Ontario Shores Advances Technology to Enhance Patient Safety

September 02, 2011
Dr. Fischler working with a mobile tablet 
Dr. Ilan Fischler, Psychiatrist and Physician Champion, can now directly enter medication orders at the point-of-care via mobile devices. Ontario Shores successfully completed the implementation of its fully integrated electronic health record system on August 15, 2011 when Advanced Clinical Systems were brought to all outpatient and offsite locations.
It's taken three years, three phases and one remarkable team of dedicated individuals, but Ontario Shores Centre for Mental Health Sciences (Ontario Shores) now operates within a fully integrated electronic health record (EHR) system. From inpatient to outpatient to in-home care, hospital staff are utilizing the new technology to support a seamless flow of information and enhance the safe delivery of care for its patients.

In the fall of 2010, Ontario Shores brought advanced clinical systems to all its inpatient units using MEDITECH 6.0, and recently integrated the system with all outpatient and offsite locations and clinics. The hospital immediately saw benefits in terms of quality of care and patient safety.

Since implementation, the hospital has been successful in reducing the number of medication incidents, and is focused on reducing incidents to zero. The development of a closed-loop medication administration system played a significant role by ensuring staff conduct proper checks at every stage of the medication process, from order entry to administration.

“A recent audit showed that approximately 95 per cent of orders are directly entered by the ordering physician,” says Dr. Ilan Fischler, Psychiatrist and Physician Champion on the project. “By entering their own orders, there is clarification around medication dose and name, and the computerized entry removes guesswork from handwritten orders.”

Dr. Fischler added that physicians can still tailor orders to the specialized needs of the individual, but overall they are much clearer, which reduces the risk of error or duplication. 

Ontario Shores also looks forward to a software upgrade this fall, which will further reduce the number of medication incidents by enabling the capacity to include a patient’s photo in their electronic medication administration record (eMAR). This additional patient identifier, coupled with current patient identifier practices, will ensure the appropriate care is delivered to the correct patient.

Mobile devices such as tablets, laptops and medication carts, which were deployed throughout the hospital, play a significant role in the enhanced care provided at Ontario Shores. Clinicians can quickly and easily check lab orders as well as document on a patient and enter a medication order at the point-of-care.

“Mobile devices facilitate true point-of-care documentation in both inpatient and outpatient settings,” says Karim Mamdani, Chief Operating Officer. “The fully integrated system enabled us to standardize hospital processes on an entirely electronic format, which has improved communication among interprofessional teams and best practices across Ontario Shores.”

In October 2011, Ontario Shores will build the Resident Assessment Instrument (RAI) into MEDITECH 6.0 so clinicians can enter assessments directly into the system and further reduce the risk of documentation error and duplication of information.

The EHR was built by Ontario Shores to support the advancement of mental health care, and the project team developed many recovery-oriented functions to meet the needs of mental health patients. These functions include:

  • Workflow oriented screens to electronically track records and eliminate the need to dig through paper records

  • Information alerts, warnings and error messages that appear on screen as medication orders are being entered

  • Additional decision-making supports that provide resources at the click of a button rather than searching through paper texts and references

“The computerized system supports the provision of the highest quality of care for our patients,” says Dr. Fischler. “For example, psychiatric medications often require complicated investigations and monitoring protocols to ensure they are being used at the correct dosage and are not causing side-effects. Ontario Shores has built these protocols into standardized order sets to reduce the risk of errors of omission.”

Building an internal system unique to mental health care enabled Ontario Shores to focus on soft assessments, patient interaction and recovery-oriented care as well as measuring both qualitative and hard data. It also provides capacity for future growth and development of EHR technology to continually improve safety practices and quality care within Ontario Shores and across the system.

“Safety is a key initiative within our organization, and we are proud to have built a system that significantly improves the safety of our patients,” says Mamdani. “We look forward to our software upgrade and RAI implementation this fall to further enhance safety and the quality of care we provide for the people we serve.”

For more information, or to set up an interview, please contact:
Communications and Public Affairs
Ontario Shores Centre for Mental Health Sciences
905-430-4055 ext. 4001