Connexall

A

Communications CoreDan Kukko

HIS Specialist

Thunder Bay Regional Health Sciences Centre

• Northwestern Ontario, TBRHSC/ SJCG and our Informatics Department

• Connexall at TBRHSC today

• Expansion we have explored

• Potential expansion of a core communication system

Agenda

•235,046 people (2006) or 2% of the population of Ontario

• Encompasses 47% of Ontario’s landmass

• About the size of France

TBRHSC/SJCG Informatics Serving Northwestern Ontario (NWLHIN)

• 235,046 people (2006) or 2% of the population of Ontario.

About TBRHSC

• Our Mission:– We will deliver a quality

patient experience in an academic health care environment that is responsive to the needs of the population of Northwestern Ontario.

• Values:– Patients First– Accountability– Respect– Excellence

• Patient and Family Centred Care (PFCC) – The provision of care that is

respectful of, and responsive to individual patient/family preferences, needs, and values and ensures that those values guide all clinical decisions.

– Partnership involving patients, families and healthcare providers that results in safe quality care.

o Academic Health Sciences Centre

o Partner with Northern Ontario School of Medicine

o Lakehead University

o Confederation College

o Thunder Bay Regional Research Institute

o Arms reach of TBRHSC

TBRHSC Partnerships

TBRHSC in 2014

• One of the busiest ER’s in the country– 105,365 ER Visits

• 18,318 admissions

• 26,131 day surgery & OR surgical cases

• 2750+ staff

• 475 volunteers

• 59.7 average ALC patients

• 97.50% average occupancy rate

• Overcapacity – ALC patients– Patient / bed processing time

• High Volume of service requests– Emergency – In and Out patient– Ambulatory Care– Cardiac Care– Surgical– Mental Health

• Serving entire North Western Ontario

• Ensuring the PFCC philosophy is the focus

• St Joseph's Care Group• Mandate Includes:

– Physical Rehabilitation and Complex Care– Mental Health and Addictions– Long Term Care– Supportive Housing

• 1700 + employees• 400 volunteers

About SJCG

TBRHSC/ SJCG Informatics Department

• Joint IS/IT department – TBRHSC / SJCG– Provides all IS/IT services for both facilities

• Provides EMR, PACS, Network Services throughout NWLHIN– 1st LHIN in Ontario to have all hospitals on a common EMR– 14 Hospitals

• 7257 active user in the region• 1,136,000 EMR patient registrations• 1.3 million referral orders• 32,000 + Service Desk Calls• 10,000 + Devices supported in the region

• OR, PACU, SDC– 2009– Approximately 60 users

• Housekeeping / Admitting / Clinical units– 2010– Approximately 40 users

• Patient Family Waiting Area– 2012– Offered to all family members

• Cardiac Monitoring– 2013– Approximately 60 users

Connexall at TBRSHC Today

Housekeeping / Admitting

• Manages bed turnover requests via ADT interface with EMR– ADT message integrates from

Meditech to Connexall– Message managed by

Connexall via a Cisco phone / Blackberry to housekeeping staff

– Uses Connexall scheduling and escalation controls to ensure the requests are managed in a timely manner

– Bed board status (ACC, MAC, DAC) used in Admitting, Housekeeping and on the units.

• Import daily OR schedule from EMR to display surgeon, patient and suite information such as schedule, progress and requests– Displayed on wall screens via Connexall

• OR nurse updates status via virtual controls– Surgical staff can monitor OR Suite and Case load– Patient family / friend can monitor on wall screen

in waiting area• Progress of the surgery• Location of the patient – In surgery, in recovery, in

unit• PFCC advisory (PFA) part of the design of the solution

• Request next patient via virtual controls directly from OR

• Initiate patient codes in OR via Connexall• Assignment of OR attendants to suites

– Attendants carrying Cisco device • Direct contact from the OR via Connexall virtual

controls• Request for assistance / equipment

OR, PACU, SDC, Family Waiting Area

• Integrated with Draeger Cardiac Monitoring system via Cisco wireless devices

• Connected to portable telemetry packs as well as bed side monitors

• On Cardiac Ward and ICU

Cardiac Monitoring

• TBRHSC has investigated and tested the additional use of the Connexall system for the:– Phlebotomists– Surgeons– Respiratory Therapists– Sterile Processing department - Portering

• Interface with Meditech Order Entry• Interface to I-Device• Using Connexall Scheduling and Escalation process

Investigating and Testing additional modules

• Installed the Connexall Application for IPhones on two surgeons phones

• Using the Connexall Virtual controls the OR staff could contact the Surgeon let them know the OR was ready

• On Site and Off Site notifications• Surgeons wanted to be able to

respond directly to the message.– “On my Way” – “Running Late”

Testing the expanded use in the OR

• Surgeons wanted to be able to send a response back to the original requestor

• Basic messaging with the IPhone cannot manage secure messaging

• Requires third party secure messaging application• Cost for single purpose• Privacy concerns• Connexall Can manage this very well

Results in the OR

• Method to receive an EMR order on a portable device – replace a pager

• Tested the use the Connexall application for I-Device

• Same as the Surgeons they wanted a bi-directional communication process

• Requires third party secure messaging application

• Cost for single purpose• Selected device needed to be able

to connect to the EMR – Meditech • Privacy concerns

Test with the Phlebotomists

• Initial investigation was a PFCC initiative to reduce the noise on the unit. – Create a better patient family experience

• Investigated the requirements / cost to implement the nurse call system as a pilot on 1 unit.

