Most senior living organizations still attempt to track adverse events by keying them into Microsoft Excel spreadsheets. Tracking, managing, and reporting adverse events is mission-critical to senior living facilities and their parent organizations.
EHRs are patient-focused, while adverse event management is facility-focused. So, quality and nursing staff take matters into their own hands to handle adverse event tracking in spreadsheets.
This has led to some severe limitations in functionality for adverse event management. And, due to regulatory and liability concerns and the general desire to improve overall quality of care, analyzing adverse events in a community or across communities has become even more “mission critical.” This has left these organizations with a less-than-optimal process that has become a sore point for management, quality staff, and the DON.
Here are some of the issues to consider with spreadsheets for adverse event management.
1) Spreadsheets require manual data entry
This results in non-value-added work and introduces the probability of errors. One study shows that 88% of ALL spreadsheets have errors in them. This isn't limited to complex spreadsheets—it applies to all spreadsheets. So it's almost guaranteed that each senior living community that uses spreadsheets for adverse event management has errors in those spreadsheets.
2) Spreadsheets aren't a database
Accessing information and reformatting takes a lot of additional manual effort and re-keying of data. Storing data in spreadsheets rather than a structured database makes the information relatively useless.
3) Spreadsheets don't possess "adverse event intelligence"
In other words, spreadsheets don't know what to look for in adverse event tracking. They don't know how to read event documents or the EHR. They can't track events by facility, shift, time of day, floor, or type of event. Every aspect of event management must by taught to a spreadsheet rather than having it inherently knowing what to do.
4) Spreadsheets aren't a reporting product
All incident report formats or analyses need to be manually created and fed with the right data. Each time an analysis needs to be done, it introduces both manual effort and the potential of more data errors. Spreadsheets simply don't allow for multi-dimensional reporting and analysis of aspects like types of events, facility, shift, time of day, and floor.
Adverse event management isn't simply about capturing data, it's about being able to reformat the data into meaningful information in report form. This is next to impossible in a two-dimensional spreadsheet. It's a 1990s solution to a critical problem.
5) Non-financial people don't love spreadsheets
If you're not steeped in financials, you won't be familiar with the sophisticated functionality of Excel. And while even sophisticated users would struggle with managing and intelligently reporting adverse events, novice users are helpless in this endeavor.
6) You can't share Excel files across the organization or outside of it
With spreadsheets, risk managers have no way of viewing or commenting on events. Information can't be shared among various people without duplicating the spreadsheet. Once that happens, there is no singular official version of the truth. Each person can corrupt the spreadsheet once it is in his or her possession.
7) Excel isn't secure
Unauthorized people can access and even steal information without much effort.
8) Excel isn't cloud-based
Cloud-based files make can easily be accessed from anywhere, but Excel spreadsheets don't have that capability. If you're off-site, you may not be able to see important data.
If you try to track adverse events in Excel, you'll spend countless hours keying and re-keying data, reformatting the information to try to answer questions, writing “macros” with inexperienced people to try to automate trivial things and violate every security issue known to mankind.
Why would you sacrifice quality nursing hours by using manual, cumbersome, error-prone spreadsheets in order to produce lower quality results? Adverse event management is as critical to senior living communitites as the EHR system is. It should be handled by a trusted cloud-based and professionally managed application that has adverse event intelligence built right in.
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