Dr. Jeniann Yi, Vascular Surgeon and Informaticist, tells of her work designing, gaining leadership support, deploying and measuring the outcome of: mandatory consult order from ED and inpatient services, before: curbside consults lead to misunderstandings and poor handoffs, after: going from 14% to 95% consult-notes same day, and 100 minutes faster for the sickest patients to get to the OR. AND BONUS UKULELE SONG: Ghostbusters parody.
Dr. Yi telling the patient story that illustrates the problem: a patient admitted to a cardiology service with leg edema and some minor erythema on the foot. Cardiology team calls vascular for a curbside opinion: what study should I order to assess this foot? Recommend: ultrasound.
Then, results return, both team think that the other team will look at the result and decide on an action. Neither acts.
Several days later the patient deteriorates. Vascular is formally consulted, finds an arterial blockage on the imaging. As patient status worsened, amputation was the only remaining option, whereas earlier re-vascularization could have saved the foot.
This led to a leadership mandate: same day consults. Mandatory. Linked as the gateway metric for quality bonuses for every department. Suddenly, the interest in accurate dashboards, effective and clear consult orders, and timing on completed consult notes, were in high demand.
We went from 14% same-day completion of consult notes related to inpatient and ED orders, to 95%.
Dr. Yi shepherded the project from inception to completion, including leadership colloboration, Epic EHR order and notes design, analytics tracking and dashboards.
This is how we do informatics.
And a ukulele song to reinforce the learnings from today.
Reward for a session well-presented? A tour of the Ice Caves, and a selfie with PRECIOUS.
Still reading? Here’s the song!
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