the leader in point-of-care informatics medical automation systems © 2006 medical automation...

The Leader in Point-of-Care Informatics

MEDICALAUTOMATION SYSTEMS

© 2006 Medical Automation Systems

RALS-TGCM

Web-based Graphical Reports for Glycemic

Control Protocols

®




Review TGCM Program at the Patient Level

Reports•Glucose results for a patient over a period of time•Glucose results by unit•Glucose values out of the protocol range•Patients with and without readings over a specified period of time

11




Glucose Results for a Patient Over Time

Glucose Results for Patient 0051874109/9/2005 – 9/17/2005

600

550

500

450

400

350

300

250

200

150

100

50

0

9/9/200512:00AM

9/11/200512:00AM

9/13/200512:00AM

9/15/200512:00AM

9/17/200512:00AM

9/18/200512:00AM

Date and Time

Glu

cose V

alu

e (

mg

/mL)

Value: 150 mg/mLDate: 9/13/2005 6:19 PMOperator: 1093940003Location: 12_ICU

RALSRALSTGCMTGCM

®

RALSRALSTGCMTGCM

®

7054832329/13/2005 11:21:38 AM18570100012189/13/2005 5:56:52 AM12_ICU18570100012089/12/2005 11:32:48 PM13495400031619/12/2005 6:46:53 PM13495400031809/12/2005 12:41:41 PM

1814381459/12/2005 5:31:45 AM1814381789/11/2005 11:43:17 PM

21018300042749/11/2005 10:11:12 PM13495400031699/11/2005 6:01:11 PM13495400031709/11/2005 12:22:21 PM

1814381549/11/2005 5:32:37 AM1814381849/10/2005 11:54:17 PM

12443100071769/10/2005 5:57:34 PM21129300091999/9/2005 10:01:39 PM14518700081689/9/2005 3:51:47 PM17328100052089/9/2005 12:15:45 PM12_3West17328100052209/9/2005 8:07:35 AM17570700062129/9/2005 6:34:37 AM17570700061199/9/2005 4:37:34 AM17570700061639/9/2005 2:34:00 AM17570700062849/9/2005 12:32:18 AM

12_3FHAL

Operator IDGlucose Value (mg/mL)Value and Date RangeLocation

Glucose Results for Patient 0051874109/9/2005 – 9/17/2005




Glucose Results for a Patient Over TimeREPORT DESCRIPTION• Visually review a specific patient’s historical blood glucose results to assess how well the

protocol performed at the patient's bedside, for a given period of time (in this case, from 9/9/2005 to 9/17/2005)

• The time period and patient are previously specified by the operator on the Report Setup Menu

• The mouse-over feature can be used to view:– a blood glucose value– the time the blood glucose test was performed– ID of the provider who performed the blood glucose test– location where the blood glucose result was performed

MAIN USER• Clinician level professionals that oversee and monitor the glycemic control program• Implementers of glycemic control protocols, such as nursing level professionals (Critical Care

Registered Nurse (CCRN), Critical Care Nurse Manager (CCNM))

REPORT BENEFITS• RALS-TGCM allows the user to easily review a patient’s historical glucose trends to determine

how effectively that patient blood glucose was kept within the protocol range• The healthcare provider can easily determine the point in time where the patient experienced

episodes of hypoglycemia and hyperglycemia




Glucose Results for I2_3West2005

100

90

80

70

60

50

40

30

20

10

0

< = 80 81-140 141-160 161-180 > 180

Perc

en

t (%

)

RALSRALSTGCMTGCM

®

38.65%

Glucose Groups (mg/mL)

Total

82.1971.985.735.4815.9713.93SD

149.00237.00171.00150.00111.0066.00Median

168.89258.93170.65150.00110.9463.42Mean

2,6789322572841,035170n

Glucose Results by Unit

RALSRALSTGCMTGCM

®

Glucose Results for I2_West2005

82.19149.00168.892,678100.00%Total

71.98237.00258.9393234.80%> 180

5.73171.00170.652579.60%161-180

5.48150.00150.0028410.60%141-160

15.97111.00110.941,03538.65%81-140

13.9366.0063.421706.35%< = 80

SDMedian Meann%Range

The counts for this report include values that were determined to be above the maximum or below the minimum detectable range of the device or collection method. These values are not included in the mean, median or standard deviation calculations.




