Back to Top Skip to main content

Madigan Army Medical Center's emergency room helps shape MHS GENESIS

Krista Marcum, a staff nurse in Madigan Army Medical Center's emergency room, offers an MHS GENESIS demonstration to Defense Health Agency staff visiting Madigan. Marcum said these demonstrations often lead to MHS GENESIS-related brainstorming and problem solving. (U.S. Army photo by John Wayne Liston) Krista Marcum, a staff nurse in Madigan Army Medical Center's emergency room, offers an MHS GENESIS demonstration to Defense Health Agency staff visiting Madigan. Marcum said these demonstrations often lead to MHS GENESIS-related brainstorming and problem solving. (U.S. Army photo by John Wayne Liston)

Recommended Content:

Military Health System Electronic Health Record | MHS GENESIS | Military Hospitals and Clinics

JOINT BASE LEWIS-MCCHORD, Wash. — From a new triage workflow to standardized order sets to communication shortcuts, the emergency room team at Madigan Army Medical Center is constantly finding new ways to use or improve MHS GENESIS.

The section's largest project by far was revamping the triage notes to improve the workflow, add stronger psychology documentation and bolster falls prevention, according to Krista Marcum, a staff emergency room nurse who runs operations for the ER's nursing section and leads performance improvement as well. In total, revising the notes took about nine months of coordinated effort.

"There was some fine adjusting to it, but I think overall it is much more user-friendly and what we've been able to do is build in more safety features that trigger the physician to be aware of the suicidal patients or the high-risk falls patients," said Marcum.

“The Madigan team has been very responsive to the introduction of MHS GENESIS and its continued deployment across the Military Health System,“ said Maj. Gen. (Dr.) Lee E. Payne, MHS Functional Champion. “User feedback from Madigan and the other IOC locations (Bremerton, Oak Harbor, and Fairchild) plays a very important role in improving the record as the Defense Health Agency continues further deployments across the entire system. In addition to these improvements the DHA Functional Champion uses this information to help Cerner improve the Millennium health record we use across their entire enterprise.”

“So, the benefits we get from user feedback have a much more important role in benefitting health care across a much broader enterprise than just the MHS,” said Payne.

Super User Dana Engness, a registered nurse in the ER, took part in revamping the note as well, to include testing it out before it went live. She said the ER team was able to suggest and help implement practical changes, such as including international traveling in the initial triage screen, and moving items like tobacco usage and medication lists to the second screening that is done in patient rooms.

Altogether it took a multiservice and a multidisciplinary team (leadership, physicians, nurses, a psychiatrist and informatics experts) to put together revised notes that affected care from the emergency room to inpatient floors.

Marcum offered some lessons learned for others attempting to influence change in MHS GENESIS.

"What I learned with the triage notes is to know ahead of time that if there's a big fix with (MHS) GENESIS that's going to require high-level people like the architects and the (solution) owners of (MHS) GENESIS, go to them knowing what needs to be fixed specifically and what you need out of it," she said. "Also know who are the key players involved and how they will be affected and make them a part of the team."

The ER team's high level of engagement with MHS GENESIS in general can be attributed to the unit's culture of flexibility.

"You can't really work in the emergency room without being flexible, so when you get a new system, you just figure it out and you learn it," said Marcum.

So far, the team has harnessed small wins like using the comment section on their patient tracking board to note status changes such as if standardized order sets are complete or if a patient is at X-ray or ready for a CT scan, for instance. Since other specialties can see the comments as well, the use of this function speeds up communication and patient care – Marcum said "the comment section has been gold."

The tracking board, which pulls data from MHS GENESIS, overall offers the team greater oversight of their patient population from the waiting room to the ER bed or urgent care, offering a finer safety net, she said.

Even ER-driven projects such as their early evaluation team, which allows patients in the waiting area to get head starts on orders and labs, improved by taking advantage of the tools in MHS GENESIS.

"(MHS) GENESIS has played a key role in that because our super user has been able to put in standardized order sets under her shared name. Any nurse can go in there and actually pull up these standardized orders, and we know they're the most accurate order," said Marcum.

She's actually working on a Lean Six Sigma project herself to shorten the admission process time from the ER to inpatient floors, and improved communication and MHS GENESIS play key roles in those plans. Likewise, the electronic health record is a part of many of the 16 ongoing performance improvement projects in the ER.

In general, the ER encourages a culture of end user engagement; anyone can make a suggestion for an improvement to MHS GENESIS, said Betty Vaughan, a licensed practical nurse in the ER.

"Collectively, when we do our morning huddles, we do discuss changes that have occurred, or if any of us have suggestions, we make suggestions," she said. "At any point if you come across something, you can immediately go talk to somebody about it or send them an email saying 'I came across this; what can I do about it?' and then it's always addressed."

The ER Super Users are easily accessible by email, and will get eyes on an issue if needed to get more information on how to address it, said Vaughan.

