Lakeland Regional Health optimizes ED system to help save clinician time

With the second-busiest emergency department (ED) in the United States, every moment counts for clinicians at Lakeland Regional Health. So, when leaders at the Florida-based organization wanted to optimize how clinicians tracked and managed patients in the ED, they knew the project had to go smoothly.

“We had so much customization around our throughput initiatives, and it was a well-oiled machine,” says Clarinda Brewer, associate vice president and chief nursing informatics officer at Lakeland Regional Health. “To us, it was really important that we didn't lose time. We couldn't have a month of people getting used to a new system.”

In September 2022, Lakeland Regional implemented ED LaunchPoint—an intuitive tracking board that delivers information face-up so clinicians can better organize their workflows.

“By moving to ED LaunchPoint, we wanted to decrease the amount of time that clinicians were spending within a patient's chart so that time could go back to patient care. We wanted them to be at the bedside more and to spend less time on documentation or searching for information in the chart,” says Lisa Hartsfield, clinical analyst and informaticist for the ED.

To help make the transition a success, the organization collaborated with the Oracle Health team to test the product and its workflows. Leaders also sat side-by-side with clinicians to address concerns and support adoption.

"When we started our training, we encountered some pushback because our clinicians were used to multiple icons on their tracking boards. Now, physicians and nurses who were resistant to this change are praising the system and showing their peers how to use it. They’re seeing how much easier their job can be,” says Hartsfield.

Since implementation, nurses averaged 4.5 actions¹ in ED LaunchPoint per patient, while physicians averaged 4.2 actions.² Completing more than one action—such as reviewing labs, placing orders, and viewing documents—indicates staff were interacting with the system to do their day-to-day work. Part of what contributed to this ease of use was the patient summary feature, where staff can access notifications, documentation, and medications for the patient in near real time.

“The patient summary has been huge for our practitioners. It’s a one-stop shop where they can see details on the patient without having to open the chart. Instead, they can use the summary to launch into documentation or labs from previous encounters, without having to go back and search for it,” says Hartsfield.

During the project, clinicians were encouraged to document and review patient information using their single MPages view instead of various components in the patient’s chart. As a result, chart review via MPages for nurses increased by 123%.³

Clinicians are also spending less time in the electronic health record (EHR), with nurses decreasing their active time in the system by 22 seconds per patient⁴ and physicians reducing their time by 49 seconds per patient.⁵ In a year, clinicians are projected to save a total of 8,669 hours. ⁶

These efficiencies can not only help providers spend more time with patients, but can help give back valuable time to get patients placed or discharged from the ED.  Aside from gaining more time, clinicians no longer have to sift through multiple icons when managing important alerts that could impact patient and staff safety.

“Before, if there was an isolation icon on the tracking board, you would have to open the patient's chart to see what kind of isolation the patient was in. Now, our clinicians can see those details using ED LaunchPoint instead of searching for it. Moving away from all those icons on the tracking board has made our alerts more visible, which I believe has helped us keep our patients and staff safe.”

Looking forward, the organization is planning to expand so it can continue to meet the health needs of its community.

“We’re in the very early stages, but we’re hoping to open two off-site emergency rooms in the next two years. Once they’re open, we’re planning on adapting our current documentation and workflows in the ED for those sites,” says Hartsfield.

¹ The summary of nurse completed actions within ED LaunchPoint from January 1, 2023, to March 31, 2023. Possible actions include refreshing the screen, opening documents and new windows as well as hovering over patient information such as labs, medications, and vitals. No baseline was available prior to go-live.

² The summary of physician completed actions within ED LaunchPoint from January 1, 2023, to March 31, 2023. Possible actions include refreshing the screen, opening documents and new windows as well as hovering over patient information such as labs, medications, and vitals. No baseline was available prior to go-live.

³ Comparing the nurse chart review via MPages of 30% from before implementation (January 1, 2022, through March 31, 2022) to 67% after go-live (January 1, 2023, to March 31, 2023). 

⁴ Comparing the 7 minute and 40 second baseline of active time in EHR for nurses from before implementation (January 1, 2022, through March 31, 2022) to 7 minutes and 18 seconds after go-live (January 1, 2023, to March 31, 2023). Active time includes users that have typed or used the mouse once every thirty seconds.

⁵ Comparing the 14 minute and 6 second baseline of active time in EHR for physicians from before implementation (January 1, 2022, through March 31, 2022) to 13 minutes and 17 seconds after go-live (January 1, 2023, through March 31, 2023). Active time includes users that have typed or used the mouse once every thirty seconds.

⁶ A total of projected time saved per patient for nurses (5,216 hours) and physicians (3,453 hours). Projected time was calculated by taking the seconds saved for nurses (22 seconds) and physicians (49 seconds) and multiplying it by the number of patients seen in 2022. Projected time is based on if nurses and physicians were using the EHR 100% of the time.