Glucose Results by UnitREPORT DESCRIPTION• Visually assess the percentage of all patient glucose results in a specific unit, within predefined blood

glucose ranges• The specific unit and time period is previously chosen by the operator on the Report Setup Menu• The blood glucose ranges are also specified by the operator on the Application Settings Menu:

Hypoglycemia range, Protocol glucose range, mild-hyperglycemia range, moderate hyperglycemia rangeand severe hyperglycemia range

• The table format provides the blood glucose ranges, the number of patients in each glucose range, thepercentage of glucose results performed that fall under each range, the mean, median and standarddeviation

MAIN USER• Clinician level professionals that oversee and monitor the glycemic control program• Implementers of glycemic control protocols, such as nursing level professionals (Critical Care Registered

Nurse (CCRN), Critical Care Nurse Manager (CCNM))REPORT BENEFITS• RALS-TGCM provides CCRNs with feedback on protocol implementation success in their unit• RALS-TGCM allows clinicians to monitor the implementation of glycemic control program by assessing

compliance level of their unit(s)• This report can be posted in places such as the nurse station, for periodic feedback to personnel on

success in achieving glycemic control




Glucose Value Extremes

Glucose Value Extremes (<=80 or >180 mg/dL)I2_3FHAL1/30/2005

721/30/2005 12:10:13 PM2261/30/2005 7:27:20 AM

1231/30/2005 4:54:30 PM721/30/2005 12:10:13 PM

2811/30/2005 7:52:32 PM1231/30/2005 4:54:30 PM

2261/30/2005 7:27:20 AM1831/30/2005 4:29:58 AM

2811/30/2005 7:52:32 PM

1831/30/2005 4:29:58 AM691/30/2005 3:48:42 AM

0014300581

1741/30/2005 9:05:13 PM1911/30/2005 5:20:03 PM0014300815

2351/30/2005 8:56:10 AM

2351/30/2005 8:56:10 AM2381/30/2005 5:07:50 PM

2381/30/2005 5:07:50 PM3201/30/2005 11:04:06 AM

3201/30/2005 11:04:06 AM2781/30/2005 8:02:32 AM

2781/30/2005 8:02:32 AM2771/30/2005 4:03:48 AM

0014300135

Subsequent Glucose Value

(mg/dL)

Subsequent Value Date and Time

Glucose Value

(mg/dL)

Value Date and TimePatient ID

RALSRALSTGCMTGCM

®




Glucose Value ExtremesREPORT DESCRIPTIONEasily review the patients whose glucose results were out the glycemic control range established by the

protocol• The healthcare provider previously specifies the unit and time period of the glucose value extremes to

bedisplayed (options include glucose extremes experienced today, during the last 48, 24, 12 and 1 hour)

• In this case, the glycemic control protocol was 80-180 mg/dL. The glucose value extremes report will showall glucose values that were out of this range, for the defined time period

MAIN USER• Implementers of glycemic control protocols, such as nursing level professionals (Critical Care

RegisteredNurse (CCRN), Critical Care Nurse Manager (CCNM))

REPORT BENEFITS• RALS-TGCM allows nursing to review the patients that experience hypoglycemia or hyperglycemia

eventsat a specific period of time, providing them with awareness of:– the patients that need to be monitored more frequently– the nurses that may need more training in appropriate protocol implementation

