World Patient Safety Day: How CST supports safe maternal and newborn care

The World Health Organization declared the theme of this year's World Patient Safety Day, September 17, as "safe maternal and newborn care". According to WHO statistics, every day 810 women lose their lives during childbirth.

The majority of these women reside in low and lower middle-income countries with barriers to safe and affordable health care. While, in Canada, these resources are readily accessible, our health organizations are continually striving to improve patient safety within maternal care. This is evident by the work currently underway at BC Children's and Women's hospital (C&W) to implement CST Cerner in early 2022.

Dr. Alain Gagnon, Chief Medical Information Officer for PHSA and Obstetrics and Gynaecology physician at C&W, shares some ways that this new system will help C&W to further elevate their maternal care services.

Q. In your work within Obstetrics and Gynecology at C&W, what are some of the obstacles your team faces in providing the safest care possible during labour and delivery?

We are at times challenged to find the information we need, often asking, "where is the chart?" or, "where is this filed?" We have multiple systems and areas to find everything, including the care plans for our patients and their at-risk newborns. Emergencies can happen at any time and having all the information readily available is key to managing them safely.

Q. What are some of the current gaps in technology for your team's work?

The information we need is in multiple places and this forces us to duplicate our work. For example, we will write a note in the chart and also have a [voice] dictation for distribution. For easy access, we also maintain a "problem list" (a document outlining patient's most important health problems) in our current version of Cerner [CW Cerner]. Unfortunately, this list has to be printed for the paper chart as well for the inpatient stay. We also struggle to find lab results that are not available in CareConnect.

Q. CST Cerner is coming to BC Women's Hospital in 2022. Which key benefits do you anticipate this new system will bring for improving safety for maternity patients?

Firstly, we'll be able to easily find the patient chart, have access to all the information in one area, or in patient context, and to experience better connectivity with other sites within the region. This means we'll have access to the appropriate patient documentation generated at other CST Cerner sites across PHSA, VCH and PHC, such as St Paul's hospital, Lions Gate hospital and BC Cancer's Vancouver centre. As Maternal Fetal Medicine physicians, we will be able to more easily contribute our expertise to the care of patients at other Vancouver Coastal and Providence sites as we will share one patient record.

This transformation will also provide us with better tools to support medication reconciliation and closed loop medication administration (read more below), two components known to decrease medication error. Early warning systems will also support in the early identification and intervention for patients at risk of rapid deterioration such as an infection or high blood pressure.

Q. Where do you hope to see the biggest impact for maternity and newborn care? Can you share a bit about the work underway by CST to achieve this?

In medicine, we always say, "first, do no harm", and I take this practice to heart; it's why patient safety is so important to me. We have to do everything we can to ensure we do not cause complications when we try to help patients so that they can be back participating in their lives and communities at their fullest potential.

There are a few 'biggest impacts' of CST Cerner that I see for our patients. We'll have real time access to the information required in one place and more integrated, shared documentation across specialties and professions. As our organizations roll out CST Cerner we are ultimately developing a shared, single health record for our patients.

We'll also have safer medication administration because the system supports closed loop medication administration. This is where every step incorporates an electronic checkpoint, whether an allergy cross check at the time of ordering, or scanning of a patient bracelet and medication barcodes, to ensure the right medication is delivered to the right patient at the right time. These have been key drivers for this important project since day one.