Ensuring compliance with some of the simplest and most effective patient safety measures relies a great deal on human nature and memory. Electronic medical records that gather, store data, and ease workflow will help. But new technologies and software programs are bringing the EMR to the bedside, giving human nature and memory a little boost.
An app for the EMR
One such system, dubbed the SmartRoom, was developed by the University of Pittsburgh Medical Center, an integrated system with 20 hospitals. It was designed to ensure compliance with best practices, reduce errors, reduce length of stay and associated costs, and improve workflow, efficiency,
The problem with EMR data, says Tami Minnier, UPMC chief quality officer, is that there is so much of it.
"You really have to know where to look and know where to find things. In healthcare, we have literally seconds sometimes to assess the situation and make a decision for patients," she says. "I refer to [SmartRoom] as the app for the EMR."
The system identifies healthcare workers, who wear small ultrasound tags, as they walk into a patient's room. It displays the person's identity and role on a wall-mounted monitor visible to patients. At the same time, the SmartRoom automatically pulls relevant, real-time patient information from the EMR and other clinical systems, including pharmacy and lab services.
More time at bedside
"The battle to improve the safety, quality, and efficiency of healthcare has many fronts. One of the most important is the inpatient nursing unit," says Michael Boroch, chief executive officer of SmartRoom (UPMC owns the product; the project is jointly funded by IBM). "It's estimated that only 30% to 40% of a nurse's time is spent on direct care. With SmartRoom, we believe that we can raise that number for the benefit of caregivers and their patients."
Studies are not yet complete, but initial data is very promising, Minnier says. The organization is "easily" saving 60% in charting time for vital signs.
Under development for three years, the latest addition to the system's functionality is a formula for evaluating all of a nurse's tasks for each patient and issuing reminders about pending patient safety actions—especially those with stubbornly low compliance rates. The idea, says Minnier, is to present the information in a way that is helpful and timely—a departure from old systems of admonishing nurses with patient safety data based on care they gave weeks earlier.
The software helps to determine which tasks should be completed in which order to most effectively and safely care for patients, and it alerts the appropriate caregiver by mobile device or when he or she walks into the patient's room.
For example, the system alerts caregivers when it is time to turn a patient or if it is time to remove a catheter. In the near future, the system will be able to tell when a caregiver enters a room without stopping at the hand-washing station. Success will be measured by patient safety data, and although the program is new, the preliminary data is "very positive," Minnier says.