Column #

Description

2 ID of the patient who has a blood glucose measurement out of the protocol range

3 Date and time when the glucose measurement was performed

4 Value of the glucose result out of range

5 Time that the subsequent glucose measurement was performed

6 Value of the subsequent glucose result performed




Glucose Values HierarchyRALSRALSTGCMTGCM

®

Patients with No Glucose Values Within the Last Hour

12588600042/6/2005 4:37.15 PM104001432966612588600042/6/2005 8:24.19 PM108001431320913196700042/6/2005 9:39.06 PM1210014331420

3885462/6/2005 9:31.53 PM12300143310483885462/6/2005 4:55.14 PM14100142772996840192/6/2005 11:43.20 PM1680014310047

13535800022/6/2005 11:46.43 AM16900142539263885462/6/2005 4:30.38 PM1720014330882

13077900042/6/2005 4:17.24 PM182001432029513077900042/6/2005 8:40.42 PM193001433107213196700042/6/2005 6:54.44 PM196001432115114165300022/6/2005 11:51.07 AM2010014323980

3885462/6/2005 9:27.08 PM21000143182903885462/6/2005 9:08.04 PM2840014309279

Operator IDDate and Time of Last ValueLast Value (mg/dL)Patient ID

Glucose Values HierarchyI2_4800PCU

2/6/2005

Previous Value 2(mg/dL)

Patients with Glucose Values Within the Last HourOperator IDPrevious Value 1

(mg/dL)Current Value

(mg/dL)Patient ID




Glucose Value HierarchyREPORT DESCRIPTION(1) Patients With Glucose Values within the Last Hour• Visually track patients that have been tested within the last hour during a predefined time period (for

a fixedday, today, last 48/ 24/ 12/ 6/ 3/ 2 or 1 hour)

• The healthcare provider previously defines this time period and the location• Patient IDs of all patients that were tested within the last hour are listed in the first column. Their last

glucose value and previous value are shown in columns 2, 3 and 4, respectively. The ID of thehealthcare provider that conducted the glucose test is listed in the last column of the report

(2) Patients With No Glucose Values within the Last Hour• Visually track patients that have NOT been tested within the last hour• Patient IDs of all patients that were not tested within the last hour are listed in the first column. Their

lastglucose value, the date and time when it was performed and the ID of the healthcare provider thatconducted the glucose test are listed in the subsequent columns, respectively

MAIN USER• Implementers of glycemic control protocols, such as nursing level professionals (Critical Care

Registered Nurse (CCRN), Critical Care Nurse Manager (CCNM))REPORT BENEFITS• RALS-TGCM allows CCRNs to track the patients that require a glucose test, according to protocol

guidelines• RALS-TGCM provides CCNMs with feedback on patients that should have received a glucose test,

according to protocol guidelines, helping them rationalize CCRN’s level of workload




Track Operator Compliance

Reports•Summary of glucose values by operator

22




Summary of Glucose Values by Operator

RALSRALSTGCMTGCM

®

Summary of Glucose Values by OperatorI2_Recovery

1/1/2005 – 1/31/2005

100.00%0.00%291-291291.001185330

25.00%75.00%90-199128.0041876780006

100.00%0.00%149-149149.0011887850004

100.00%0.00%178-178178.0011787780004

0.00%100.00%92-9292.001200956

100.00%0.00%225-225225.0011694950005

80.00%20.00%135-207167.805674721

83.33%16.67%128-246180.0061566050009

72.73%27.27%69-281170.64111145150007

5.48150.00150.0028411119540001

15.97111.00110.941,0354089961

13.9366.0063.421709001651

% Out of Range% In RangeRangeMeannOperator ID

* “% In Range” denotes all values that fall within the optimal glycemic range (81-140 mg/dL); “% Out of Range” denotes all values that fall outside the optimal glycemic range.




