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CiLN: Nursing director takes lead on EMR project

Monday, 13 May 2019  
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Picture: Southern Cross Hospitals director of nursing Carey Campbell editor Rebecca McBeth


Carey Campbell is director of nursing and clinical lead for the electronic medical record implementation at Southern Cross Hospitals, the largest private hospital network in New Zealand.


Southern Cross Hospitals is a nursing organisation at heart, so when a new electronic medical record was going to be introduced, the director of nursing was the obvious choice to lead it from a clinical perspective.


Carey Campbell was given the portfolio of clinical lead for the implementation, which is part of Southern Cross Hospitals’ goal to be paper-light by 2021.


“With such a strong nursing focus in our organisation, and with me as the director of nursing, we needed to ensure that the development of our EMR would suit our business requirements,” she says.


“To move from paper to electronic you’re looking to change how nurses practice, not the philosophical or professional aspects of nursing practice, but how our processes fit with an EMR and our operational context.”


The roll-out


Southern Cross Hospitals chose Orion’s Clinical Workstation for its EMR project and began implementation in 2014, when Campbell took up her role as clinical lead.


Following two years of development work, the first pilot hospital in Auckland went live with the core EMR in February 2016. After several months of minor fixes and further enhancements, the roll-out began in earnest, going hospital by hospital on a monthly basis across the country.


Each site involved two to three weeks training and two weeks for go-live and Campbell was at every implementation, doing training sessions and sitting elbow to elbow with fellow nurses, helping them use the new technology.


“It was a really big change for nursing and we needed to have a nurse there for training, not just an IT training person, but both working together as a team,” she says.


The philosophy from the start was that this was not an IT project, but a business change project that was enabled by computers and software.


Campbell says nurses are exceptionally good at finding workarounds if something does not fit into their day-to-day practice. Tailoring an EMR to their needs was essential, and by doing that well the benefits of an electronic system flow from there.


A practical approach


Campbell was initially unsure about taking on the EMR role, but was encouraged by the insight and belief of the project sponsor that getting nurses on board from the start would be crucial to its success.


While she has always been interested in health informatics, she needed convincing that she could do it, but now believes “it was absolutely the right thing to do”.


“I didn’t know the lingo and I don’t know all the technical details, but I just ask questions. The IT team don’t know the medical jargon so they ask questions too. It works really well,” she tells


Campbell does not have any formal qualifications in IT, but says she picks things up quickly and loves change that improves patient care and progresses nursing.


“There are so many benefits to going electronic in a medical record that we just have to do this.”


She believes that being honest with staff that things will go wrong during a big implementation helps to create a supportive team atmosphere of tackling problems together.


“I said, ‘trust me, things are going to go wrong, but let’s get together and deal with them’ and we did. There was never anything insurmountable.”


The clinical face of EMR


Having spent many years “living and breathing EMR”, Campbell admits to the pressure of being “the face of Clinical Workstation”.


While it’s not perfect, she’s immensely proud of the work done to get clinical staff to the point of relying on the EMR for their day-to-day patient care. Now, they do not want to work without it.


“Having a clinical focus was key to making this a success,” she says.


Key user groups across the network continue to provide feedback on issues and suggest improvements for the next iteration.


Campbell argues that directors of nursing should be involved in any EMR implementations to ensure that critical patient care processes are well understood and systems developed accordingly.


Read more in the Clinicians in Digital Health series:

Ian Martin: Getting clinicians and IT talking to each other

Rebecca George: Raising the profile of allied health

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