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Paper-Lite is part of the BMDH Expansion Project
www.bmdhproject.health.nsw.gov.au | BMDH Project 1800 155 102
Paper-Lite Fact Sheet Electronic Medical Records Project | Blacktown Hospital , NSW | 2014 - 2015
Paper-Lite is an initiative involving the
transition from written notes to electronic
documentation for the majority of inpatient
records at Sydney’s Blacktown Hospital.
It’s a clinician-driven change to provide staff
with anywhere, anytime access to hospital
medical records via any authorised device
including laptops, iPads, tablets, or
smartphones.
The innovation enhances our capacity to make
informed decisions about patient care because
clinical staff (nurses, doctors, allied health &
support staff) always have access to the most
up-to-date information.
Paper-Lite was initiated by our Western Sydney
Local Health District Information Technology
Services and BMDH Expansion Project Teams
with our doctors, nurses, allied health and
support staff.
Why change?
As part of the planning for the expansion of
Blacktown Hospital, a strategic decision was
made to design and build the new facilities on
the assumption that an eMR would be adopted
and medical record scanning implemented.
This decision presented two challenges – the
need to transition clinicians from paper records
to an eMR, and the requirement to achieve both
this and scanning in the existing facility ahead of
the opening of the new facilities in early 2016.
What did we change?
The scope of the program of changes included:
Implementing electronic Assessments and
Progress Notes for all disciplines.
Implementing electronic consults (Nursing)
Implementing electronic operation reports
(all specialties)
Implementing electronic Emergency
Theatre Bookings
Implementing electronic Adult Observation
Charts
Increasing uptake of electronic Discharge
Summaries (all disciplines)
Implementing electronic decision support
tools including an electronic Sepsis Alert,
Care Compass and VTE Assessment tools.
Increasing uptake of clinician mobility
including Bring Your Own Device (BYOD),
corporate devices and Remote Access
Implementing enhanced eMR functionality
including patient summary (mPage) and
continuous docs.
These changes needed to be implemented in 16
of the hospital’s units and involved over one
thousand clinical staff from a range of
disciplines.
To align with the capital works program, the
entire program of changes needed to be
implemented within 30 months.
How did we do it?
To achieve the implementation of Paper-Lite
within the constraints of time and resources, a
locally developed change approach was adopted
with:
Strong clinician engagement and leadership
with genuine clinician involvement in
planning and empowerment to make
meaningful decisions on all elements of the
project.
Strong internal partnerships with clinicians,
administrators and IT professionals working
collaboratively towards a shared goal.
Strong interagency partnerships with
Western Sydney LHD working closely with
Health Infrastructure & eHealth NSW.
Just-in-time training with the majority of
training occurring as
hands on, small
group sessions
conducted in the
work environment in
the two weeks prior
to go-live.
NSW Health Awards
Finalist 2015
Paper-Lite Fact Sheet Page 2 |Updated October 2015
A focus on internal sustainability from
the outset with local expertise
developed and imbedded into each
clinical unit.
A focus on implementation as opposed
to installation, with efforts directed to
achieving a change in clinician practice
instead of merely installing an IT
solution.
“The aim of Paper-Lite was to
accelerate the implementation of an
inpatient eMR in an existing, major
metropolitan, public hospital”
Peter Rophail, Transition Manager
How did we communicate?
The change program was underpinned by an
innovative communications approach which
was used to build awareness and
commitment for the program.
Our key focus areas included:
Branding - a stakeholder concept for a
logo was further developed to create a
readily identifiable brand for Paper-Lite.
This branding helped establish Paper-
Lite in the busy physical hospital
environment. Consistent use of the
branding, plain language and visual
communications tools helped explain
complex technical changes.
Collaboration - communications
materials were produced in
collaboration with clinicians to support
staff training and to help patients and
carers understand the technology
changes.
People-centred approach - despite
Paper-Lite being primarily an IT change,
communications focused on people as a
way of telling the Paper-Lite story in an
engaging and meaningful way. Major
change messages were packaged with
case studies, genuine staff and patient
stories to personalise the technological
changes, create excitement, encourage
behaviour change and build acceptance
for the changes.
How did we do?