Summary of Glucose Values by OperatorREPORT DESCRIPTION

• Visually review the level of success that CCRNs had in keeping patients’ glycemic levels in protocol range

• The healthcare provider previously specifies the period of time of the operators’ performance to be displayed (fixed date/ last year/ year to date/ last month/ month to date/ last 7 days), and the protocol range

MAIN USER

• Implementers of glycemic control protocols, such as nursing level professionals (Critical Care Registered Nurse (CCRN), Critical Care Nurse Manager (CCNM))REPORT BENEFITS

• RALS-TGCM lets CCRNs know how successful they have been in keeping their patient in the glycemic range

REPORT BENEFITS

• RALS-TGCM provides CCNMs with feedback on the level of compliance of their CCRNs, helping them determine the ones that may need further education on how to implement a glycemic control program

Column #

Description

1 ID of the healthcare provider (CCRN)

2 Number of glucose measurements performed by each healthcare provider

3 Average of all glucose results performed

4 Glucose results range

5 Percentage of glucose results that were in the protocol range

6 Percentage of glucose results that were out of the protocol range




Generate Intra/Inter Site Assessment

Reports•Retrospective aggregate glucose results by:

•Unit•Location•Institution•Enterprise

33




Glucose Results by Hospital

Glucose Results for I2_3West2005

100

90

80

70

60

50

40

30

20

10

0

< = 80 81-140 141-160 161-180 > 180

Perc

en

t (%

)

RALSRALSTGCMTGCM

®

38.65%


Total

82.1971.985.735.4815.9713.93SD

149.00237.00171.00150.00111.0066.00Median

168.89258.93170.65150.00110.9463.42Mean

2,6789322572841,035170n

RALSRALSTGCMTGCM

®

Glucose Results for I2_West2005

82.19149.00168.892,678100.00%Total

71.98237.00258.9393234.80%> 180

5.73171.00170.652579.60%161-180

5.48150.00150.0028410.60%141-160

15.97111.00110.941,03538.65%81-140

13.9366.0063.421706.35%< = 80






Glucose Results by HospitalREPORT DESCRIPTION• Visually assess the percentage of all patient glucose results in a specific unit, within

predefined blood glucose ranges• The specific unit and time period (year to date/last month/month to date/last 7 days) is

previously chosen by the operator on the Report Setup Menu• The blood glucose ranges are also specified by the operator on the Application Settings

Menu:Hypoglycemia range, Protocol glucose range, mild-hyperglycemia range, moderate hyperglycemia rangeand severe hyperglycemia range

MAIN USER• Clinician level professionals that oversee and monitor the glycemic control program

REPORT BENEFITS• RALS-TGCM allows clinicians to monitor the hospital’s level of success in achieving

glycemic control• This report can be posted for periodic feedback to personnel, glycemic control committee

and administration on success in achieving glycemic control




Glucose Results by Enterprise

Glucose Results for Demo Health System2005

100

90

80

70

60

50

40

30

20

10

0

< = 80 81-140 141-160 161-180 > 180


Perc

en

t (%

)

RALSRALSTGCMTGCM

®

37.82%

Total

82.1971.985.735.4815.9713.93SD

149.00237.00171.00150.00111.0066.00Median

168.89258.93170.65150.00110.9463.42Mean

2,6789322572841,035170n

RALSRALSTGCMTGCM

®

Glucose Results for Demo Health System2005

80.39147.00165.96633,087100.00%Total

72.02235.00256.24209,90733.16%> 180

5.75170.00170.1160,2149.51%161-180

5.75150.00150.1874,74311.81%141-160

16.38113.00112.39239,42637.82%81-140

13.9966.0062.6248,7977.71%< = 80






Glucose Results by EnterpriseREPORT DESCRIPTION• Visually assess the percentage of all patient glucose results in a specific unit, within

predefined blood glucose ranges• The blood glucose ranges are also specified by the operator on the Application Settings

Menu:Hypoglycemia range, Protocol glucose range, mild-hyperglycemia range, moderate hyperglycemia rangeand severe hyperglycemia range

MAIN USER• Clinician level professionals that oversee and monitor the glycemic control program

