Chris Wagner in Materials Management at Mercy found that over 200 forms used on the chart were being printed inhouse or by outside vendors.The expense in dollars and time to buy these forms, inventory them and distribute them to all using areas was extremely high and hindered the ability of a lean staff to focus on effective management of even more expensive medical-surgical stock items and capital purchases. She learned that a company called FormFast, Inc. in St. Louis, MO had developed a software product which would enable a laser printer to print both the form and patient identification onto blank paper at the nursing stations. This product also worked well on the Meditech software installed at Mercy, which might eliminate all 200 preprinted forms. She proposed it to the documentation committee, where it was approved as the first step of a system-wide conversion.
Radiology reports can be printed directly to the nursing stations serving the patient rather than being printed as a batch in radiology and manually distributed at a later time.
This allows paper-based information to be distributed immediately in real-time.
Forms and systems can be changed quickly, eliminating obsolescence and reducing cost, while also enabling better control of the documentation process, eliminating administrative time and errors and improving patient care.
All chart forms are generated automatically in batches at the touch of a button. Unit clerks or nurses can then focus on other things. Night unit clerk, Judy Zarter, said it saves her a tremendous amount of time ordering, assembling and distributing forms. Connie admitted that they had some learning curves, but none that were not overcome. “It was an exciting project. It keeps all your forms up to date and the nurses state it is easy to use,” said Connie.
Since the pilot, the system has been expanded to the other six nursing stations at Mercy. The next phase will be to expand the use of the system to print blank forms on demand on the laser printers, thus eliminating another 500 forms.
Additional forms automation applications have been installed in the registration area at Affinity’s other facilities, St. Elizabeth Hospital and Oakwood Outpatient Medical Center.
Goals set by Affinity for the registration forms were:
- Ability for patient to report to point of service without need to stop in registration to sign consents or pick up a form.
- Wristband automatically generated with registration form
- Consent laser-generated when necessary, system-driven without the need for decision making by the registrar.
- All forms contain the patient identification.
- Use of plain paper and laser printer to generate forms (i.e. eliminate preprinted forms)
- Bar code functionality.
- Ability to use printers for multiple functions since they were not stocked with forms.
- Reduced noise in areas with laser printers rather than impact printers.
- Improved legibility of forms generated with laser printers.
- No obsolescence of forms.
Per Dianne Schuettpelz, Director Registration and Health Information, the new registration system from FormFast prints to plain paper with a label affixed which is used for the wristband. Additional copies print to blank paper. A copy of the registration form prints automatically in the Health Information department. The consent is designated to print when needed, and contains the patient identification. The system intelligently tracks what forms are necessary for the encounter by parameters designed by the facility. For instance a Champus notification will automatically print for all Champus inpatients and outpatients.
New systems are installed so other reports will print where they are needed. Radiology reports can be printed directly to the nursing stations serving the patient rather than being printed as a batch in radiology and manually distributed at a later time. This allows paper-based information to be distributed immediately in real-time. The radiology requisition has also been converted to print to a blank form with labels. The FormFast software also allows generation of a Date of Birth barcode and an inch high medical records number for radiology folders.
Future applications may include therapy forms, personnel forms or administrative forms which still fill a lot of drawers.
Eventually all the paper forms may disappear and the medical record will be completely electronic, but this will not happen in the near future. Today, however, Affinity has achieved many of the important objectives of the paperless automation process with the laser printing system. Forms and systems can be changed quickly, eliminating obsolescence and reducing cost, while also enabling better control of the documentation process, eliminating administrative time and errors and improving patient care.