In fact, she said she believes that their system of communication could work for sections throughout the hospital, encourage regular MHS GENESIS feedback during morning huddles or weekly meetings, allow end users to directly engage with super users to demonstrate what they'd like to improve, and encourage super users to elevate these concerns to the next higher level. She also said she encouraged end users to learn from one another and to remain flexible as they learn more about MHS GENESIS and work to improve it.

Disclaimer: Re-published content may have been edited for length and clarity.  Read original post.

You also may be interested in...

Army, FDA discuss 3D printing at workshop

Article
1/21/2020
When a medical device breaks down on a medical unit deployed to a remote part of the world, the closest repair parts could be thousands of miles away (U.S. Army photo by Francis S. Trachta)

Army medical logisticians are looking to 3D printing as a potential solution to this challenge

Recommended Content:

Military Hospitals and Clinics | Technology | Combat Support | Medical Logistics

U.S. Transportation Command: DoD’s manager for global patient movement

Article
1/9/2020
An ambulance bus backs up to the Mississippi Air National Guard C-17 Globemaster III as Airmen prepare to unload patients at Joint Base Andrews, Maryland. The bus transports the ill and/or injured to Walter Reed National Military Medical Center in Bethesda, Maryland. JBA and Travis Air Force Base, California, serve as the primary military entry points or hubs for patient distribution within the continental United States. (U.S. Air Force photo by Karina Luis)

On a weekly basis, USTRANSCOM moves up to 40 patients from overseas to CONUS

Recommended Content:

Health Readiness | Military Hospitals and Clinics

Navy Medicine demonstrates Virtual Health options to Africa

Article
1/6/2020
Air Force Staff Sgt. Danny Lim practices conducting a throat examination on Army Sgt. Harvey Drayton at Chabelley Airfield, Djibouti. Drayton and Lim were introduced to the Telehealth In A Bag system during a recent visit that included personnel from Regional Health Command Europe's virtual health team. (U.S. Army photo by Russell Toof)

Djibouti hosts the largest U.S. American military base on the African continent

Recommended Content:

Health Readiness | Military Hospitals and Clinics

Achievements in 2019 provide strong foundation for year ahead

Article
12/23/2019
A Year in Review: Year of Military Health 2019

Dedication, commitment to mission praised as changes continue

Recommended Content:

TRICARE Health Program | MHS GENESIS | Research and Innovation | Preventive Health | MHS Transformation

DHA PI 6025.10: Change 1: Standard Processes, Guidelines, and Responsibilities of the DoD Patient Bill of Rights and Responsibilities in the Military Health System (MHS) Military Medical Treatment Facilities (MTFs)

Policy

This Defense Health Agency-Procedural Instruction (DHA-PI), based on the authority of References (a) through (d), and in accordance with the guidance of References (e) through (t), establishes the Defense Health Agency’s (DHA) procedures to begin standard processes and guidelines for the Patient’s Bill of Rights and Responsibilities, Reference (e)), in MTFs.

Air Force, Army medics save groom

Article
12/19/2019
Airmen from the 18th Aeromedical Evacuation Squadron simulate life-saving procedures to a training manikin onboard a KC-135 Stratotanker during an exercise out of Kadena Air Base, Japan. The 18th AES maintains a forward operating presence, and was instrumental in saving an Airman’s life. (U.S. Air Force photo by Senior Airman Matthew Seefeldt)

NCO’s first aeromedical evacuation mission was definitely challenging

Recommended Content:

Health Readiness | Military Hospitals and Clinics

Payne visits service members, facilities in Puget Sound

Article
12/18/2019
Air Force Maj. Gen. Lee Payne, assistant director for Combat Support, Defense Health Agency, speaks with service members and staff at Madigan Army Medical Center during a town hall in Letterman Auditorium. Payne visited Madigan as the final stop of his tour of the Pacific Northwest military treatment facilities, also including the Air Force’s 62nd Medical Squadron, Naval Hospital Bremerton and Naval Health Clinic Oak Harbor. He conducted town halls at each location, focusing on MHS transformation, and answering questions from the audience on topics ranging from MHS GENESIS, readiness and training, and the future of military medicine. (U.S. Army photo by Ryan Graham)

Effective combat power depends on military health’s ability to build a medically ready force

Recommended Content:

MHS Transformation | Military Hospitals and Clinics | MHS GENESIS

MHS GENESIS enabler to more effective military health system

Article
12/17/2019
Air Force Maj. Gen. (Dr.) Lee Payne director for Combat Support at the Defense Health Agency, discusses the transformative effects of MHS GENESIS, the Department of Defense’s new electronic health record, during the 2019 Society of Federal Health Professionals’ annual meeting in National Harbor, Maryland. Payne explained that the new electronic health record will ensure high quality care for patients while protecting the safety and security of patient information. MHS GENESIS will deploy in phases to all DoD military treatment facilities by 2023. (DHA Photo)

New health record helps advance patient safety, quality care

Recommended Content:

MHS GENESIS

DHA transition discussion hosted at Naval Hospital Bremerton

Article
12/12/2019
Air Force Maj. Gen. Lee E. Payne, Assistant Director for Combat Support Agency, Defense Health Agency explained to Naval Hospital Bremerton staff members during a Town Hall meeting there are four overlapping areas of focus for DHA which are great outcomes, ready medical force, satisfied patients, and fulfilled staff, all contributing to the goal of having a medically ready force and a ready medical force.

