SmartRoomTM

The Naked Truth about Quality and Errors on the Front Line

August 26, 2010

Michael Boroch, CEOSmartRoom

Agenda

• Challenges of Caregivers at the

Bedside

• SmartRoomTM Overview and Value

• Questions / Answers

2

Policy vs. Reality

• What should be done and what “does” get done are often two (or more) different things.

• Example: Observed nurses using bar code medication administration and recorded all of the different steps (both actions and sequence of actions)

3

START

Obtain meds

scan self enter pt room

check med vs device

scan self

scan med enter pt room

enter pt room

scan pt ID band

doc admin

give med to pt

scan pt ID band

give med to pt

doc admin

check med vs device

scan med

scan pt ID band

give med to pt

doc admin

scan self

obtain meds

check med vs device scan med

scan med

enter pt room

scan pt ID band

give med to pt

doc admin

doc admin

give med to pt

give med to pt

scan pt ID band

doc admin

doc admin

double check

enter pt room

scan pt ID band

give med to pt

doc admin

doc admin

give med to pt

scan pt ID band

doc admin

enter pt room

give med to pt

double check

scan med

scan pt ID band

give med to pt

doc admin

enter pt room

scan pt ID band

give med to pt

doc admin

enter pt room

scan med

scan pt ID band

doc admin

give med to pt

check med vs device

enter pt room

scan pt ID band

give med to pt

doc admin

enter pt room

scan pt ID band

doc admin

give med to pt

Process of Medication Administration – Task Sequences

Evaluation of Nurse Interaction With Bar Code Medication Administration Technology in the Work EnvironmentCarayon, Wetterneck, Hundt, Ozkaynak, DeSilvey, Ludwig, Ram, Rough, Journal of Patient Safety March 2007 4

Bar Code Medication Admin

There are 4 unsafe pathways and 6 most frequent workarounds

5

START

Obtain meds

scan self enter pt room

check med vs device

scan self

scan med enter pt room

enter pt room

scan pt ID band

doc admin

give med to pt

scan pt ID band

give med to pt

doc admin

check med vs device

scan med

scan pt ID band

give med to pt

doc admin

scan self

obtain meds

check med vs device scan med

scan med

enter pt room

scan pt ID band

give med to pt

doc admin

doc admin

give med to pt

give med to pt

scan pt ID band

doc admin

doc admin

double check

enter pt room

scan pt ID band

give med to pt

doc admin

doc admin

give med to pt

scan pt ID band

doc admin

enter pt room

give med to pt

double check

scan med

scan pt ID band

give med to pt

doc admin

enter pt room

scan pt ID band

give med to pt

doc admin

enter pt room

scan med

scan pt ID band

doc admin

give med to pt

check med vs device

enter pt room

scan pt ID band

give med to pt

doc admin

enter pt room

scan pt ID band

doc admin

give med to pt

Process of Medication Administration – Task Sequences

Bar Code Medication Admin

Healthcare’s Major Problem

Many new innovations, projects, safety devices, computer systems and

improvements require more time and effort on the part of the front line. We

have to stop adding work….we must to find a way to take hard work away and make success easy for the front line.

6

With all the advantages of EMRs, the last mile to improve productivity, reduce errors and improve quality has not been reached.

SmartRoom helps leverage the large EMR investments.

7

Mind Clutter & Distractions

36 Hospital Med/Surg Nursing Time and Motion

Source: A 36-Hospital Time & Motion Study: How Do Medical-Surgical Nurses Spent Their Time? – Hendrich/Chow-The Permanente Journal/ Summer 2008

8

What is SmartRoom

A “smart” patient room that…– Organizes and simplifies the workflow of front-

line staff– Makes retrieving the right patient information at

the right time as simple as walking into the room– Pushes information to direct and indirect

healthcare workers in context of situation - who, what, where

– Solves problems at the point of care

9

SMARTROOM VIDEO

10

Subtraction

• Study – 30 tasks in 10 rooms…– Batch at end of day– Chart between rooms using mobile COW– Chart using Smart Room real time

0

100

200

300

400

500

600

700

Batching Mobile cart Smart Room

589 612

255

57% reduction in time spent

charting + real-time

documentation

57% Reduction in Tasks69% Reduction in ADLs82% Reduction in Vital Signs

11Batching Mobile Cart SmartRoom

SmartRoom Value

Value Drivers Examples of Benefits

Cost Reduction •Real time bedside documentation•Compressed Workflow and dynamically balancing workloads•Reduced OT, Agency Staffing, Turnover and Better Recruiting

Increased Reimbursement

•P4P with Core Measures•Minimize losses from Never Events•HCAHPS Customer Services Reimbursement•Legal fee may reduce as documentation exists

Improved Quality, Outcomes and Decreased Errors

•Tasks done as prescribed and reduced charting errors•More time critical thinking and with patients•Less time at shift report charting and more sharing/educating •Less mis-transcribing numbers

Improved Caregiver & Patient/Family Satisfaction

•More time with patients and less documentation time•More time critical thinking vs. task and documentation•Patient/Family see caregivers more•Wandering management

Perfection is achieved, not when there is nothing left to

add, but when there is nothing left to take away.

-Antoine de Saint-Exupery

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Thank you!