Genesis Health System has a long and proud history of providing healthcare services: In 1869, the Sisters of Mercy launched one of the first community hospitals west of the Mississippi River. With hospitals in Davenport and DeWitt, Iowa, and Silvis and Aledo, Illinois, Genesis Health System serves the Quad Cities metropolitan area and the surrounding communities in 10 counties across the two states.
Known for its groundbreaking research and clinical capabilities, and having earned recognition as one of the nation’s top 100 health systems, Genesis has embraced healthcare technologies such as computerized physician order entry (CPOE) and has implemented one of the leading EHR systems throughout its operations. In fact, Genesis has been named “Most Wired” by Hospitals & Health Networks magazine for 10 straight years based on its use of information technology to accomplish key goals, including patient safety and quality objectives. But the Genesis hospitals discovered they needed to extend the capabilities of their clinical systems in order to achieve their ambitious goals of continuously improved patient care.
“With stat orders, in particular, we still faced the challenge of how to get the information from physicians’ orders to the nurses as fast as possible,” said Shirley Gusta, IT Manager of Client Services for Genesis Health System.
Genesis found that integrating Vocera hands-free wireless communication with their EHR system has allowed healthcare professionals to tap the full potential of their clinical systems, with results ranging from faster stat order responses to shorter hospital stays for patients.
From Paper to Automation
Before implementing CPOE, Genesis physicians would do rounds, pull out a paper chart, and place hand-written orders in the chart. For routine orders, they would just write the order in the chart for review the next time someone checked the chart. For stat orders, they would pull a flag to tag the chart before putting it in the rack, or they would notify someone verbally.
With CPOE, physicians don’t need to be physically present on the unit to place orders, so they can’t just turn to a nurse and verbally convey that a stat order has been placed. And with stat orders, it’s crucial that the information gets to nurses quickly. Prior to integrating with Vocera, orders would be made available in the EHR, or stat orders could be sent to printers or email addresses, but they weren’t always checked regularly.
Improving Responsiveness, Accuracy, and Overall Patient Care
Now any order with a stat status triggers the EHR system to send a message via Vocera to the charge nurse for the appropriate unit. The integrated EHR and Vocera solution leverages the intelligence within the EHR clinical decision support system to determine the urgency level of orders, ensuring stat orders are delivered with a high priority. An audible alert signifies a stat order, followed by a text message outlining the nature of the order. The nurse then knows to check an urgent order on the chart of the patient in a specific room number. A nurse busy with a patient when a stat message arrives can review the message again as soon as it’s convenient to make sure all the details are clearly understood.
“The combination of audible alerts, text follow-up, and the ability to review messages makes it easy for the right message to reach the right person at the right time in the right context—so each stat order is carried out in an accurate and timely manner,” said Gusta. “Integrating our CPOE process with Vocera has improved our workflow so much that orders are sent within 10 to 30 seconds of physicians placing them, and they can be carried out nearly instantaneously. Plus, it provides guaranteed communication that can be reviewed after the fact.”
Genesis Health System implemented the integrated Vocera/EHR solution quickly and easily. “Vocera is a simple, safe, effective, and expedient solution, and we deployed the integration using minimal resources over the course of a day and a half,” said Mike Malloy, Senior Systems Analyst. “The Vocera-integrated solutions allow our nurses to focus on patients, not charts. As a result, our patients receive more timely services, safely, which provides a better experience for all involved.”
Genesis has also integrated Vocera with its TeleTracking® solution to alert nurses when new patients arrive on the unit, and is evaluating the integration of Vocera with additional clinical systems in its hospitals. The health system also plans to utilize dynamic group settings in the Vocera® Staff Assignment application, which will enable the delivery of alerts and alarms directly to the care team members responsible for a given patient.
Immediate and accurate responses to stat orders and prompt communication about patient admissions can reduce patients’ length of stay and contribute directly to improved patient care. For instance, if a patient cannot get an X-ray or other diagnostic procedure completed fast enough, it could mean an extra night in the hospital. Or if a nurse does not learn about a new patient arriving in his or her unit, the patient could wait unnecessarily before important care begins.
The integration of Vocera and other clinical systems is just one part of Genesis Health System’s long-term focus on the optimal use of alerts and alarms to improve patient care. By reducing alarm fatigue and providing the data needed to audit and improve performance, Genesis is well positioned to meet the requirements of the Joint Commission’s National Patient Safety Goal for Alarm Management.
“Delivering the right alerts to the right person, with two-way communication and verifiability, is invaluable for enabling us to deliver the best quality patient care possible throughout our healthcare system,” said Gusta.