Increased Patient Safety, Workflow Improvements, and Financial Benefits Realized from the Implementation of a Virtual Care Environment

Transcription

1 Incresed Ptient Sfety, Workflow Improvements, nd Finncil Benefits Relized from the Implementtion of Virtul Cre Environment R. Renee Johnson, RN, MBA IT Clinicl Project Mnger Indin University Helth

2 Objectives History Solution/Technology Success Stories

3 Indin University Helth System 2+ Hospitl System in Indin Prtners with Indin School of Medicine U.S. News & World Report rnks 11 Indin University Helth progrms mong the top 5 in the ntion 13 th stright yer recognized in the report Mgnet In top 2% of Hospitl Systems to recertify Mgnet sttus Recognized s one of the ntion s Most Wired hospitls nd helth systems by the 21 Most Wired Survey nd Benchmrking Study 9 th Yer in Row

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5 Indin

6 Evolution of Virtul Cre Dr Goldmn Build integrted clinicl environments Hve to use technology for the chnge in prctice Glen Allmendinger Ptient died fter lrms turned down Surveillnce Slve monitors or chnge workflows Dr. Sims Deploy systems to meet unique clinicl needs Ed Cntwell Aging popultion Fewer helth cre providers Rising Costs Jim Keller Bck to the future Think outside the box t where we re heded Alrms

7 Evolution of Virtul Cre

8 eprtners Video

9 eprtners IU Helth University 33 Bed Hospitl Mjor teching hospitl Pioneer in trnsplnts nd cncer 1 mile 14miles 14miles IU Helth Methodist 747 stffed beds, 3, nnul dmissions Recognized leder in criticl cre since 198; consistently ntionlly rnked for high qulity cre Level 1 Trum Center, One of re s lrgest teching hospitls IU Helth West 13 Bed Hospitl 14 miles West of VCC IU Helth North 17 Bed Hospitl 14 miles North of VCC

10 Bckground Incresing trend in ptient cuity nd complexity Need for clinicl dvncement for novice nd cute cre nurses to meet the cuity demnds Immedite need to enhnce ptient outcomes nd stisfction Finncil restrints with limited options Qulity nd sfety concerns relted to outdted model of cre Countered with limited intensivists nd experienced criticl cre nurses

11 Gols nd Objectives Improve workflows nd cre processes Decrese vrition in prctice Retin sesoned nurses Leverge physicins Bckup the front line Decrese LOS Increse throughput Decrese Mortlity Enhnce ptient cre sfety nd qulity

12 INet Virtul Architecture Summry Vents, Pumps, BIS BMDI Concentrtors SAN Philips Gtewy CPC Bernoulli Audio/Visul eprtners LIS, Registrtion (ClinDoc) Systems CreAdmin CreMobile Millenium Objects Cerner PowerChrt

13 Bedside 2 wy video conferencing Bedside Documenttion EMR Integrtion Direct line to virtul bunker Cre Admin iawre Connectivity Engine

14 Worksttion Globl View with Rel Time Vitl Signs Alrms 2 wy video conferencing APACHE Detil Screen Dshbords EMR

15 Integrted EMR Cerner PAL: Continully feeds informtion to the enurse Alerts

16 Integrted Dshbords

17 Reltime Alerts Red Alrms Pss thru Lethl rrhythmis Yellow Alrms BP/Resp/HR/O2 Combined Blue Alrms Technicl Leds off Different prmeters thn the bedside monitor

18 Alrm Admin

19 Globl View CPC Bernoulli Tile Screen: Allows for continuous monitoring of multiple ptients t glnce

20 Detil Screen

21 Trends Prmeter Buttons Hover Over Discrete Dt Points Time Frmes zooming

22 Prmeter Buttons

23 The Cmer Two Wy 19 in screen in ech ptient rm Stelth mode Rel time no tping This is NOT surveillnce Smllest prt of n eclinicin role Beginning nd end of Shift If needed

24 Cmer

25 Cll Button

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27 People eprtners Stffing Model RN s 24/7 Coverge 7 8 nurses per shift Must hve min. 5yrs criticl cre experience 1:4 RN:Pt rtio ICU 1:5 RN:Pt rtio PCU Physicins Bord certified intensivists One physicin/night 4p9p 9p7 Supported by tem of 78 ern s for 35 ptients IT Three dedicted support nlyst In house MonFri 24/7/365 on Cll Response time 15 minutes In house within 1 hr All hrdwre nd softwre for virtul system

28 Workflows 2+/month Code blue support/reviews 75+ IOPO referrls Centrl Line Insertion checklists 11 hours/mo 2 nd witness for high lert medictions Sfety Collbortion Apche Everything the bedside cne do without hnds

29 Shining Moments BSI Rtes

30 Shining Moments VAP Rtes

31 Shining Moments Svings $35, BSI Cost Svings $3, $25, $2, $15, $1, $5, $ If BSI rtes hd not chnged from the 25 rte of 2.7, nd if the VAP rtes hd not chnged from the 25 rte of 1.8, it would hve cost n dditionl 1.4 million to provide cre to ptients from /15/ BSI Incrementl Cost of Cre $16,138 VAP incrementl cost of cre $12,883

32 Mortlity MH NCC Mortlity Index M o r t l i t y I n d e x J n 3 M r 3 M y 3 J u l 3 S e p 3 N o v 3 J n 4 M r 4 M y 4 J u l 4 S e p 4 N o v 4 J n 5 M r 5 M y 5 J u l 5 S e p 5 N o v 5 J n 6 M r 6 M y 6 J u l 6 S e p 6 N o v 6 UCL=1.927 PCL=1.216 LCL=.54 USL=1. eicu3/5 CGS2/5 PCL, UCL & LCL clculted from 1/3 1/5 MH ACC Mortlity Index M o r t l i t y I n d e x J n 3 M r 3 M y 3 J u l 3 S e p 3 N o v 3 J n 4 M r 4 M y 4 J u l 4 S e p 4 N o v 4 J n 5 M r 5 M y 5 J u l 5 S e p 5 N o v 5 J n 6 M r 6 M y 6 J u l 6 S e p 6 N o v 6 UCL=1.945 PCL=1.132 LCL=.318 USL=1. eicu3/5 CGS12/4 PCL, UCL & LCL clculted from 1/3 11/4

33 Lives Sved 655 LIVES SAVED BETWEEN /15/211 33

34 Needed to be successful Rel Time Physiologic Dt Trends Rel time Alrms/Alerts Esy button from ptient room Integrted EMR Documenttion Lbs ADT Phrmcy Audio/Visul People

35 Wht s Next Alrms Development Contextul Pssing Alerts Mturtion Decisions Support Sky s the Limit

36 QUALITY mens you would bring loved one to our hospitl, SAFETY mens you would leve them here. Michel Niemeier, M.D. Chief Medicl Officer Methodist Hospitl

37 Questions?? Renee Johnson