My daughter is a junior in high school and we happened to be discussing “boys” one night recently at dinner. During the conversation, my daughter was outlining an exchange she had with a friend earlier in the day on how frustrated she was with her boyfriend because he “should have known” how to handle whatever the situation was at the moment based on what she told him.
As I listened, ever intently, to the story being laid out before me, it hit me that this poor young man had done what all young men do. He heard what my daughter was telling him, but didn’t interpret what was being said! Not an uncommon problem for all men, I guess, as my wife has alluded to me being that way now, even after 20 years of marriage.
In our professional roles, it happens the exact same way. We sit in meetings planning strategy, getting project updates, and moving technology forward in our organizations. As I’ve discussed in other posts, we just don’t listen and interpret things in the right way. Narrowing that divide is what our Medical Informatics Committee is all about. Our MIC works at closing the gaps between our professional biases and tries to commonly solve issues that affect patient care and the systems that support that process across our disciplines.
In other posts, we discussed the layout of the MIC and how important it is to have sufficient representation of your medical staff on that committee. Now, to make it productive for the physicians to attend, we have to get to the meat of what is covered.
The FIRST and MAIN rule of the MIC is that this is the one place open communication needs to happen without anyone taking it personally. To solve these complex issues, open communication is a must. Let’s face it, these systems are not where they should be from a user standpoint. The CPOE systems on the market today are not as good as what will be available in 10 years, but we have to work with what we have. So as you schedule the meetings, let your physicians build the agenda and take a “no question or topic is unimportant” approach.
In our committee meetings, we cover everything from policy and procedure issues related to documentation of information by physicians, to order and drug names that make the system more user friendly for the physician user. We discuss what workflow issues there are in the system and what barriers there are to successful use of the systems.
If the physicians are doing something wrong, this committee is the place to say that and explain what should be done to fix the issue. If the system isn’t working, this is the place for your physicians to lay it on the table for discussion. It’s much easier to work through issues in this room than when you hear about them from the floors. As your CPOE system or any physician system goes into place, there are a number of critical issues you have to work out. None of these are fun discussions, but you have to get them done. Do it here, in this committee.
In your committee meeting, present data to your physicians on where you are from an ordering percentage standpoint. Give the committee the details, showing for the last month, for example, your organization had 18% of all medication orders done via the CPOE system. Then discuss the goal of 30% and what barriers stand in the way. Don’t be afraid or shy away from the tough topics like, “Dr. Jones is trained, but refuses to use the system.”
Your committee members need to know the issues so they can help. Physicians are very data driven people — give them the data, remind them of the goal and use them to help work through the issues.
Patient safety concerns are our number one discussion in meetings. Anything involving a patient safety concern is addresses first and foremost. We even have physicians log on during the meeting and walk through issues on the projector screen so everyone can discuss how the system functions, and can see what the issues are and where they are. That way everyone, no matter the discipline, is on the same page. That way, we work together to make the systems work for us in order to work for the people we care for in our communities.
Remember, nothing should be personal, nothing should be sacred … happy problem solving.