February 15, 2017 ‐ PSQH
Instead of looking at technology as the entire solution, hospitals should view it as one potential enhancement integrated into a larger process. Failing to do the legwork to ensure effective integration can lead to wasted expenditures on ineffective gadgets, or, worse, a disorganized process that leads clinicians to find potentially dangerous workarounds.
Hospitals should focus on six important factors before purchasing and implementing any new technology that impacts patient care:
Impact on humans: Any new technology needs to integrate seamlessly with the clinicians who are going to use it. For example, patient monitoring technology can be a useful way to alert clinicians if a patient on a PCA pump is suffering from respiratory depression, Lavanchy says. However, when this technology is implemented in a lower-acuity setting where clinicians are not used to monitoring patients or responding to alarms, it leads to negative consequences associated with alarm fatigue.
Impact on the system: Every facility’s workflow varies, presenting different obstacles for implementing technology. Prior to adopting any new technology, hospitals should review their workflow and applicable policies, and then determine how the technology would disrupt or enhance that process. Input from clinicians is critical, since they understand the nuances of patient care interventions.
Clinician training: New devices or gadgets are limited by their operator’s knowledge and training, which means preparing clinicians for new patient safety technology is critical to ensure it is utilized effectively. Many hospital leaders consider this kind of training “unproductive time” since it takes clinicians away from patients, says Marilyn Neder Flack, senior vice president of patient safety initiatives at AAMI and executive director of the AAMI Foundation. “What we hear is nurses get 20 minutes to learn a new piece of complex technology, and that’s not fair to the nurse and it’s not fair to the patient,” she says. In the same vein, new technology may require new physician privileging requirements. Robotic surgery equipment, for example, requires specific, in-depth training before surgeons are qualified to perform surgeries autonomously. And ongoing training is equally important.
Contact with other hospitals: Although each hospital’s processes are different, there may be some commonality in the barriers they encounter. Talking to other facilities that have implemented the same technology can establish an understanding of potential problems that might arise.
Dialog with the vendor: Vendors will do their best to sell their product, but they can also answer important questions about how to effectively implement their technology and what kind of preliminary training is required for clinicians. Hospitals that have already reviewed workflow concerns can ask specific questions about the implementation process.
Input from all departments: Typically, new technology has a ripple effect that impacts several different units or departments. Although the IT department may take the lead on certain products, like EHR software, it’s imperative to gather input from clinicians, patient safety experts, risk managers, quality care coordinators, and C-suite leaders.
Emerging technology that’s making a mark on patient safety
According to Neder Flack, any technology that is used on or will interact with a patient should be considered a form of patient safety technology. This terminology is far-reaching: Even technology that doesn’t directly interact with the patient can, and often does, have patient safety implications. EHRs, for example, are used by nurses and physicians, but in recent years, researchers have uncovered a number of potential patient safety concerns born out of EHR software, ranging from incorrect drug dosages to missed diagnostic tests.
Listed below are some of the important and potentially impactful patient safety technologies on the market.
Keeping tabs on patients
Data analytics and real-time vital signs are providing clinicians with more valuable information to make care decisions.
For example, EarlySense, based in Waltham, Massachusetts, has been around since 2004, offering patient monitoring for hospitals and health systems. A sensor placed under a mattress detects critical vital signs, alerting nurses to patient deterioration via a central display station or individual handheld device. The motion-detecting sensor is also designed to prevent falls and pressure ulcers. In 2014, the American Journal of Medicine found that continuous monitoring using the EarlySense System led to a decreased length of stay and fewer code blue events. Another patient monitoring software known as The Rothman Index captures data from a patient’s EHR to create an individual score that can be used to alert clinicians if a patient is experiencing subtle declines.