Implementation of a computerized bedside data management program in the ICU

Meeting abstract

Intensivists are reluctant to take the step into paperless documentation in the ICU mainly due to uncertainty concerning the time investment, the impact of a radical change in documentation method on the staff as well as reliability of the software and hardware involved. We describe the implementation of a computerized data collection and management system – 'Metavision' (IMD-Soft^®) – in a 10-bed general ICU (admission rate 750 patients/year) of a 1200-bed tertiary care medical center.

Methods

Metavision, which is Windows™ (Microsoft^®) based, is a program charting patient clinical data, including monitoring parameters, medical and nursing treatment orders, treatment reports, diagnoses, followup documentation and laboratory results, which are inserted either automatically or manually. The system data collection is based on a central server for data storage connected via the intranet with bedside terminals and other user stations in the ward. Most of the medical and nursing staff were computer users with basic knowledge of Windows™, while 20% had no computer experience at all.

Implementation was divided into three phases, Phase 1 (3 weeks), project manager and superusers were trained, and the database was customized to local ICU needs. Phase 2 (4 weeks), configuration and programming of interphases as well as staff training (12 doctors, 51 nurses, a pharmacist, a physiotherapist, a social worker and a respiratory technician underwent 45 min of individual teaching and 45 min of exercise training). The project manager invested 240 hours in training and customization. Phase 3 Go-live (105 days after start day), documentation was switched to computerized charting with no double charting. No major difficulties were registered. Since then all data collection is automated and the documentation is paperless.

Conclusion

A paperless documentation data collection program in a 10-bed ICU can be implemented in a relatively short period with no major difficulties.

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