While the ECRI’s top 10 safety concerns will vary in applicability among individual hospitals, the list is an insightful guide for any organization seeking to improve patient safety and quality. What is a clear overriding theme in the list, however, is that how many, if not all, could be addressed with the application of mobile health IT tools that have helped many provider organizations make significant gains in reducing errors while improving safety and the patient experience. Both safety and patient experience directly impact a hospital’s financial performance, but they also influence how its brand is viewed by patients, providers inside and outside the organization, and the community.
A renewed focus on patient safety and preventing harm helps hospitals address many of the concerns highlighted in the ECRI report. However, a more profound impact on safety, but also efficiency and care quality, is possible when hospitals transition from their current EHR computer-tethered workflow to “Mobile Care Orchestration.” Defined as the ability to orchestrate all of the complex people, data, and processes that need to converge in a synchronized fashion in real-time, Mobile Care Orchestration delivers safe, high-quality care and recovery experience.
Using a mobile-enabled care solution, providers and clinicians can “choreograph” complex processes in a clinically valid, standardized, reliable way to deliver intended outcomes and avoid many of the safety concerns highlighted by the ECRI.
Alarm hazards
Topping the ECRI list is “alarm hazards,” which in this report refers to inadequate alarm configuration policies and practices. To address the “alarm fatigue,” caused by the growing cacophony of electronic alerts and notifications in modern hospitals, alarm systems could be configured with mobile technology to alert clinicians in the following ways:
- Type and assignment. Combining reliable alert delivery with reliable alert assignment and escalation can be much more easily executed through a mobile solution that clinicians always carry with them versus an antiquated pager, or piece of stationary equipment that might be at the other end of a hallway.
- Priority. With alarm delivery localized to a mobile form factor, clinicians can more easily differentiate alarm priority via visual, auditory, and sensory cues—critical to minimizing untimely interruptions to patient care.
- Context and Action. By delivering clinical context surrounding the patient, as well as content through mobile, clinicians can better interpret the nature of the alert, helping them respond, prepare and deliver safe care more efficiently.
This orchestrated efficiency also encourages clinician productivity. When tasks and requests can be more effectively shared throughout care team with secure, HIPAA-compliant communications functionality, interruptions are fewer and less disruptive. Meanwhile, patient satisfaction and HCAHPS performance also improve as nurses can respond in a timelier manner while noise from unnecessary alarms is eliminated.
Data integrity
The second item in ECRI’s list of patient safety concerns, “data integrity,” refers to incorrect or missing data in EHRs and other health IT systems. One common issue is “missing data or delayed data delivery,” which stems from entry completed away from the point of care.
Mobile Care Orchestration drives for simpler access, capture and communication of patients’ information—such as vitals, current medications, drug allergies—from anywhere and in real time. This type of documentation, however, is still often captured on handwritten paper notes that are then entered into the EHR at a later time, creating potential data integrity issues due to missing or illegible notes and forgetfulness regarding a note’s precise meaning. Handwritten notes are also not immediately accessible to the rest of the care team, such as physicians who may be in another facility, but still require the most current status of their patients to guide their treatment plans.
The answer here is not to force clinicians to become glued to a workstation, but rather to deploy mobile solutions that make it practical and easy to capture the complete data electronically at the bedside without EHR distraction. The best of these tools will include integrated clinical communications functionality such as secure text messages and VoIP phone calling, but also patient safety features, such as built-in, contextually-aware alerts delivered at appropriate times during clinician rounds and tasks.
Instead of interrupting the clinician’s workflow, these alerts attach contextual patient information, enabling more accurate data capture at the bedside. This improved data integrity during the hospital care episode ensures safer inpatient care, but also safer care transitions, such as when the patient is transferred to another department, facility, or their home, creating a smoother, more satisfying patient experience.
Medication reconciliation
“Care coordination events related to medication reconciliation” was ranked number 5 on the ECRI list of patient safety concerns. ECRI focuses not only on patient safety issues associated with incomplete medication reconciliation at care transitions, but also on the need to conduct medication reconciliation “every step along the way of the hospitalization,” so that the patient is on an appropriate combination of medications at discharge.
Equipping clinicians with mobile solutions that overlay EHR systems and the hospital’s electronic medication administration record are essential to ensure an accurate medication list, but secure clinical communication functionality is also vital. The ability to quickly share or confirm medication information with the care team, especially the hospital pharmacists, ensures an accurate, complete medication list, while preventing administration errors. The result is safer care, but also a more satisfying experience for patients, who are instilled with greater confidence in the clinicians and providers.
Handoffs at Transport
“Inadequate patient handoffs related to patient transport” is number 9 on the list of ECRI patient safety concerns. Some of the most serious concerns are procedural, but many are related to inadequate communication regarding patient condition, which is where Mobile Care Orchestration is essential.
Just as a mobile overlay to the hospital’s EHR can help with medication reconciliation, it can also assist with accurate, complete and real-time vitals, I/O information, assessment status and checklists for safer care transitions. The key is for the platform to extend that information to each subsequent clinician in the designated care team so that the standardized protocol is easily accessible to each team member. Ideally, this view should include the patient’s pertinent alerts, messages and orders and history.
The subsequent seamless transfer helps prevent the patient’s care plan from being overlooked, delayed or mistaken, resulting in safe, high-quality and cost-effective care.
Mobile bridges safety gaps
Instead of dedicating more resources to EHR sustainability to improve patient safety and reduce harm, hospitals can shift to a more effective strategy focused on mobile first with Mobile Care Orchestration technologies. With this strategy and the right mobile care solution, we can effectively address the issues in the ECRI report, especially the four safety concerns highlighted here.
Through the liberation of EHR data, the transformation and standardization of workflows and improvements to clinical communication through the capturing of higher-resolution data in real time, Mobile Care Orchestration betters patient safety, but also, help hospitals progress toward consistently safe and efficient care, an improved patient experience and recovery; and better hospital financial performance – in issues ranging from reduced medical errors to improved HCAHPS scores to care team satisfaction – because ultimately, improvements in safety and efficiency have a path to the hospital’s bottom line.
Joseph Condurso is the President and Chief Executive Officer at PatientSafe Solutions. Mr. Condurso has more than 25 years of experience across the patient safety, medical devices, mobile health, and clinical information technology industries.
The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker’s Hospital Review/Becker’s Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.
