Clinical Alerting: Beyond the Nurse Call

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!

Learn more:

CASE STUDIES VIDEOS

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