communication system that highly simplifies the work in the emergency ward. None of us would want to give up E.care ED now. Our bed management is very thankful for E.care as well. Thanks to the connection the search, assignment and communication about the place for the patient goes much easier and faster.
We still want to extend the implementation of E.care with the following: process management and billing. In cooperation with the invoicing department we configured all the tasks so that when they are executed a document is automatically drawn up on the basis of which the administration can do the entire invoicing.
We are also proud of the fact that, by means of a number of connections and templates, and especially thanks to the implementation of a number of ‘decision instruments’ we have evolved together with E.care from documentation system to process guiding application. We see plenty of opportunities for the future as well and are still putting a great deal of effort into the whole thing.
Doctor Thomas Fleischmann, FCEM FESEM MHBA, chief physician of the interdisciplinary emergency room
Doctor Karsten Kraatz, leading chief physician of the interdisciplinary emergency room