To meet The Joint Commission’s National Patient Safety Goal on alarm management, hospitals throughout the United States need to assess their current alarm and alert signals and create a clinical alarm system management plan by January 2016. While that may pose a challenge for some healthcare organizations, others are seizing on the mandate as an opportunity to improve their technologies and processes, reduce the problem of “alarm fatigue” … and ultimately enhance patient safety.
Right now is a perfect time to:
- Upgrade your mobile communication solutions.
- Integrate multiple alarm- and alert-producing systems, such as patient monitoring and nurse call.
- Implement new technologies to include waveforms and other important patient data in alerts.
Cincinnati Children’s Hospital, a nonprofit academic medical center that’s one of the oldest and most distinguished pediatric hospitals in the country, is taking a proactive approach to meeting patient safety goals. Last year, to alleviate the problem of excessive alarms and update its clinical communication, the hospital decided to replace pagers with a single mobile solution for communication and secondary alarm notification.
That’s when hospital leaders turned to Voalte. Over a six-month period, the Voalte Clinical Workflow Solutions team worked with the hospital using the ADPIE methodology to assess, develop, plan, implement and evaluate a comprehensive Mobile Communication Strategy. The initial goal was to improve caregiver communication and streamline alarm and alert notifications in the Cardiac Step-Down Unit.
First up was replacing Statview pagers with an enhanced smartphone solution, the Motorola MC40-HC, with the Voalte One™ application for voice, secure text messaging, and alarm and alert notifications. Next, alarms from GE patient monitors were routed through Connexall middleware to be sent as secondary alert notifications to the Motorola smartphones. Finally, the hospital installed the AirStrip ONE® application on the smartphones to deliver waveforms and other critical data directly to caregivers, providing context for alarms and alerts. (See more about our collaboration with Connexall and AirStrip.)
As our Voalte Clinical Workflow Solutions team has worked with customers such as Cincinnati Children’s Hospital, we’ve learned that some key elements are integral to the success of these projects. Here are a few to keep in mind:
- Identify who needs to be involved in an alarm and alert management project.
- Choose a project leader who is well respected across the organization.
- Understand vendor product limits and dependencies before completing clinical workflow design.
- Identify which systems require staff assignments to be entered for proper functioning.
- Plan alarm and alert escalation pathways and protocols.
- Connectivity is key – be sure to perform integration testing with all systems involved (nurse call, patient monitoring and middleware) before setting expectations.
- Create a workflow simulation lab for hands-on testing.
- Create a comprehensive plan for clinical training.
- Allow ample time for clinicians to use the new system before go-live.
At Cincinnati Children’s Hospital, one nurse in the Cardiac Step-Down Unit reported the new alarm and alert management system caused “alarm withdrawal,” as she adjusted to no longer receiving excessive notifications throughout her shift. By analyzing alarm data, configuring systems appropriately, and building escalation protocols that define primary, secondary and tertiary notifications, the hospital can send actionable alarms and “re-sensitize” clinicians who have previously suffered from alarm fatigue.
Tying together multiple complex systems is neither quick nor simple. But when patient safety is at stake, it’s an effort that’s well worth the return on investment. To get started with your alarm safety and event response plan, contact us for a free clinical workflow consultation.
Eric Brill is General Manager of Clinical Solutions at Voalte.