By Don Klingen, CMIO, and Deb Laumer, Director Clinical Informatics
A new initiative will soon be enabled through SmartChart EMR, and require participation by the interdisciplinary care team. Though it is effective April 20, 2017 in the state of PA, it will be formally implemented in SmartChart at the end of May (date to be determined) at the Main Line Health hospitals, in order to allow time to disseminate information about this important new regulatory requirement.
The CARE (Caregiver Advise Record and Enable) Act of Pennsylvania has been enacted as an initiative promoted by AARP to include lay caregivers in inpatient discharge planning, decision-mailing and education of care needed. The CARE Act requires hospitals to:
- Record the name and contact information of the lay caregiver in the medical record (Responsible persons: Nursing)
- Obtain patient’s written consent to release medical information to the lay caregiver (Responsible persons: Patient Registration; Nursing if revised)
- Notify the lay caregiver of discharge plan or transfer, including Estimated Date of Discharge (Responsible persons: Primarily Nursing, but Care Coordination and Providers may do so as well)
- Provide lay caregiver with education and instruction of medical tasks they will need to perform for the patient at home (Responsible persons: Nursing)
- Provide contact information for a hospital employee who can respond to questions after discharge (Responsible persons: Nursing)
While most of this initiative will be enabled by Nursing, one component will be initiated by the Provider, and that is the Estimated Date of Discharge identified upon admission. When the Admitting Provider completes the “Admit to” order in Smart Chart CPOE, there will now be a mechanism for the Estimated Date of Discharge (EDD) to display. This will auto-calculate when the Provider enters the Anticipated Total Length of Stay (midnights) for between 1-3 days. Should the anticipated Total Length of Stay (midnights) be > 3 days, the Provider will be required to enter the Estimated Date of Discharge in the Admit-to Order.
The Estimated Date of Discharge information will then display when hovering over the diamond-shaped icon in the patient’s name banner in the EMR.
Should revisions to the Estimated Date of Discharge order be needed, do not revise the Admit-to Order. A new stand-alone Estimated Date of Discharge Order will need to be completed. This can be done by the Nurse or Care Coordinator (or Provider) during patient care rounds. No co-signature will be required for this order, as It is primarily for communication purposes.
Thank you for your participation in this important new PA State Law to include a formal process for lay caregivers to be part of the patient care team.