Paper-Lite is part of the BMDH Expansion Project

www.bmdhproject.health.nsw.gov.au | BMDH Project 1800 155 102

Paper-Lite Fact Sheet Electronic Medical Records Project | Blacktown Hospital , NSW | 2014 - 2015

Paper-Lite is an initiative involving the

transition from written notes to electronic

documentation for the majority of inpatient

records at Sydney’s Blacktown Hospital.

It’s a clinician-driven change to provide staff

with anywhere, anytime access to hospital

medical records via any authorised device

including laptops, iPads, tablets, or

smartphones.

The innovation enhances our capacity to make

informed decisions about patient care because

clinical staff (nurses, doctors, allied health &

support staff) always have access to the most

up-to-date information.

Paper-Lite was initiated by our Western Sydney

Local Health District Information Technology

Services and BMDH Expansion Project Teams

with our doctors, nurses, allied health and

support staff.

Why change?

As part of the planning for the expansion of

Blacktown Hospital, a strategic decision was

made to design and build the new facilities on

the assumption that an eMR would be adopted

and medical record scanning implemented.

This decision presented two challenges – the

need to transition clinicians from paper records

to an eMR, and the requirement to achieve both

this and scanning in the existing facility ahead of

the opening of the new facilities in early 2016.

What did we change?

The scope of the program of changes included:

Implementing electronic Assessments and

Progress Notes for all disciplines.

Implementing electronic consults (Nursing)

Implementing electronic operation reports

(all specialties)

Implementing electronic Emergency

Theatre Bookings

Implementing electronic Adult Observation

Charts

Increasing uptake of electronic Discharge

Summaries (all disciplines)

Implementing electronic decision support

tools including an electronic Sepsis Alert,

Care Compass and VTE Assessment tools.

Increasing uptake of clinician mobility

including Bring Your Own Device (BYOD),

corporate devices and Remote Access

Implementing enhanced eMR functionality

including patient summary (mPage) and

continuous docs.

These changes needed to be implemented in 16

of the hospital’s units and involved over one

thousand clinical staff from a range of

disciplines.

To align with the capital works program, the

entire program of changes needed to be

implemented within 30 months.

How did we do it?

To achieve the implementation of Paper-Lite

within the constraints of time and resources, a

locally developed change approach was adopted

with:

Strong clinician engagement and leadership

with genuine clinician involvement in

planning and empowerment to make

meaningful decisions on all elements of the

project.

Strong internal partnerships with clinicians,

administrators and IT professionals working

collaboratively towards a shared goal.

Strong interagency partnerships with

Western Sydney LHD working closely with

Health Infrastructure & eHealth NSW.

Just-in-time training with the majority of

training occurring as

hands on, small

group sessions

conducted in the

work environment in

the two weeks prior

to go-live.

NSW Health Awards

Finalist 2015

Paper-Lite Fact Sheet Page 2 |Updated October 2015

A focus on internal sustainability from

the outset with local expertise

developed and imbedded into each

clinical unit.

A focus on implementation as opposed

to installation, with efforts directed to

achieving a change in clinician practice

instead of merely installing an IT

solution.

“The aim of Paper-Lite was to

accelerate the implementation of an

inpatient eMR in an existing, major

metropolitan, public hospital”

Peter Rophail, Transition Manager

How did we communicate?

The change program was underpinned by an

innovative communications approach which

was used to build awareness and

commitment for the program.

Our key focus areas included:

Branding - a stakeholder concept for a

logo was further developed to create a

readily identifiable brand for Paper-Lite.

This branding helped establish Paper-

Lite in the busy physical hospital

environment. Consistent use of the

branding, plain language and visual

communications tools helped explain

complex technical changes.

Collaboration - communications

materials were produced in

collaboration with clinicians to support

staff training and to help patients and

carers understand the technology

changes.

People-centred approach - despite

Paper-Lite being primarily an IT change,

communications focused on people as a

way of telling the Paper-Lite story in an

engaging and meaningful way. Major

change messages were packaged with

case studies, genuine staff and patient

stories to personalise the technological

changes, create excitement, encourage

behaviour change and build acceptance

for the changes.

How did we do?

