With patient care, circumstances can change in an instant. The complexity is compounded for hospital nurses, who typically have several patients to care for at a time—thus, prioritizing care and managing patient populations can become rather difficult.

This is where surveillance comes in. A surveillance tool works in the background of an EHR, and gives clinicians real-time, meaningful information to evaluate and interpret whether a patient experiencing shortness of breath may meet the criteria for sepsis, chronic heart failure, pneumonia or any other condition.

This information is pushed to clinicians as an early warning system, enabling them to quickly identify patients that may be trending toward a bad outcome. Being able to have crucial information sent to staff enables them to save time and intervene earlier in patient care.

Bloomberg photo

Surveillance has really turned the corner in making data work for nurses, by taking all the data that’s been collected and offering it back to them, without the need to do anything extra. Prior to having these tools, not only did the data have to be entered into the system, but data in the EHR had to be analyzed in order to recognize trends, let alone whether it was acted upon. With surveillance, live, actionable, real-time data is collected on patients every hour and is pushed to the nursing staff, enabling them to focus on the patients that need the most attention.

Surveillance delivers meaningful and potentially life-saving information to prevent hospital-acquired conditions and meet core measures. It’s useful for new nurses that might not intuitively know certain parameters they should be looking for, and also helps more experienced nurses incorporate high-level technology and change the way they address potential patient risks.

Having a strong surveillance tool enables nurses to take advantage of the data that’s been collected as part of the normal workflow of delivering and documenting patient care, saving a step.

Here are some vital components of a well-rounded surveillance approach.

Tracking boards
Real-time tracking boards give staff the tools to prioritize care and manage patient populations. Software with evidence-based rules can search the clinical and demographic data in an EHR 24/7. Any patients who meet profile criteria will automatically populate boards that indicate when quality measures are due or if the patient is showing signs of a potential hospital-acquired infection, saving critical time in care delivery.

These boards also give staff the power to manage their patients by the status board. They can see everything that they need to do for the patient, can sort tasks by time, and can also highlight the normals and abnormals. The board also lets clinicians know which patients have met a certain criteria, and more importantly, why they met that criteria.

An efficient tracking board won’t force staff to spend extra time looking for or analyzing data. It will clearly spell out the items that need immediate action. A big bonus is that these boards are also actionable, giving staff the ability to immediately order, document or message the rest of the care team.

Surveillance boards
Surveillance boards not only enable clinicians to look at an individual patient, they also enable them to look at the whole house. Tasks such as recording patient observations and capturing acuity can populate a watch list and trigger the surveillance board. This gives quality managers, for example, a grand view of the landscape to see what’s really going on in their environment.

Paired devices
Using a system that broadcasts alerts to status boards while also sending them to individual devices such as tablets and smartphones will ultimately help a provider increase patient compliance, reduce communication delays, expedite interventions and enable better overall care.

Standard content and best practices
While this takes time to set up, comprehensive standard content available with surveillance boards will already have outcome-based components and rules/algorithms incorporated to analyze data, easing clinicians’ burden of having to create the content in the first place. Developing content can be eased by identifying a solution that will have a library of standard surveillance boards, which include the embedded rules needed to comply with clinical quality measures and protocols.

Healthcare organizations will want to find content that provides active and predictive surveillance for early detection of sepsis, VTE, CAUTI, stroke, pneumonia and other potentially life-threatening conditions or diseases. The board should also monitor patient populations that may be costly or high risk, such as patients who are readmissions risks, have specific therapy consults or carry restraint orders. This can help improve clinical outcomes and reduce lengths of stay.

Watch lists
A solution with watch lists can give nurses real-time, accurate information to identify the most vulnerable patients by itemizing every profile that patients meet and their qualifying criteria. The most effective solutions can compile information (fall risk, restraints, CAUTI, sepsis and other risks) and deliver it to caregivers electronically in real time.

Surveillance adds value by fitting into a provider’s workflow and making the data work for you, not the other way around. It’s essentially a byproduct of what is already being done. Surveillance is not only an asset to nurses. It’s also helpful to the clinician who needs clinical decision support to help render a diagnosis, the quality manager taking care of all the inpatient areas, the care manager who can take a granular view and focus on one area of risk, and the VP looking to identify areas of improvement for all the potential points of service across single or multiple facilities.

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Cathy Turner, MBA, RN-BC

Cathy Turner, MBA, RN-BC

Cathy Turner, MBA, RN-BC, is an associate vice president of MEDITECH.