Avera Critical Lab Value Alarms. Candice Friestad, MSN, RN, MBA Director, Clinical Informatics

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1 Avera Critical Lab Value Alarms Candice Friestad, MSN, RN, MBA Director, Clinical Informatics

2 Avera Innovation Vision To integrate technology into the patient experience such that patient satisfaction, patient safety, staff satisfaction and operational efficiency are achieved To have voice, text and alerts on one device

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4 Picture Click to edit Master title style Click to edit text

5 38 Hospitals 160 Clinics 2.5 million Outpatient and Clinic Visits 110,000 Home Health Visits 45,000 Annual Discharges 100,000 Portal Users 1,000,000 People Covered $2.8 Billion in Revenue

6 Avera Innovation Vision To integrate technology into the patient experience such that patient satisfaction, patient safety, staff satisfaction and operational efficiency are achieved To have voice, text and alerts on one device

7 The Many Components of Care Physician RN Pt Care Tech Ancillary Depts. TV Patient Call Equip Electronic Health Record

8 Basic Communication Device Portable, secure voice and text Ability to communicate wirelessly with all patient care providers Communication device is effective, reliable, affordable and efficient

9 The patient caregiver complaint: Pagers, Cisco phones, Vocera, landline phones, flip phones, iphone, Android in addition to stethoscopes, bandage scissors, paper reports and various other associated items.

10 Connexall Alerts from equipment (patient monitors, nurse call) and EMR Ability to assign designated patient care staff to appropriate alarms Alarm escalation and cancellation is bidirectional with secure text phones

11 Smart TV Patient Satisfaction / Communication Patient education Patient feedback Electronic white board Messages from patient to Dietary Housekeeping/Maintenance Entertainment internet

12 Integrating Technology Physician RN Pt Care Tech Ancillary Depts. Voalte Smart TV Voice/Text Patient Portal TV Patient Call Equip Middleware Electronic Health Record

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14 ECRI top 10 technology hazards Alarm Hazards: Inadequate Alarm Configuration Policies and Practices 2. Data Integrity: Incorrect or Missing Data in EHRs and Other Health IT Systems 3. Mix-Up of IV Lines Leading to Misadministration of Drugs and Solutions 4. Inadequate Reprocessing of Endoscopes and Surgical Instruments 5. Ventilator Disconnections Not Caught because of Mis-set or Missed Alarms 6. Patient-Handling Device Use Errors and Device Failures 7. Dose Creep : Unnoticed Variations in Diagnostic Radiation Exposures 8. Robotic Surgery: Complications due to Insufficient Training 9. Cyber security: Insufficient Protections for Medical Devices and Systems 10. Overwhelmed Recall and Safety-Alert Management Programs Source: Health Devices 2014 November ECRI Institute

15 THE SMART PHONE WON THE CONTEST

16 Functionality of Directory

17 2014 US Mortality Statistics 1 Heart Disease 2 Cancer 3 Preventable Medical Adverse Events 4 - Stroke 5 - COPD July July

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19 Alarms from patient monitors, patient call system and EMR V-Tach, V-Fib, Asystole, Tele leads off, Tele battery low, bradycardia, ventilator Nurse call OT, Bed Exit, Staff Assist All Heparin and INR levels, Critical labs, Respiratory orders, Discharge orders, Wound orders

20 Alarm Escalation V-Fib, V-Tach, Asystole go to bedside RN/designated RRN then escalates to 2 nd RRN Tele leads off & low battery go to PCT then bedside RN then RRN (if PCT not logged in will go to RN) Call light OT to PCT then RN then RRN Bed exit to bedside RN/PCT then RRN Staff Assist to all staff

21 Alarm/Alerts from EMR Heparin and INR levels to bedside RN which will prompt the check/double check in EMR Critical Labs to bedside RN/designated RRN Lab will still call to verify critical lab value, must still notify physician All RT orders to floor RT, Wound to WRN Discharge orders go to bedside RN, RT, Social Worker/Case Manager,Pharmacy,etc

22 Guidelines for accepting/rejecting alarms Accepting an alarm or alert means you will physically take care of the alarm and patient care issue in a timely manner. This is similar to ACK an order in the EMR, you don t accept if you can t complete the task Rejecting an alarm means you are in the middle of patient care i.e. a bath or a procedure and are unable to physically take care of the alarm

23 Connexall assignments

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25 Staff Satisfaction Pre- Pilot (N=66) Implementation Week 1 (N=26) I can contact others easily Satisfied with time it takes to reach others Current devices enables me to do job effectively

26 Outcome data Patient Satisfaction Staff Satisfaction Efficiencies, Labor Savings TEXTing orders Joint Commission Questions?

27 Thank you