From December 2003 until August 2004, a sample population consisting of 30 registered and licensed vocational nurses participated in the project where Achieve tested its Matrix product in the Garrison Center to manage the facility’s resident, clinical and business operations.

In collaboration with TTU Health Sciences Center, the Garrison Center is a teaching facility for future geriatric nurses and physicians. Initially, the project participants sought to include physicians in the study. However, the quarterly rotations of the resident physicians deemed it difficult to efficiently adapt the automated communications and notifications with the multilayered hierarchy among the physicians in the facility. In addition, Achieve and TTU decided that attempting to include resident physicians would result in a considerable time and expense increase by Achieve and the facility.

The most significant results of the project suggest that electronic health records may contribute to:

• Decreased turnover rates for nurses;
• Decreased falls;
• Reduced hospitalization rates;
• More efficient daily work processes; and
• An increase in job satisfaction for nurses due to the amount of time available to spend with residents.

Further studies to determine the cost savings to the government and facilities are under consideration.

In addition, the project concluded that:

• The nursing staff was able to move from one resident’s record to another very quickly with an EHR;
• The EHR allowed multiple staff to review and document a resident’s record at the same time;
• Access to the EHR on each staff’s desktop facilitates more efficient work processes and the ability to provide prompt information to resident’s families; and
• Laptop computers allowed staff to instantly access resident information during care plan and medical meetings and eliminated the need to find charts at the nursing unit.

While most of the project outcomes are positive, certain topics require further explanation to ensure that the report accurately represents situations and circumstances that impacted the results of the survey. For example, due to the implementation of the EHR system throughout the facility, a pre-post study was the only feasible design, but it limits generalizations because of the lack of a control group. In addition, a need exists to improve communications between pharmacy providers and long-term care facilities. Matrix is capable of communicating with pharmacy providers using HL-7 standards, but pharmacies are unable to return results without using outside technologies. Achieve is working with federal and state agencies and vendors to promote the mandates and standards outlined by the Medicare Modernization Act and the National Committee on Vital and Health Statistics.

Finally, the participants noted an increase in overtime cost for nurses, but further investigation proved that the facility remained within its budget and cost was the same pre and post implementation. In fact, overtime costs are likely due to the recent opening of the facility, which means the facility was still hiring staff requiring some nurses to work additional shifts to fill vacant positions.

All told, the positive results of the study far outweigh the negatives and further suggest that technology does help improve quality resident care by allowing nurses more time with residents. Specifically, Achieve Matrix provides streamlined business processes, decreases paperwork and allows nursing staff more time with residents.