Mobilising 1200 Private Consultants

Erin Thompson, eMM Project Pharmacist, Cabrini Health

Shrivana Mawren, eMM Project Pharmacist, Cabrini Health

Cabrini Health: a snapshot....

Cabrini Malvern 508 bed acute care, emergency, coronary care, intensive care, maternity, paediatrics, day oncology, hospital in the home.

Cabrini Ashwood 90 bed residential aged care, medical, social, recreational , emotional and spiritual care.

Cabrini Prahran 22 specialist palliative care, medical, nursing, pastoral, allied health, home care.

Cabrini Brighton 141 beds, five theatres, high dependency unit, endoscopy, sleep centre, imaging, pathology, consulting suites.

Cabrini Rehabilitation 71 beds across two campuses, specialist in patient and out patient rehabilitation services.

Today’s Agenda

1. Mobility as a necessity and an enticement

2. Engaging and supporting new users

3. Training – how do we make eLearning work?

…..and a few key learnings.

1. Mobility as a necessity and an enticement

Mobility at Cabrini: A brief overview

• Mobility at Cabrini: A brief overview

Why mobility?

Few doctors are employed by Cabrini….

1,100 accredited doctors300 accredited anaesthetists

25 full time staff doctors120 part time, casual staff doctors

Many of our doctors…

Need to master systems and processes across multiple hospitals

Are not supported by Registrars or Interns who can absorb a process workload

Limited availability for meetings

Limited availability for training

Admit patients infrequently

Not always easy to contact

Not always on site

Ours is essentially a mobile workforce…

Our challenge

• To demonstrate the benefits

• To counter the objections

• To make transition painless

Our enticements

• Always with you

• Always available

Productivity

Convenience

Technological

• Take the time to become proficient

• Efficiency gains through use of protocols

• Integration with other Cabrini clinical tools

• Robust, reliable, well supported

• Component of Electronic Medical Record

And in the beginning it did feel a little like….

2. Engaging and supporting new users

How did we engage?

• We had outstanding executive support delivering a clear and consistent message: ‘MedChart or No Chart’

Peter Lowthian Executive Director of Medical ServicesSimon Woods Executive Director, Cabrini Malvern John Reeves Medical Director, Practicing AnaesthetistToni Grossi Chairman of Medical Staff, Practicing AnaesthetistAnne Zandegu Director of Nursing, Cabrini MalvernAmanda Footit Director of Pharmacy, Cabrini

We promoted the benefits

• Demonstrable reduction in medication errors

• Improved patient safety

• More efficient workflow –doctor : pharmacy : nursing

• More efficient prescribing (once the basics are mastered)

We made on-boarding easy

Movember supporters

We understood our users...

We looked at discharges over the period Aug – Sept – Oct 2015, immediately prior to go liveAnd then at Mobility Suite UsageAdmitting doctors only, anaesthetists not included

35 docs had 61 – 99 patients (1027 patients in total )

39 docs had 100+ patients (2654 patients in total)

Potential champions – harness the energy of the early adopters,support the ‘laggards’ as they are equally influential.

Ensure these users are well informed and have easy access to support.

Work at maintaining contact with these users. They are occasional visitors and do not build their competency or confidence via frequent usage.

327 docs had fewer than 60 patients(5396 patients in total)

Doctors Patients

We understood their support needs…

time

Basic functionality

Complex workflows

Problem solvingMastery

Emotional Response

Apprehension

ConfidenceInefficiency

Frustration

Acceptance

Our less frequent visitors spend more time here…..and needed plenty of support!

Our champions quickly find themselves here…

Our Key Users provided ubiquitous support

Key Users had no initial clinical load

We listened …

…and responded to our users, daily.

3. Training – How do we make eLearning work?

Easily available through Cabrini Dr Portal

Well structured, intuitive interface

Externally hosted and accessible

• To agency doctors

• To agency nurses

• To medical students

Learning Support via Drop In Centre…

IT and Clinical Support working in tandem….

We encouraged self sufficiency

What did we learn?

Caffeine was essential….

Resilience was useful!

Being available was important…

A little self care does no harm….