Implementing an event tool in Cerner FirstNet to identify the physiotherapy service in the emergency department and determine its impact on patient care

Abstract

Background: Physiotherapy services in the emergency departments (EDs) are in a state of transition, either provided through the traditional 'secondary contact' role or more recently through the 'primary contact' role of the Emergency Physiotherapy Practitioner (EPP). There is a growing body of evidence that the EPP play a valuable role by providing targeted care for patients with isolated musculoskeletal injuries and improving ED performance and patient flow. However, in most cases this evidence is descriptive or limited to data collected at a single site. Moreover, the role of the EPP is not easily defined in FirstNet, the system that is used in most EDs in NSW to monitor patient follow. Objective(s): To establish a data collection tool in FirstNet in order to determine the impact of the physiotherapy service on the ED performance and care for patients with musculoskeletal injuries and distinguish between different models of physiotherapy care provided in the ED at numerous intervention sites. Method(s): Two research events which indicate the different physiotherapy models of care within the ED (Primary Contact or Secondary Contact) were implemented in Cerner FirstNet Set Events function based on a suggestion from a Senior Analyst at Information Technology Services (ITS) for WS and NBM LHD. ITS for WSLHD were then asked to schedule and implement the Events in FirstNet so EPPs on duty can view and select the relevant icon on FirstNet simultaneously when they are assigned to a patient. This will also enable ED data managers to extract the data of interest for all patients seen by EPP. A list of SNOMED Diagnosis codes for all musculoskeletal injuries which fit within the inclusion criteria of the study were used to capture the data of interest for all patients how received care by usual care providers using Discern Analytics 2 (DA2) report writing module available via Cerner FirstNet. The final report is designed to provide patients' journey within the ED including waiting times, length of stay and discharge disposition in all participating sites. Result(s): The research event is currently implemented at all SWLHD participating sites: Westmead Hospital, Mt Druitt Hospital, Blacktown Hospital and Auburn Hospital. Electronic records showed that the event icons can capture the data of interest precisely as the report obtained locally at Westmead Hospital was found to match exactly the hand written paper records completed by EPP. Conclusion(s): Activating FirstNet event icons can be powerful tools for data collection that will enable researchers and stakeholders to capture high quality evidence-based clinical practice and translate it to improve ED performance.