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Wrapping Safety Around Patients
April 1, 2008
Deep vein thrombosis, the formation of blood clots, is a common risk factor for hospitalized patients, particularly those immobilized in bed or undergoing surgery.
To better prevent the condition, 67-bed Riverside Walter Reed Hospital in Gloucester, Va., has programmed a workflow process in its Soarian clinical information system from Siemens Medical Solutions, Malvern, Pa.
Six hours after admission of a patient, the program checks the pharmacy information system to see if blood-thinning drugs have been ordered. If so, the program does nothing else. If not, it checks the clinical system to see if compression stockings were ordered for the patient. If so, the program does nothing else. If not, an alert — with a hypertext link to an order sheet—is sent to the appropriate nurses’ worklists so they can ask the attending physician if any preventive measures should be taken.
Riverside Walter Reed, part of Newport News, Va.-based Riverside Health System, worked with the vendor to develop the deep vein thrombosis workflow program, which operates in sync with the Soarian rules engine. The workflow program went live in late 2005, and it now is one of the “model” workflow programs offered with the Soarian product.
Riverside Walter Reed launched the deep vein thrombosis workflow program “because we wanted to get information in front of the doctor,” recalls Charles Frazier, M.D., director of medical informatics at Riverside Health System. Since the program started, the percentage of patients who get preventive treatment has risen 30%, he adds. As the Soarian system is implemented at the delivery system’s two larger acute care hospitals, clinicians there also will adopt the patient safety tool.
Beyond Medication Safety
Eliminating errors during the medication administration process gets the lion’s share of attention in the patient safety arena. Many information technologies are marketed specifically to help prevent medication errors.
But a growing number of organizations, like Riverside Walter Reed, are applying information technologies beyond the realm of medication administration to improve patient safety.
Some are using radio frequency and infrared technologies not just to track equipment and supplies, but also to track patients to prevent wandering and identify those who need immediate help. Others are using specialized software to improve the safety of blood transfusions and to identify patients who might be developing an infection.
Some clinicians even offer a convincing argument that software designed to automate the patient consent process also serves as a patient safety tool.
The University of Miami Hospital, for instance, is rolling out the English and Spanish-language iMedConsent application from Atlanta-based Dialog Medical to standardize and document communication with patients during the informed consent process.
“It’s a tool that supports consent and provides a double-check that the patient and family are informed and that we’re really doing the right procedure on the patient,” says David Arnold, M.D., a head and neck cancer surgeon and assistant professor at the Leonard M. Miller School of Medicine.
Arnold particularly likes the Spanish version because of the region’s large Hispanic population. But he’d also like to see the vendor devise a Creole-language model to serve that sizable population in South Florida. “Anything that helps me practice better is a safety tool,” he adds.
Nursing Home Innovation
At long-term care facilities, a huge patient safety issue involves patients wandering the facility and risking a fall. One organization has discovered that specialized wireless technology can play an important role in addressing this challenge.
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