Trinity Health Cuts Mortality Rate With New App Platform

Creative thinking is essential for any IT team, but unless it's combined with lots of sweat equity, it doesn't get you far. Trinity Health clearly knows how to combine the two.

The hospital system, the fifth-largest Catholic healthcare system in the country, has put a great deal of creativity and man hours into a platform it calls Genesis. Genesis includes 28 computer applications from nine vendors, and touches virtually every major clinical and revenue process at the hospital.

Getting Genesis up and running required the tightly choreographed integration of new systems with multiple legacy applications, including laboratory, picture archiving, communication, and enterprise resource planning systems. More than 60 real-time and batch interfaces were activated during conversion.

All the work has paid off with measurable improvements in patient care. When compared with benchmark data from the Centers for Medicare and Medicaid Services that looked at similar health systems, Trinity has seen a 44% drop in severity-adjusted mortality rates. In practical terms, that means more than 2,600 lives are saved across the system annually. Similarly, since going live with Genesis, emergent medications are delivered 40% faster, and nurses spend 8% more of their time at the bedside.

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Structured document templates in the EHR have let Trinity clinicians do a more thorough job of monitoring patient care and led to the lower mortality rate, a spokesperson explained in email. The new platform also relies on task lists, evidence-based care sets in CPOE, status displays, and automatic alerts to keep the clinical team members in-sync with one another and reduce delays and errors in care.

Structured document templates sound useful in theory but no doubt will irritate clinicians who are accustomed to free text documentation, which raises the next logical question: How do you get clinicians' cooperation in the switch to templates?

Clinicians are data driven and interested in improving patient safety and quality of care, so Trinity's IT team worked with multidisciplinary teams of clinicians early in the planning process, taking advantage of doctors' insights, the spokesman said. "To really pull them in and gain their support of CPOE, we focused on the role of physician leadership, the training approach, and the role of the nurse," he said.

Early in the planning process, Trinity found physician leaders who could guide the rest of the physician community.

The hospital system also put a great deal of thought into providing the appropriate training to address its physicians' varied backgrounds and specialties. Because some doctors aren't as comfortable using computers as others, the IT team offered flexible training depending on each clinician's skill level.

And finally, when Trinity implemented the system in each hospital, it turned on nursing e-documentation at the same time it switched on programs for other clinicians. This approach kept all clinicians in sync in terms of training and system activation.

As nurses developed proficiency on the system, they were able to assist physicians. Furthermore, physicians and nurses from Trinity facilities that were activated early in the process were able to provide support during the first month of go-live at other facilities. "Having these peers from other organizations that are power users on the exact same system provides a knowledgeable shoulder to lean on and reduces fear of the change," the spokesperson said.

Trinity's success has pivoted not just on creative thinking and sweat, but on respect for its most important customers--the doctors and nurses who use Genesis daily.