The most important outcome for us is a medically ready force

Recommended Content:

MHS Transformation | Military Hospitals and Clinics

Changes to military health care system aimed at readiness

Article
12/6/2019
Speaking before the House Armed Services subcommittee on personnel during a Dec. 5 hearing on Capitol Hill, Assistant Secretary of Defense for Health Affairs Thomas McCaffrey (left), Army Lt. Gen. (Dr.) Ronald Place (second from left), director of the DHA, the service Surgeons General, and Joint Staff Surgeon outlined the necessity for the health care system to change in order to support warfighter readiness. (MHS photo)

Merger of all hospitals and clinics to DHA a key step

Recommended Content:

MHS Transformation | Military Hospitals and Clinics

Keesler renovates cardiac cath lab to provide better, safer care

Article
12/5/2019
Air Force Staff Sgt. Matthew Slaven (right), 81st Medical Operations Squadron cardiopulmonary technician, briefs 81st Medical Group staff and guests on cath lab capabilities during the cardiac catheterization laboratory ribbon cutting ceremony inside Keesler Medical Center at Keesler Air Force Base, Mississippi. The lab was upgraded with an entire suite of technology to provide better and safer care for patients and the surgical team. (U.S. Air Force photo by Senior Airman Suzie Plotnikov)

The clinic also has a joint DoD – VA partnership

Recommended Content:

Military Hospitals and Clinics

Military hospital transformation – introducing the market construct

Article
12/5/2019
Barclay Butler, Ph.D., MBA, assistant director of management at DHA, explains the market concept to an audience of active-duty and civilian conference attendees at the 2019 AMSUS Annual Meeting in National Harbor, Maryland, Dec. 4. (Photo by MHS Communications)

Markets will manage hospital and clinic needs within a geographic region

Recommended Content:

Military Hospitals and Clinics | MHS Transformation

Tri-Service surgeons perform the first surgeries at new hospital

Article
12/3/2019
The Army, Navy and Air Force surgeons and physician assistant met with the hospital command team. (Left to right) Army Col. Alfonso Alarcon, orthopedic surgeon at BDAACH; Army Maj. Harry Aubin, general surgeon at BDAACH; Army Command Sgt. Maj. Nicole Haines, the hospital senior enlisted advisor; Air Force Capt. Christopher Ng, Air Force general surgeon with 51st MDG; Army Maj. Eric de la Cruz, chief of general surgery at BDAACH; Navy Lt. Cmdr. Paul Lewis and Lt. Cmdr. Dan Sanford, general surgeons with 3rd Medical Battalion; Army Maj. John Fletcher, general surgeon at BDAACH; Army Col. Andrew L. Landers, hospital commander, and Air Force Capt. Steven Maya, physician assistant with 51st MDG. (U.S. Army photo by Inkyeong Yun)

This event showcased the collaboration amongst the tri-service general surgeons

Recommended Content:

Military Hospitals and Clinics | MHS Transformation

NMCP hosts ‘The Future of Military Medicine’ discussion panel

Article
12/3/2019
Navy Capt. Joel Schofer, deputy chief of the Medical Corps at the Navy Bureau of Medicine and Surgery, talks about the Defense Health Agency transition during Naval Medical Center Portsmouth’s Future of Military Medicine panel. The panel participants were (left to right) Schofer, deputy chief of the Medical Corps at the Navy Bureau of Medicine and Surgery, Navy Capt. Lisa Mulligan, NMCP’s commanding officer and Capt. Guido Valdes, Navy Medicine East deputy commander (U.S. Navy photo by Seaman Imani N. Daniels)

The readiness of the Navy Medicine team is paramount to combat survival in the future

Recommended Content:

MHS Transformation | Military Hospitals and Clinics

Keesler Medical Center receives national recognition

Article
11/27/2019
Keesler was one of 56 participating hospitals to be recognized in both patient care categories – all patients and high risk patients. (U.S. Air Force photo)

The ACS National Surgical Quality Improvement Program recognized Keesler Medical Center

Recommended Content:

Military Hospitals and Clinics
<< < 1 2 3 4 5  ... > >> 
Showing results 1 - 15 Page 1 of 11

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or learn more about PDFs.