REPORT BENEFITS• RALS-TGCM allows clinicians to monitor the enterprise’s level of success in achieving

glycemic control• This report can be posted for periodic feedback to personnel, glycemic control committee

and administration on success in achieving glycemic control




Glucose Comparison by Location

12_3FHN

12_4800PCU

12_3FHAL

12_EDTriage

100

90

80

70

60

50

40

30

20

10

0

< = 80 81-140 141-160 161-180 > 180


Perc

en

t (%

)

RALSRALSTGCMTGCM

®

25.53%


Glucose Comparison by Location1/1/2005 – 1/31/2005

RALSRALSTGCMTGCM

®

Glucose Comparison by Location1/1/2005 – 1/31/2005

13.2068.0064.20816.01%< - 80

12_4800PCU

16.35114.00113.3744533.01%81-140

5.91151.00150.8815311.35%141-160

5.92170.00170.3414210.53%161-180

77.47240.00263.4052739.09%> 180

86.70160.00179.121348100%Total

14.1267.0064.71343.88%< - 80

12_3FHN

67.00

164.00

221.00

169.50

150.00

113.00

Median

9.6166.71243.29%< - 8012_3FHAL

73.84174.64877100%Total

64.59242.1635940.94%> 180

5.43169.989811.17%161-180

6.05149.6210612.09%141-160

16.27112.5328031.93%81-140

SDMean n%RangeRange




Glucose Comparison by LocationREPORT DESCRIPTION• Visually compare aggregated glucose results of up to 4 units or hospitals, within

predefined blood glucose ranges• The units or hospitals to compare and the blood glucose ranges are previously specified

in the Report Setup Menu• This report is also available in a table formatMAIN USER• Clinician level professionals that oversee and monitor the glycemic control program

REPORT BENEFITS• RALS-TGCM allows clinicians to make intra-site comparisons, determining the units that

are more successful in protocol implementation• This report can used as a tool to foster protocol adoption throughout the institution by

comparing glucose control between units that have a protocol and those that do not




Glucose Comparison by Date Period

1/1/2005-6/30/2005

1/7/2005-12/31/2005

100

90

80

70

60

50

40

30

20

10

0

< = 80 81-140 141-160 161-180 > 180


Perc

en

t (%

)

RALSRALSTGCMTGCM

®


Glucose Comparison by Date PeriodI2_4800PCU

37.04%

RALSRALSTGCMTGCM

®

Glucose Comparison by Date PeriodI2_4800PCU

13.1368.0064.686364.88%< - 80

1/7/2005-12/31/2005

16.04114.00113.50482737.04%81-140

5.79150.00150.23156912.04%141-160

5.80170.00170.17136710.49%161-180

66.36232.00251.28463335.55%> 180

76.21153.00170.5913302100%Total

13.3369.0065.014384.75%< - 80

1/1/2005-6/30/2005

157.00

232.00

170.00

150.00

114.00

Median

77.71173.269218100%Total

67.48252.24344837.41%> 180

5.76170.3796610.48%161-180

5.82150.26106811.59%141-160

16.11113.41329835.78%81-140

SDMean n%RangeDate Period




Glucose Comparison by Date Period REPORT DESCRIPTION• Visually compare aggregate glucose results from two time periods (Last year/ YTD/ Last

month/ Month to date/ Last 7 days)

• The time periods are previously specified in the Report Setup menu

MAIN USER• Clinician level professionals that oversee and monitor the glycemic control program• Implementers of glycemic control protocols, such as nursing level professionals (Critical

Care Registered Nurse (CCRN), Critical Care Nurse Manager (CCNM))

REPORT BENEFITS• RALS-TGCM provides clinicians with feedback on protocol implementation improvement

in a unit from one predefined time period to another

• This report can be used as a feedback tool that helps hospital’s committee understand the level of improvement in achieving glycemic control and potentially help determine if any changes need to be made in the protocol implementation




For more information…

• To arrange an in-depth look at RALS-TGCM, click here to contact the MAS Regional Business Manager in your area.

the leader in point-of-care informatics medical automation systems © 2006 medical automation...

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