Discussions on implementing Paper-Lite

commenced in February 2013 with all 16

units having completed transition to an

inpatient eMR for the majority of their

documentation within 19 months. This was

followed by the implementation of medical

records scanning in December 2014.

Post implementation surveys and interviews

incorporating over 100 clinical staff have

revealed a very high degree of satisfaction

with the Paper-Lite changes.

The most commonly nominated benefits

include:

Ability to access all records from

anywhere in the hospital which results

in improved ability to prioritise clinical

workloads and also better manage

remote patients such as outliers

Time savings as a result of the ability for

multiple people to access the record

simultaneously

Ability to access the record remotely

Reduced duplication of data entry

Improved compliance with assessments

and other tasks.

Our partners

Thank you to our partners:

Blacktown & Mount Druitt Hospitals

(BMDH) Expansion Project

Western Sydney Local Health District

(WSLHD)

WSLHD & NBMLHD Information

Technology Services

Health Infrastructure

eHealth NSW

Clinical Excellence Commission - for

Australian-first Sepsis Alert project

implementation

The staff and executive of Blacktown

and Mount Druitt hospitals.

Paper-Lite is part of the BMDH Expansion Project

www.bmdhproject.health.nsw.gov.au | BMDH Project 1800 155 102

As part of our expansion project, Blacktown Hospital doctors, nurses, allied health and support staff

ask us to accelerate the introduction of inpatient electronic medical records in the hospital. If it can be

achieved, it will make us the first existing major public hospital in NSW with electronic records.

Our Paper-Lite Story (so far) October 2015

The expansion project and the ITS teams know it’s a ‘can do’. The project gets executive endorsement and the

working group suggests “light on paper” as a concept. The image of a stack of paper being tightened with a belt seems to grab everyone’s

attention and “Paper-Lite” is

born.

Clinicians tell us they want anywhere, anytime access to hospital records. For maximum accessibility, flexibility and mobility, we make Paper-Lite available on

mobile devices and BYOD as

well as on desktop computers and COWs (computers on wheels). From bedside to staff station to consulting room, it’s all Paper-Lite.

The project partners with the Clinical Excellence Commission to develop

a sepsis alert - an

algorithm that automatically scans the patient’s electronic records for markers indicating a clinical review is

required because of the risk of

sepsis. It’s an Australian first.

On launch day we get green lollipops.

B42 Surgical ward nominates to be the pilot site. Testing begins and the project creates such a buzz around the hospital that other wards and services are lining up to participate. We prepare information for

patients too, so they know

what’s going on when they see staff on COWs, mobiles and tablet devices.

At 8am on Tuesday 29

July 2014, the project goes

live. B42 Surgical becomes the

first electronic records ward in NSW.

The support team is on hand to assist (in green t-shirts of course).

The project team creates a communications plan for the project

and develops a logo and branding from the working

group’s initial concept. The

branding supports training, launch

events and all communications, creating a fresh, appealing instantly recognisable (and very green) project identity.

Clinician training begins, supported by senior medical, nursing and allied health staff.

We train about 100

staff ready for go-live including sessions for VMOs, JMOs, nurses, allied health and ward staff. Info packs include quick reference guides for forms, log-ins, records and other Paper-Lite functions.

The project is so successful and so well-supported by hospital staff that the implementation

program is shortened from

6 months to

6 weeks.

Training starts for more than 1,000 staff.

Our Health Information Records Service starts

scanning millions of pages

of paper files to create digital records for every patient.

1st

Paper-Lite supported by a

delivery of 60

COWS (computers

on wheels).

Our first two COWS are named in honour of long-term patient Bill (who says he’s been a patient in every ward except Maternity) and his wife and long-term carer Marian.

Upgrades are added to enhance

functionality and we survey

staff to gather information about the next round of improvements.

On 2 September 2014, the remaining 15 units go live.

Within three days, all new patients are Paper-Lite.

We reward ourselves with green

cupcakes!

In late 2015, Paper-Lite rolls out at Mount Druitt Hospital.

Dietetics becomes

the first ambulatory care unit to go

Paper-Lite as we start to transition outpatients to electronic records.

About 40 groups (so far) of visitors from NSW, interstate and overseas have come to see how we did it.

1st

Paper-Lite is part of the BMDH Expansion Project

www.bmdhproject.health.nsw.gov.au | BMDH Project 1800 155 102

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