clinical alerting: beyond the nurse call
TRANSCRIPT
CLINICAL ALERTING: BEYOND THE NURSE CALL
WHEN COMMUNICATIONS FAIL
CEO
INCREASED LENGTH OF STAY
POTENTIAL PATIENT HARM
CONTINUATION OFINCORRECT TREATMENT
INCREASED COSTS
DELAYS IN CARE
Potential Increase inMalpractice Suits
CFO
POTENTIAL INCREASE INMALPRACTICE SUITS
• Implemented 2006, reporting started 2008
• Now HCAHPS scores used in Hospital Value-Based Purchasing program
• 10 questions specifically target communications
HCAHPS SCORES
Hospital Consumer Assessment of Health Providers and Systems
NURSE CALL
Patient Hits Nurse Call Received on Mobile Device
Nurse Messages DoctorPatient Quickly Get Meds
Nurse Call Request:7523
Thx!
Ms Avery 523 requesting more pain control
I’ll enter an order
MOVING BEYOND NURSE CALL
LabResults
Patient Care Devices
EMR Integration
Facility Systems
PATIENT CARE DEVICES (PCDs)
JOINT COMMISSION
NATIONAL PATIENT SAFETY GOAL (NPSG) #3
Improve the safety of clinical alarm systems
NPSG.06.01.01Diminish alarm fatigue
alarm conditions per day - per bed350
85-99% non-actionable
Sorting, prioritizing, and routing input sources like
patient monitoring and nurse call to staff’s mobile devices
TELEMETRY ALARM - BATTERY LOW
Telemetry Alarm Battery Low
Nurse Contacts BioMedWait for BioMed
TELEMETRY ALARM - BATTERY LOW
Telemetry Alarm Battery Low-BioMed Notified
Evaluated and FixedNurses Never Interrupted
PATIENT ALARM - V-FIB ALERT
Patient V-fib Alarm Urgent Priority Mobile Alert
Care Team Begins Defib
LAB RESULTS
IMPROVING HOSPITAL COMMUNICATION
NATIONAL PATIENT SAFETY GOAL (NPSG) #2
Improve the safety and effectiveness of communication among caregivers
NPSG.02.03.01Report critical results of tests and diagnostic procedures on a timely basis
MANY TESTS, MANY RESULTS
400Radiology exams in the U.S. each year
Million
Lab tests in the U.S. each year
6.8Billion
Of test results specifically cited as a factor in a malpractice case:
MOST COMMON PROBLEMPatient didn’t receive test resultsSECOND-MOST COMMON PROBLEMClinician didn’t receive test results
THE CHALLENGE: TIME TO DELIVER CRITICAL LAB RESULTS
• After some phone tag, Lab speaks with Dr. Jones about Sue
• Dr. Jones recognizes the need for immediate treatment
• He must contact the appropriate physician for immediate action
WITHOUT SPOK: 25 MINUTES TIME TO COMPLETE THE PROCESS:
START
Results entered into hospital’s results
system
Laboratory techs attempt to contact
Dr. Jones
Lab results are critical - ordering physician
must be notified .
Sue’s physician, Dr. Jones,
orders lab tests
SPEEDING CRITICAL LAB RESULTS WITH SPOK
• Results sent directly to physician's device
• Alert message is transmitted securely
• Physician is able to close the loop
• Alert will escalate in 15, 30, 60 min if the loop is not closed
• Escalation period can be configured by the hospital
• Results can be sent to multiple devices and multiple caregivers
WITHOUT SPOK: 25 MINUTES TIME TO COMPLETE THE PROCESS:
START
WITH SPOK: 3 MINUTES
Lab results are critical - ordering physician must
be notified .
Sue’s physician, Dr. Jones, orders lab tests
EMR Audit Trail
EMRs
EHR INTEGRATION
84%OF U.S. HOSPITALS HAVE A BASIC EHR
EHRs = complex functionality, but increasing reliance on purpose-built solutions to interoperate
http://dashboard.healthit.gov/quickstats/pages/FIG-Hospital-EHR-Adoption.php
PATIENT REMINDER
Jeff is discharged with instructions for taking his meds.
Jeff’s physician knows he is an at-risk patient, and doesn’t want to see him readmitted.
“…should be taken once daily with food…”
Spok can take data from your EMR to send SMS reminders to patients
CLOSING THE CLINICAL LOOP
Acknowledgment and audit trail sent to EMR
Results directly to ordering
provider
Test results enteredin the laboratory
information system (LIS)
Draws blood, delivers vials to the lab
Physician orders
lab testsvia CPOE
Request to Phlebotomist
via EMR
Results published
Patient Care Devices
SUMMARY
Lab ResultsEMR
Integration
REDUCED READMISSIONS
QUICKER PATIENT DISCHARGE TIMES
IMPROVED PATIENT SATISFACTION SCORES
JOINT COMMISSION COMPLIANCE
LET’S GET IN TOUCH!
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CASE STUDIES VIDEOS
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