Roger Williams Medical Center: Meeting and Exceeding Quality Expectations
(3/01/2007)

"We have a history of using information systems to achieve higher quality of care," declares Susan Cerrone Abely, VP and CIO of Roger Williams Medical Center (RWMC) in Providence, RI. "The culture here has historically been one of pushing and moving forward, setting ambitious goals, and then striving to meet, or hopefully exceed, them." The organization's pioneering spirit was certainly evident from the start, as RWMC brought patient management software, EMR, general financials, and all department clinicals LIVE within the first seven months of their initial MEDITECH installation, back when Abely first joined in 2001.

That same energy and dedication served them well in 2005, with the full implementation of PCS, and again in 2006 when they tackled Operating Room Management, Emergency Department Management, PACS, outcomes measurement through the Institute for Health Metrics, and integrating information with their affiliated long-term care facility. In their spare time, they went LIVE with a CPOE pilot program—no small feat, as many hospitals can attest.

We recently took a quick trip down I-95 to interview our friends at RWMC, so we could see their success firsthand and discover what strategies helped them along the way. During this visit, we learned more about why they've been able to tackle several high-intensity implementation projects during relatively short periods of time, as well as how these efforts have significantly improved quality.

It Starts at the Top
According to Abely, strong executive-level commitment to information technology is the foundation that drives the projects at RWMC. "Everyone here, from our clinical service chiefs, to our CNO, to our CEO, and up to our Board, sees the information system as crucial to improving quality," she says. "It's a united front, and that's the message we send out. Everyone responds to a mission to achieve higher quality."

Ken Belcher, the organization's CEO, also sees this level of dedication as crucial to the industry-wide success of I.T. fundraising efforts. "It's interesting, we find when it comes to fundraising, the question people always ask is 'Who donated the money first?'" he explains. "Fundamentally, people judge the importance of the venture by seeing who's already in the game, and how deeply they are invested."

RWMC is nothing if not vested in their technologies: Abely attends every Board meeting, and is often asked to present directly, on topics ranging from specific metrics of how I.T. has improved quality, to actual system demonstrations. "The Board is always supportive, and looking to see the connections that lead to quality," she says.

That executive support, in turn, leads to greater knowledge, and that knowledge has a distinct trickle-down effect throughout the enterprise at large. "When people see what I.T. brings to the table, knowing it's key to reaching our quality and patient safety goals, that establishes a certain standard that people are willing to follow," says Belcher. "It always starts with quality and patient safety."


Delivering Results Creates an Atmosphere of Success
Beyond understanding the organizational benefits, people still want to see results. "Success breeds success," says Abely. "When people see us making aggressive deadlines, then consistently meeting those deadlines, and then delivering clinical results, it's much easier to get them on board for the next project."

Joanne Dooley, CNO, agrees. "My first criteria for measuring success is figuring out if this system allows my nurses to spend more time with patients," she says. "Secondly, I'm always looking toward compliance and meeting The Joint Commission standards." A good example of an I.T. project that met both criteria was RWMC's implementation of on-line documentation on all nursing floors. Dooley found that on-line documentation was more accurate, which increased compliance. She also discovered that on-line chart reviews were not only more accurate, but a huge time-saver as well, which led to more nursing time spent on providing patient care.

Karen Bissonnette, nurse manager on the Maxi-Care Unit, is another staffer at RWMC who's spent much of the past two years toggling between the worlds of patient care and information technology. The I.S. department "borrowed" her during the Patient Care System installation, and charged her with organizing the input from RWMC's nursing community.

"As a manager, the nurses had a level of trust with me, and that in turn led to them trusting the system," says Bissonnette. "They felt that I would make sure that the system made nurses' lives easier."

And it has. In addition to the documentation benefits, nurses found that on-line charts were much easier to access than their paper predecessors were, and that led to the doctors finding information more quickly, which made them happy. "Any nurse will tell you, happier doctors make for happier nurses," laughs Bissonnette.

Sue Connell-Quetta and Dottie Rapson were the nurses "borrowed" by I.S. to serve in a similar role to ensure success with the Emergency Department, where early results have been positive. "Everyone's quite pleased down here," states Connell-Quetta. "The ED Tracker helps from a physical standpoint, seeing where everyone is in terms of treatment, where we are in the process, what rooms are open for new patients, what the registration statuses are. It saves us time and, in general, makes life easier."


Connecting with the Right Partner
For RWMC, dedication and focus are a big part of the puzzle, but having MEDITECH as their primary I.T. vendor also plays a substantial role in their accomplishments. "There's no other vendor we could do this with, because you have to have integration," states Abely. "To meet these kinds of deadlines, to have these kinds of results, you can't devote your resources to making interfaces work. Interfaces dilute our resources, both human and financial."

Belcher agrees that the one vendor approach has worked best to suit this organization's long-term needs. "We have confidence in MEDITECH and their products, and we believe in their people," he says. "Having one place to turn to just increases everyone's comfort level, and that ultimately leads to the results we've seen to date."

 

About Roger Williams Medical Center
Located in one of the city's oldest neighborhoods, Roger Williams Medical Center (Providence, RI) is a community-owned and governed health care organization that provides some of the most advanced specialty care available. Over the years, RWMC quality care has earned many distinctions including its formal affiliation with Boston University School of Medicine.

Roger Williams went LIVE with patient management software, EMR, general financials, and all department clinicals within the first seven months of its initial MEDITECH installation in 2001. They also fully implemented PCS, Operating Room Management, Emergency Department Management, PACS, and went LIVE with a CPOE pilot program in 2005 and 2006, completing more than ten MEDITECH implementations in just five years time.

MEDITECH
Medical Information Technology, Inc.
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Westwood, MA 02090
781-821-3000
www.meditech.com