SQWM Surgical Quality Workflow Manager

Report
Introduction to the Surgery Quality &
Workflow Manager
(SQWM)
SQWM Business Drivers
Address the key issues of patient safety and wait times
- Patient wait time for surgery may be lengthy
- Patient surgeries are being canceled at the last minute for missing tests / results
or lack of ICU beds
Improve the efficiency and cost effectiveness of the surgery scheduling
process, including alerting bed management and ancillary services of daily
needs
- Expensive staffed OR rooms may be unused
- Regional and National view of resources and utilization
Allow for day of surgery patient tracking, provide local management reports
- Manual OR reporting processes result in lower information quality
- OR documentation/reporting is not consistent
Improve data availability for the national surgery quality programs
- Allow relevant clinical data collection on all cases
- Automate data collection to improve data quality and timeliness
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SQWM Objectives
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Standardization of VA surgery
Support business process change
Streamline surgery workflow
Improve efficiency
Monitor wait times
Track compliance with VA surgery complexity
Provide interface capabilities to other VA systems
Improve quality and patient satisfaction
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SQWM Overview
The Surgery Quality & Workflow Manager (SQWM) software
solution will allow the tracking of surgery patients through the
pre-surgical process, scheduling of surgery, peri-operative
period and post-operative assessment and disposition, including
quality outcomes reporting. This solution includes GE Centricity,
a Commercial-Off-The-Shelf (COTS) product, and development
of system integration to the existing VA patient support
applications.
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SQWM Product Description
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End-to-End patient tracking and clinical documentation from consult to discharge
Centralized management of all resources needed for surgery
Configurable clinical manager component to allow standardization and updating of
business processes across the VA in the shortest amount of time
Maximize re-use of existing components to interface with VA information assets,
such as standardized terminology services, Standard Data Services, Identity
Management, etc. without the need for further development
Industry best practices of quality monitoring and reporting built in the highly
configurable product to meet the VA’s local, VISN, and national level quality
assurance goals
Optimized peri-operative workflow and surgical block time utilization to improve
patient safety and Veteran access, increase overall patient and employee
satisfaction, and reduce wait times, first-time late starters, and cancellations,
improved efficiency = increase in capacity
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SQWM Project Activities
 PMAS Approval Granted 3/28/2011
 Contract awarded for SQWM Solution on 9/13/2011
 GE Centricity team completed walk through of Alpha Site,
Portland VAMC, week of 9/26/2011
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Training Recommendation completed in January 2012
SQWM Demonstration Presentation April 2012
Software Delivery, testing initiation August 2012
Begin use in Production (first site) April 2013
IOC roll-out in May 2013
National roll-out complete August 2014
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SQWM Interfaces
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Integration
Training –
Phase 1
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ADT
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SQWM will receive patient demographics, VA specific fields (e.g. service connected,
radiation exposure, etc.) and admitting data for patients
Scheduling
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SQWM will receive patient demographics, VA specific fields, and surgery Clinic
Appointment data at the point of scheduling and checking in the patient
TIU
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SQWM will send notes to CPRS at the end of documentation by the clinical provider
(e.g. progress notes, procedure notes, operation reports, operative note, etc.).
These will show on the appropriate tabs with signer, location, and date/time in CPRS
as text.
MVI
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SQWM will receive veteran demographic updates from MVI and utilize MVI during the
ADT and scheduling process to confirm correct patient demographics prior to
processing the ADT and Scheduling interfaces.
VASQIP
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SQWM will send VASQIP data to the national report center
VistA Surgery
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SQWM will send select data elements to VistA Surgery to allow for other downstream
reports and systems to access data from the existing VistA Surgery data elements
PCE
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SQWM will send PCE forms to PCE for workload accounting.
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Integration
Training –
Common Questions
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Will Medications integration be available in SQWM during phase 1?
SQWM will not be integrating medications during phase 1 but is on the roadmap for
future phases
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How are allergies integrated during Phase 1 in SQWM?
Yes, allergies are received into SQWM via the ADT interface in Phase 1.
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Will Labs be sent to SQWM during Phase 1?
SQWM will integrate labs during a future phase.
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What documentation is available to review about these interfaces?
Each interface has an ICD that is available
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SQWM will have new note types.
New note names and types are being rolled out with SQWM. This will allow for
standardization across the VISN and Nation
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Will notes and documentation elements from SQWM be in CPRS? And on the
correct tabs (e.g. surgery)
Yes, notes and forms completed in SQWM will be in CPRS via the TIU interfaces.
Surgery documentation (e.g. Operation Report & Operate Note) will be on the
surgery tab. Notes will have signer, date/time, and location.
