Category Archives for Patient Safety

Alarm Fatigue — Do You Have It?

I know you can relate to this situation. You’re walking through a parking lot when suddenly a car alarm starts going off and doesn’t stop, and (I’m willing to bet), you keep on walking without looking back. Sound familiar?

When car alarms first emerged back in the 80s they were few and far between. The ear splitting sounds of the alarms turned heads of onlookers, to what could be a serious situation in need of attention. It didn’t take too long, however, for us all to become desensitized to the familiar warbles and chirps, and we no longer paid any attention to them — defeating their purpose.

The same desensitization, or fatigue, happens with clinical alarms in hospitals. But, there are ways to help reduce alarm fatigue according to a study published in Pediatrics.

In the study researchers at Cincinnati Children’s Hospital Medical Center, led by Christopher Dandoy, M.D., of the hospital’s Cancer and Blood Diseases Institute, found that a standardized, team-based approach could dramatically reduce alarm fatigue — helping to eliminate the possibility of not responding to a true event.

The researchers created a standardized cardiac monitor care procedure for the hospital’s 24-bed pediatric bone marrow transplant unit.

As part of the project, Dandoy and his team developed a process for ordering monitor parameters according to age-appropriate standards, pain-free daily electrode replacement, personalized daily cardiac monitor parameter assessment and a reliable way of appropriately discontinuing monitors. Under these protocols, the median number of daily cardiac alarms fell from 180 to 40, while caregiver compliance increased from 38 percent to 95 percent.

“Cardiac monitors constitute the majority of alarms throughout the hospital,” Dandoy said in a hospital announcement. “We think our approach to reducing monitor alarms can serve as a model for other hospitals throughout the country.”

Fewer false alarms, he added, will allow hospital staff to devote more attention to significant alarms. Although the process was enacted in a pediatric unit, Dandoy and his team said it was applicable to “most units with cardiac monitor care.”

“Hospitals are greatly concerned about alarm fatigue because it interferes with patient safety, and it exposes patients–and the hospitals themselves–to grave harm,” said Michael Wong, executive director of the Physician-Patient Alliance for Health & Safety, who presented findings at the Society for Technology in Anesthesia, earlier this year that hospital staff are exposed to an average of 350 alarms per bed, per day based on a sample from an intensive care unit at the Johns Hopkins Hospital in Baltimore.

Cincinnati Children’s Hospital Medical Center says nationwide adoption could increase patient safety

You can read the full study here.

How can Health IT increase scheduled patient visits?

Researchers from Oregon Health & Science University and Kaiser Permanente Northwest’s Center for Health Research argue in an article published in the November/December issue of Annals of Family Medicine that Health Information Technology, in particular health records and health information exchange, can be a conduit for keeping patients insured — which can lead to higher percentages of scheduled visits.

“There is a significant business case for implementing health IT systems to help keep patients insured,” the authors say. “Patients who lose coverage are often unable to schedule visits, so they seek care outside of visits … in ways that are not commonly reimbursed.”

One way to help keep patients insured is by sending them a simple reminder of their policy renewal dates.

“A good starting place is the data already being collected and/or automatically imported,” the researchers say. “[Patient-centered medical homes] could work with their healthcare systems and/or EHR vendors to create or enhance electronic interfaces with insurance plans, populating EHR fields with more detailed information about patients’ health insurance coverage status.”

The full article can be found here.

eHealth Initiative roadmap calls for alignment of HIT regulatory efforts

The eHealth Initiative has unveiled its 2020 roadmap for transforming health IT.

Calling it “much broader” than the Office of National Coordinator for Health IT’s interoperability roadmap, the eHealth plan calls for an extension of time between Stages 2 and 3 of the Meaningful Use program, and also says that compliance with ICD-10 by next October is mandatory.

Wikipedia tracking helps with disease prediction

Researchers at Los Alamos National Laboratory in New Mexico say that tracking Wikipedia page views can forecast the spread of influenza and dengue fever.

The researchers claim their algorithm allows them to overcome the challenges that hamper the reliability of other similar data surveillance methods based on Internet information.

Google Flu Trends, is a web service operated by Google, which provides estimates of influenza activity by aggregating Google search queries. But, early last year it was reported that they drastically overestimated peak flu levels, casting some doubt on the search giant’s ability to predict flu trends.

“Using simple statistical techniques, our proof-of-concept experiments suggest that these data are effective for predicting the present, as well as forecasting up to the 28-day limit of our tests,” the Los Alamos researchers say. “Our results also suggest that these models can be used even in places with no official data upon which to build models.

Though there are still detractors to the notion of using such systems to predict disease outbreaks, it is no doubt amazing to witness the many uses to which the growing volumes of meta data available on the internet will be used.

Read the full report here.

Evidence-based protocols drive quality improvement

An article published in FierceHelathcare’s eBook “Systemwide Transformations that Improve Healthcare Quality and Efficiency.” argues the best way to treat patients is with evidence-based protocols (EBPs).

Here is an excerpt:

In a new and evolving healthcare market that rewards efficiency and quality care, hospitals must find a way to streamline their systems to put forth better results for patients and more savings for their organizations.

One way to accomplish this is by focusing on evidence-based care protocols–the clinical care recommendations supported by the best available evidence in the clinical literature.

Although there may be 200 ways to do something, in some cases clinicians have strong evidence that reveals the best way to do it, says David J. Ballard, M.D., Ph.D., chief quality officer for Baylor Scott & White Health, a not-for-profit healthcare system based in Dallas that includes 46 hospitals and more than 500 patient care sites. For instance, Baylor implemented a standardized heart failure order set, which has the potential, if it were deployed across the country, to save $2 billion in annual hospital costs and prevent 1,500 in-hospital deaths annually.

The results of EBPs are better care for patients, and cost savings for healthcare organizations.

You can read more about Evidence-Based Practices here.