Discussions on implementing Paper-Lite
commenced in February 2013 with all 16
units having completed transition to an
inpatient eMR for the majority of their
documentation within 19 months. This was
followed by the implementation of medical
records scanning in December 2014.
Post implementation surveys and interviews
incorporating over 100 clinical staff have
revealed a very high degree of satisfaction
with the Paper-Lite changes.
The most commonly nominated benefits
include:
Ability to access all records from
anywhere in the hospital which results
in improved ability to prioritise clinical
workloads and also better manage
remote patients such as outliers
Time savings as a result of the ability for
multiple people to access the record
simultaneously
Ability to access the record remotely
Reduced duplication of data entry
Improved compliance with assessments
and other tasks.
Our partners
Thank you to our partners:
Blacktown & Mount Druitt Hospitals
(BMDH) Expansion Project
Western Sydney Local Health District
(WSLHD)
WSLHD & NBMLHD Information
Technology Services
Health Infrastructure
eHealth NSW
Clinical Excellence Commission - for
Australian-first Sepsis Alert project
implementation
The staff and executive of Blacktown
and Mount Druitt hospitals.
Paper-Lite is part of the BMDH Expansion Project
www.bmdhproject.health.nsw.gov.au | BMDH Project 1800 155 102
As part of our expansion project, Blacktown Hospital doctors, nurses, allied health and support staff
ask us to accelerate the introduction of inpatient electronic medical records in the hospital. If it can be
achieved, it will make us the first existing major public hospital in NSW with electronic records.
Our Paper-Lite Story (so far) October 2015
The expansion project and the ITS teams know it’s a ‘can do’. The project gets executive endorsement and the
working group suggests “light on paper” as a concept. The image of a stack of paper being tightened with a belt seems to grab everyone’s
attention and “Paper-Lite” is
born.
Clinicians tell us they want anywhere, anytime access to hospital records. For maximum accessibility, flexibility and mobility, we make Paper-Lite available on
mobile devices and BYOD as
well as on desktop computers and COWs (computers on wheels). From bedside to staff station to consulting room, it’s all Paper-Lite.
The project partners with the Clinical Excellence Commission to develop
a sepsis alert - an
algorithm that automatically scans the patient’s electronic records for markers indicating a clinical review is
required because of the risk of
sepsis. It’s an Australian first.
On launch day we get green lollipops.
B42 Surgical ward nominates to be the pilot site. Testing begins and the project creates such a buzz around the hospital that other wards and services are lining up to participate. We prepare information for
patients too, so they know
what’s going on when they see staff on COWs, mobiles and tablet devices.
At 8am on Tuesday 29
July 2014, the project goes
live. B42 Surgical becomes the
first electronic records ward in NSW.
The support team is on hand to assist (in green t-shirts of course).
The project team creates a communications plan for the project
and develops a logo and branding from the working
group’s initial concept. The
branding supports training, launch
events and all communications, creating a fresh, appealing instantly recognisable (and very green) project identity.
Clinician training begins, supported by senior medical, nursing and allied health staff.
We train about 100
staff ready for go-live including sessions for VMOs, JMOs, nurses, allied health and ward staff. Info packs include quick reference guides for forms, log-ins, records and other Paper-Lite functions.
The project is so successful and so well-supported by hospital staff that the implementation
program is shortened from
6 months to
6 weeks.
Training starts for more than 1,000 staff.
Our Health Information Records Service starts
scanning millions of pages
of paper files to create digital records for every patient.
1st
Paper-Lite supported by a
delivery of 60
COWS (computers
on wheels).
Our first two COWS are named in honour of long-term patient Bill (who says he’s been a patient in every ward except Maternity) and his wife and long-term carer Marian.
Upgrades are added to enhance
functionality and we survey
staff to gather information about the next round of improvements.
On 2 September 2014, the remaining 15 units go live.
Within three days, all new patients are Paper-Lite.
We reward ourselves with green
cupcakes!
In late 2015, Paper-Lite rolls out at Mount Druitt Hospital.
Dietetics becomes
the first ambulatory care unit to go
Paper-Lite as we start to transition outpatients to electronic records.
About 40 groups (so far) of visitors from NSW, interstate and overseas have come to see how we did it.
1st
Paper-Lite is part of the BMDH Expansion Project
www.bmdhproject.health.nsw.gov.au | BMDH Project 1800 155 102
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