By Kris Gillen, Tegria Program Manager

I talked to several people following UGM 2018 and from a nursing perspective, the updates to Rover and introduction of the Brain seem to be the two things that caught most people’s attention.

The Brain is Epic’s solution to the piece of paper nurses carry around to remind them of significant nursing tasks. It is a one-stop shop for nurses and can include required documentation, medication, dressing changes, assessments, and other tasks necessary to provide comprehensive care to their patients.

When I was a nurse at the bedside, I had one piece of paper divided into the number of patients I was assigned to and it included pertinent information for their care for the shift. If a nurse lost his or her piece of paper—or “brain”—they would literally be lost.

When you Google “nurse’s brain,” you’ll find a bevy of posts with suggestions on how to configure your sheet, when to use your sheet, examples for the myriad types of sheets, and even a database.

But what about the EHR? Nobody is talking about how the “nurse brain” can be replaced with the EHR. Or can it?

Epic’s Brain in the 2018 upgrade is designed to be the nurse’s home activity. The Brain is organized in a timeline, so nurses can see upcoming tasks for their patients, such as orders, labs, medications, tasks, and required documentation. Each row begins with the patient demographic information, which is now referred to as the Patient Card.

What does that mean for nursing workflow? Rather than spending time filling out a piece of paper, nurses can save time at hand-off by logging into Epic and having the brain already configured.

The Brain will also be updated as orders are entered into the system. For a typical inpatient unit, the nurse would log into Epic, review the brain for upcoming tasks at hand-off and throughout the shift, and execute without delay.

When implementing or optimizing, here are a few things to consider:

1. Like the Work List, if the Brain is not used consistently, efficiency will not be realized and items will linger and become less useful over time. The Brain is meant to be a real-time tool for the nurse to access and document throughout the shift to minimize redundancy and time spent searching thru the various activities in the patient record.
2. By having all tasks in one location for all patients, the clinician can better organize their time and meet the needs of the patient in a timelier fashion.
3. The clinician will have more time to spend at the bedside when they don’t have to update the paper tool. It’s as simple as that. The chances the paper tool becomes outdated is too great. The near-constant stream of condition changes for the patient’s care creates the potential for error based on obsolete information.
4. It’s important to enable the Sign-In feature, as this ensures your clinicians are assigned to the correct patients faster.
5. By utilizing the “Required Documentation” and “Work List” task features, nurses can see an overview of the upcoming tasks and documentation requirements for all their patients. Not utilizing this forces them to select patients individually.
6. While the Brain does allow you to print, I highly recommend not doing so as you risk the information being outdated. This will cause delays and documentation and task requirement omissions. The Brain should be accessed from Hyperspace on fixed devices and mobile workstations.

Need help deciding which tasks to enable and require for clinicians? Wondering how you can start weaving the Brain into your workflows? Kris has ideas, so email her if you’d like to chat with her.