I have settled into work rather well lately. There are always new things for me, but I've developed a simpler rhythm over the last month or more. At the same time, there have been some very new things for me, like becoming a member of a unit committee and taking on the entering of pediatricians' phone/address info into Excel.

The Committee
As a new 2006 employee of AMC, I was not required to be part of a committee, but since the new year I have begun the orientation to "QuadraMed" - our patient classification system. As a committee member, I'm in the process of becoming a SuperUser, someone who learns the system more than the average staff member. In addition, the QuadraMed program is changing - in the next month - from a ScanTron process to an online software program. The amount of work with this committee is staggering.

I am still learning the process and the theory behind it, but basically, every bed/patient is placed in the system with a certain amount of workhours required to care for that patient. The number of hours is dependent upon the level of complexity at which the patient is classified.

At this point in time, the hospital, and the BirthPlace in particular, is unable to take credit for patients staying less than 12 hours in the day. This includes discharges and post-op surgical admissions.

When this software is implemented, our unit will be able to take credit for these patients who require additional care - the new admissions requiring a higher level of care, as well as the coordination and teaching that discharges require. The other type of patient not captured by our current system is the short-stay admissions. These patients may require a high level of care, but for only 2-3 hours. The patient must still be admitted to and discharged from the unit, and they require attention during their stay that takes away from your longer-term patients. If these patients as well as our general admissions and discharges can be captured, management will *hopefully* be able to budget for the actual needs of the unit, rather than the projected needs that may not be accurate.

The other facet of the software that is not in place at this time is its use in staffing and budgeting. With a better picture of actual patient/unit load, high- and low-complexity patients can potentially be managed and assigned to staff in an improved manner. At this point in time, many nurses are given "that hallway" or "all your patients from yesterday", when, depending upon the situation, it may be a huge disservice to both the nurse and the patients.

And the budget. Ah yes, the budget. They wonder why the BirthPlace went so horribly over-budget? I guess we'll get a better picture...perhaps.

And my other project...The Pediatricians' Book
We currently have a huge binder full of pediatrician's names, addresses, license numbers, phone numbers...

they are duplicates...not alphabetized anymore...erased...triplicates...taped-over...scribbled out...in handwriting from nurses who left the hospital 20 years ago...dead pediatricians, as well as those who have moved across the country...

Needless to say, I have my hands full. I got into this project because I tried to find several pediatricians at one point in the last few months. And I tried some more. It was very frustrating. I spoke with the Assistant Nurse Manager and asked her if I could spend some time working on updating it, and so here I am...16 hours and 400+ Excel entries later... I can't believe I proposed this project!

However, the response from my fellow nurses has been positive! Several have asked me about it recently. They can't wait for the results to be in their hands. Some have given me requests - make the font big enough to be read easily - reinforce the binding holes - how soon can we have it? Are you done yet?

The great thing is that I've gotten a whole lot of data into Excel. Now I just need to figure out how to format it appropriately - enough of the information we need in an easy-to-use format. I'm thinking of making a short list with the Pediatric Groups (many have 3-8 pediatricians) only. Optimally, this would be an online and searchable tool. But I think that might be biting off just a little more than I could chew! It would be great to be able to search by town, pediatric group, name, and license number. I wish there were one such tool already available.

Unfortunately, the American Academy of Pediatrics (AAP) doesn't list the license number of the pediatricians, although they list "last-updated" address and phone number for pediatricians. In addition, many of our "pediatricians" are really Family Practice docs, and as such are not listed under the AAP. The New York State licensing board office of the professions (NYS OP) doesn't list the address and phone number of the physician, only their name, license number, and town of licensing. The other piece is that we have many families from rural, distant, and even out-of-state locations. Many pediatricians in our listings are from Western Mass, Vermont, and even a few from Connecticut. As such, the NYS OP isn't a reliable one-stop search for pediatricians.

At Manchester Memorial Hospital, our pediatrician listing was a fairly comprehensive 1" binder with protective sleeves. It was alphabetical, and it was NOT unwieldy. I know that with our patient population, AMC will have a larger pediatrician listing, but the current one is just unbelievable. In the "A's" alone, I found 2-3 repetetive listings of some of the more frequently-used pediatricians on different pages. Plus, the updated listings were placed in front of the older versions, which just meant more confusion.

Anyway, I'm really getting there.

Amber's Inspiration...
When Amber (my orientation preceptor) showed up today, another topic of conversation became further education - in particular, the Master's Program that Amber's applying to for the fall. She wants a buddy for the program, and has asked me about it. I had thought about waiting a year - I can't even imagine applying! (the deadline does happen to be ... ah ... March 1st!)

I'm inspired. But 6 days to apply? And I'm working ... well ... whew, only 3 out of those 6 days. Wish me luck. Suny Stony Brook Distance Learning in Nursing