overcoming communications challenges in an acute care hospital beyond … · 2019-10-10 ·...
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Peter-Marc Fortune
Consultant Paediatric Intensivist,
Chief Clinical Informatics Officer
Royal Manchester Children’s Hospital
NHS Digital Academy Cohort 2
Overcoming communications challenges in
an acute care hospital – beyond pagers!
Invited presentation supported by Vocera Communications
Royal Manchester Children’s Hospital
• Busiest children’s hospital in the UK
• 312 beds
• 276,000 annual patient visits• ED 48,000
• Day Cases 25,000
3
Communication Errors are Widespread
(1) Joint Commission Center for Transforming Healthcare Releases Targeted Solutions Tool for Hand-Off Communications 2012. (2) Ponemon Institute, as cited in WSJ, May 2013. (3) CRICO Strategies. Malpractice risk in communication failures; 2015 Annual Benchmarking Report, as cited by The Joint Commission in 2017 Sentinel Alert. (4) Association for the Advancement of Medical Instrumentation: Alarms Pose Challenges to Healthcare Facilities, Horizons, Spring 2011, cited in The Joint Commission Sentinel Alert Medical device alarm safety in hospitals April 2013 (6) Healthcare IT News December 2015 (7) Brixey, A. Interruptions in Workflow for RNs in a Level One Trauma Center. IJMI. April 2008. (8) WSJ July 2014.
80%of serious medical error in hospitals1
Miscommunication is behind
4
Consequences
Delays in making contact
Delayed
diagnosis/treatment
Sub-optimal patient
experience
Sub-optimal staff
experience
Patient harm
C A R E T E A M
I N T E R R U P T I O N S
C O M M U N I C A T I O N
S I L O SA L A R M
F A T I G U E
Caregivers need to recognize and respond effectively to a change in
a patient’s status and collaborate with appropriate care team
members inside and outside the hospital.
This is not easy as the hospital setting is a complex, chaotic,
unpredictable environment.
The Challenge
Contemporary Communications
Hospital Communications
Hospital Communications
Fixed Telephones
Cordless Telephones
Pagers
10% of the world’s pagers are in the UK
About 130,000
Costing an estimated £6.6M per year!
eMails
eRefferral
Fax
Legacy Communication Technology
Hospital Communications
Locate free telephone
Call Switchboard
Identify on-call specialist
Bleep specialist
Wait!
Speak to bleep holder
The Digital Transformation!
1 2
Alerts
Alarms
Messaging
Voice
• Noisy care environment
• Information overload
• Alarm fatigue
• Delays in response time
Today’s Clinical
Communication Environment
Lack of Central Control
1 3
Communicate, Collaborate, Act
Nurse Call
EHR
Patient
Monitoring
Medical
Device
SYSTEMS AND DEVICES
Consultant
Nurse
Nurse Supervisor
Hospitalist
House Keeping
CARE TEAM
Alarms Text Alerts VoiceData
Workflow Dictates Device
Different Clinical Roles = Different Device Needs
Callflow Tailored to department/user
Our experience
Single Solution
Right time
Better Patient &
Staff Experience
Right person
Our experience
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