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Mobile Point-of-Care Devices

Medication errors, such as omission, wrong dosage and infusion rates, are among the most common mistakes that lead to longer hospital stays and drive up treatment costs.

The Institute of Medicine (IOM) reports these errors injure 1.5 million Americans every year at a cost of $3.5 billion in lost productivity, wages and additional medical expenses. And, while these mistakes can be made by any member of the care team, the fault often falls on the nurses since they spend an estimated 40 percent of their time administering medicines.

In a busy organization like Parkview Medical Center, a nonprofit health system located in Pueblo, Colo., many factors can lead to quality, efficiencies, and unsafe practice, including noisy and cluttered workstations, inefficient processes as well as distraction, fatigue and miscommunication. Hospital leaders decided the optimal solution was to find a single mobile device to reduce medication errors and improve patient safety.

Improving Bedside Medication Verification
Parkview offers general acute healthcare and behavioral health specialty services for Pueblo and 14 surrounding counties, providing services to the area’s 370,000 residents. With nearly 2,600 employees, the facility provides a full range of healthcare services including the region’s only certified and verified Level II Trauma Center as well as the region’s first certified Stroke Center.

In 2007, Parkview saw a need to automate bedside medication administration in order to streamline processes, and reduce medication errors and harm. It leveraged PatientSafe’s wireless handheld device that enables clinicians to perform safety checks and safely administer and document medications at the bedside using barcode medication administration. Nurses were able to better manage all tasks related to the five rights of medication administration: the right patient, right drug, right dose, right route and right time.

As a result of implementing the system, Parkview realized a significant reduction in errors. A study of more than 250 medication administration procedures both before and after implementation revealed that the hospital reduced total medication errors from 20 percent to eight percent. Serious errors (wrong patient, drug or dose) were reduced from five to zero.

Expanding Outreach and Capabilities
Based on the success of the single-use device, Parkview leadership initiated discussions with nurses and its vendor partner to examine how PatientSafe Solutions’ additional capabilities could be used to improve patient safety, streamline processes and communication while maximizing the value of its existing Meditech electronic health record (EHR). Parkview worked closely with the PatientSafe team to extend its system through new capabilities that unite multiple departments in order to enhance patient safety and facilitate care team coordination. The highly efficient point-of-care solution allows nurses to document patient data directly into the EHR from the mobile device in real-time, and to improve patient safety through medication and lab specimen barcode verification, mother-infant identity and human milk matching, and blood transfusion verification. The system enables clinicians to create daily task lists so pharmacy, lab and other departments can see the healthcare team assigned to a particular floor or unit.

As more and more clinicians were bringing their personal smart phones to work, the desire to have an all-in-one system that included voice and secure text messaging was a natural one. Nurses complained about having to carry multiple devices during rounds and executives were concerned about the potential HIPAA violations.

To address both group’s concerns, Parkview selected PatientSafe’s clinical communications that integrated with the handheld devices the organization already uses. Through Voice-over-IP (VoIP) and HIPAA-compliant, patient-centric messaging, PatientTouch communications facilitates contextual care team communication and collaboration for maximum outreach. In addition, its workflow automation includes a rules engine with notifications, routing and alert features for timely communication.

Implementation Tips
For hospitals considering deploying a mobile health solution, it’s important to keep the following best practices in mind.

1. Pilot the program: Conducting a trial evaluation allows the organization to anticipate, remedy and manage both real and potential issues. Doing so saves time, money and headaches.

2. Take a phased approach: Change is good, but it can also be hard on staff. Once you have the results you need to justify deployment, consider taking it in stages. For example, launch the program within a single department or even on a unit, and build on small successes.

3. Partner with vendors: Working closely with vendors is mutually beneficial. At each step of the way, vendors should understand exactly how systems are operating. With real-time feedback, adjustments can be made in a timely manner for the best overall experience.

4. Consult staff: Before trialing a new system, check-in with staff house-wide to understand their needs and desires by position, department, and function. Not everyone requires the same capabilities. Understanding employees’ needs will help the organization scale the technology.

5. Choose easy integration: Test to make sure the technology easily integrates with other hospital information systems. The product should solve problems, not create new ones. The simplest and perhaps most reliable software solutions are usually device agnostic.

By implementing a highly efficient point-of-care mobile solution that gives busy clinicians the information they need in a timely, user-friendly way, Parkview is able to maintain its commitment to serving the community through superior patient care by reducing medication errors, improving safety, and enabling nurses to spend more time with patients for better care and higher staff morale. We are always looking ahead to determine how we can continue to build on the PatientSafe platform in the future for even better results.



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