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SQWM Project Team Members
VA Team Members:
VA Initiative Lead – Craig Powell
VA Deputy Initiative Lead/Budget Manager – Craig Powell
VA Project Manager / IPT Chair – Daniel Reed
Business Sponsor – Dr. William Gunnar
Director of Surgery, Portland – Dr. James Edwards
VA Requirements Representative – Dr. Jack Varga
VA Health Systems Representative – Avaretta Davis
National Training Manager – Scott Ridings
~75 other members of SQWM IPT
Harris (Prime Contractor) Team Members:
SQWM PMO Contract Team Members:
Harris Program Manager – Mark Merz
SQWM Lead – Sarah Abdow
Harris Chief Systems Engineer – Keith Bourke
Project Coordinator – Ashley Crews
GE Centricity Program Mgr – Joe Smith
Risk Manager – Jeff Morris
LSI Training Lead – Charlie Houghton
Lead Planner – Stephen Jones
Integration Documentation – Amanda Peckham
Functional/Business Analyst – Rosie Perez
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SQWM - Where to get Information
• SQWM Project Notebook –
– http://tspr.vista.med.va.gov/warboard/anotebk.asp?proj=1387&Type=Active
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SQWM VA OIT SharePoint:
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http://vaww.oed.portal.va.gov/projects/sqwm/Public%20Library/Forms/AllItems.aspx
• SQWM Project Management Team
– Dr. William Gunnar, Business Sponsor – [email protected]
– Dr. James Edwards, SQWM Medical Director – [email protected]
– Daniel Reed, SQWM Project Manager – [email protected]
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SQWM Technology
• COTS: GE Centricity Perioperative
• Servers Hosted at AITC
• Access via Citrix
All VA facilities are
associated with one of the
eleven SQWM Install
Groups hosted within the
AITC where Citrix XenApp
and VMware technologies
are used.
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SQWM Access – Citrix Login
• SQWM users will select an icon on their desktop that will route
them to the SQWM Citrix farm
– VA credentials are
used to access
SQWM capabilities
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SQWM Access – Select Environment
• After valid entry of VA credentials, SQWM users will have selections
to choose the appropriate SQWM environment
DEV
SQA
Training
Pre-Prod
PROD
SQWM users will normally be working
in the Production environment.
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SQWM Access – Install Group Selection
• SQWM Users will select the SQWM install instance associated
with their hospital
PROD
Notional approach depicted that would
enable users to identify their hospital
location on a map. The user is then routed
to the correct install instance associated
with their selection.
Alternatively, icons/list may be presented.
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SQWM Access – Centricity Functions
• Once a user has navigated to the instance of SQWM they want
to use, they are presented with a number of icons
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SQWM Access – Centricity Login
• Once a SQWM user selects a SQWM function, they log into the
SQWM COTS Product
– Centricity Perioperative
– Role-based credentials
administered by the
SQWM business owners
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Centricity Perioperative
VistA Scheduling
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SQWM Modules / Components
• Census – List of Patients
• vForm – Notes (H&P, Anesthesia, Nursing)
• Scheduler – Schedule Cases
• Nursing Documentation - Perioperative
• Tracker – Patient Tracking
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Censuses
• Surgery Clinic Census
• Miscellaneous Census
• Pre-op Clinic Census
• OR Census
• Pending Work Census
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Surgery Clinic Census
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Miscellaneous Census
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Pre Op Clinic Census
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OR Census
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Pending Work Census
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vForm – Overview
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Pending Work Census
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vForm – WNL = Default Values (1 of 2)
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vForm – WNL = Default Values (2 of 2)
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vForm – No Change (1 of 2)
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vForm – No Change (2 of 2)
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vForm – Field Choices
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vForm – Field Choices
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vForm – Field Choices
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Anesthesia “Worksheet”
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Anesthesia “Worksheet”
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Anesthesia “Worksheet”
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Anesthesia “Worksheet”
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Anesthesia “Worksheet”
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Tracker Board
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Users (multiple - with role specific access)
1. Surgical Resident
2. Attending Surgeon
3. Facilitator
4. Scheduler
5. Pre-op Clinic Nurse
6. Tracker User
7. Anesthesia Resident
8. Attending Anesthesiologist
9. Pre-op Holding Nurse
10. Circulating Nurse
11. Administrator
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12. Biological Implant Tracking Coordinator
Reporting
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Crystal – Wait List*
Crystal – Bed / Resources Report
Crystal – Staff Privileges Report
Crystal – Implant Reports
Crystal – Multisite Report: Executive Summary
Crystal – First Case Late Starts
Crystal – Turn Over Times
Crystal – Utilization Report Block & Room
Crystal – Pathology Report
Business Objects – Adhoc Reporting
Etc.
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Questions
Questions can be forwarded to the SQWM Implementation support team at:
[email protected]
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