• Existing Nurse Call system is end of life• Not feasible to upgrade the existing Nurse call to

accommodate a pilot.• Need to upgrade the Nurse call system prior to implementing

the Connexall integration.• Pilot put on hold

Nurse Call / Paging

• Want to eliminate the paging process

• Want the be able to send bi-directional messages

• Need to be able to access Meditech on device

• Need to have telephone access from device as well

Respiratory Therapists

• Existing system was end of life

• Investigated the use of Connexall as the Portering Solution

• Took the upgrade to the existing system as the solution at this point in time

SPD - Portering

• In the past the new as well as the potential expanded uses of system were evaluated as individual components

• Recently a communication group has been struck to review the communication needs at TBRHSC

• Primary goal of this group is to identify all the communication needs within the hospital

• One core system can manage or integrate with systems that manage all the communication needs of the hospital

A Core Communication SystemWhat can it do

• Real time information on the patient location– Where they are now– Where should they be– Where are they going next

• Less wait time for staff and patient– Reduce wait time for porters– Reduce wait time for patient– Order acknowledgement, acceptance is processed via

communication system

• How does the social networking fit– Can a patient be notified from the system– Privacy issues

The Potential / The Benefits

• Improve patient flow

• Improve patient safety

• Improve patient privacy

• Improve patient satisfaction

• Leverage investment in the hospital infrastructure

• Leverage Informatics team knowledge

• Provide quality performance data

The Potential / The Benefits

Current and Indentified use

• Existing– Housekeeping / Admitting– OR, PACU, SDC– Cardiac Care, – ICU

• Identified potential – Equipment tracking– RFID – Location services– Porter Services– Diagnostic Imaging

Ordering– Nurse Call integration– Phlebotomists, Therapists

RT, PT , OT services– Surgeons– Staff Callout– Security

• Equipment monitoring– All medical equipment could be tagged and

located– Lost or stolen

• Patient wandering– Patient ID tagged

• Patient locations – Patient getting a test

• Connect to security system

RFID/ RTLS – Location Services

• Combination of locations services, EMR and Connexall Controls

• Can locate the patient and their equipment at all times• Increase patient safety• Increased efficiency right place at the right time for

staff and patient• Track the patient in Connexall• Promotes Just in time for the patient

– Timing of and readiness of a patient for transport

Portering, Diagnostic Imaging, OR, PACU, Ambulatory Care, SDC

• Reduce bed turnover time

– Patient flow improvement

• Provide real time bed status

• Improves the patient experience

• Enhance the use of the system

• Automate the discharge process

Housekeeping and Admitting

• Integrate the Nurse call system with Cisco Handheld devices

• Enhanced patient family experience. – Noise reduction

• Reduced response time to patient requests– Staff can answer from wireless device directly to the patient

room

• Room scheduling and escalation• Increased patient safety

On Unit - Nurse Call

• Bi-Directional communication with Surgeon via handheld device

• Requires secure solution

• Improves patient flow

• Improves Patient experience

• Reduced call time to surgeon

OR - Surgeons

• Integrated orders from EMR

• Integration with I-Device via Connexall

• Workload scheduling and task escalation

• RT’s OT’s, PTs’ SW’s

Therapists, Phlebotomists

• Automate the process of calling in staff for coverage• Clinical manager requests a replacement staff member

– Virtual control– From portable device

• Human Resources maintains a staff call in list• Integrating with the in house telephone system the call list is used to call

staff• Could be a text or email as well• Staff can respond via their device• Manager is notified when staff member accepts• Potential to save significant effort by HR and Manager• Creates performance data

Staff Call in

Synopsis

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OR,PACU and SDC x x x x x x x

Housekeeping & Admitting x x x x x x x

Cardiac Monitoring x x x x x x x

Nurse Call x x x x x x x

OR Contact Surgeons x x x x x x x

Equipment / Patient Tracking x x x x x x x

Porter Services x x x x x x x

Phlebotomists x x x x x x x

Staff Callout x x x x x

DI Ordering x x x x x x x

• Corporate communication plan is key.

• The solution needs to be able to integrate and function with the wide variety of technology available

• What are the impacts or potential benefits of social networking to our patients and staff

• How do the patient needs impact the direction we take

• Need to look at all systems

• Patients come first

Summary

• Dan Kukko, HIS Specialist

• Informatics Department

• Thunder Bay Regional Health Sciences Centre

• kukkod@tbh.net

• 807-684-6437

Questions

Thank you