Nordland hospitals save time and improve quality with Checklists

Nordland hospital group first implemented the Medanets app in 2022. Already back then, the Checklists feature was on their wish list, but it made sense to start with Observation values, Early Warning Score and Clinical forms first. After getting these features in place, Checklists were introduced in October 2021. The hospital group talked about their experiences on Medanets User Days in April.  

For the Nordland hospitals, checklists are a tool that is used within the care process of a specific patient. The checklists serve as a memory aid for the nurse to remember every task to be done and contain important information about the patient that needs to be recorded in the electronic health record. Examples are admission checklists and preoperative checklists.

Standardised procedures, quicker

The purpose of healthcare checklists is to harmonise practices and eliminate human errors to improve patient safety and the quality of care. Traditionally, checklists used in care work have been in paper format. According to studies, their use tends to be inconsistent, and the full benefits of checklists are often not achieved^1,2. This was also true at the Nordland hospitals. 

Today, we have about 100 different kinds of checklists in use in our hospitals. Before Medanets, these were all filled in by hand and stored in the patient’s paper folder. Only after the patient was discharged, the papers were scanned to the electronic health record.

Nina Nedregård Jensen, Department Manager in the Unit for Clinical IT at the Norland Hospital

The scanned documents were often copies of copies and did not look good. They were neither easy to read nor filled in a standardised manner. Both problems are solved when the checklists are filled in using the mobile app.

All lists that are filled in and saved on mobile are directly transferred to the DIPS electronic health record, also when the list is not yet complete. If the same list is later modified or completed on mobile, also the new version will be available in the EHR right away. In the EHR view, recently updated checklists are highlighted with a specific marking.

Process transformation calls for change management

Transforming the checklist procedures from paper to mobile is still on-going at the hospitals – not all the 100 checklists can be digitalised at once. The feature is always configured based on specific customer needs and requirements, and Medanets and the Nordland hospitals have been working closely on developing checklists for mobile use.

Moreover, the hospital group has developed an internal process for managing the change from paper to mobile. The wards need to define their checklist needs themselves and document the procedure in the hospital’s quality system. This is to ensure that the people who have the best professional knowledge of their needs get to define what is needed in the mobile checklist.  

The documentation in the quality system needs to include the information that the specific checklist is available in the Medanets app. This is to ensure that everyone knows the procedure should primarily be completed on mobile, not on paper. At the same time, the documentation works as a back-up for exceptional circumstances when the checklists are not available digitally. If the procedure needs to be updated, the same update is done in the quality system and in the Medanets app at the same time. 

All in all, the process transformation calls for change management. The staff need some time to get accustomed to the new ways of working. However, the usage rates of the Nordland hospitals show that the adoption has been quick. From the nurses‘ point of view, the main benefit of the Medanets app, and of the Checklists feature, is that it gives them time.

Time is why we use Medanets at our hospital. As one of our nurses has said, sometimes five minutes mean a lot.

Nina Nedregård Jensen, Department Manager in the Unit for Clinical IT at the Norland Hospital

Sources:

1. Tian et al. (2019): WHO Surgical Checklist in Dermatology: Compliance, Barriers, and Attitudes. Dermatologic Surgery.

2. Pugel et al. (2015): Use of the surgical safety checklist to improve communication and reduce complications. The Journal of Infection and Public Health.

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