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PatientNet Users Group Meeting April 18-19, 2002 Presentation By: Sharon Meadowcroft, BSN, RN Vice President Patient Care Services Iowa Heart Hospital at Mercy Terri Hockins, BGS, RNC Director, 9 South and Central Telemetry Coleen Waage, BSN, RN Director, W3 Cardiovascular Care

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PatientNet Users Group MeetingApril 18-19, 2002

Presentation By:

Sharon Meadowcroft, BSN, RN

Vice President

Patient Care Services

Iowa Heart Hospital at Mercy

Terri Hockins, BGS, RNC

Director, 9 South and

Central Telemetry

Coleen Waage, BSN, RN

Director, W3 Cardiovascular Care


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Mercy at a Glance

  • 931 bed acute care, not-for-profit, Catholic Medical Center located on three Des Moines campuses

  • Maintains a network of healthcare facilities in 14 rural communities in Central Iowa

  • Maintains 23 family practice and specialty clinics throughout the Des Moines metro area


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Mercy at a Glance

  • Oldest hospital in Des Moines, founded by the Sisters of Mercy in 1893

  • Member of Catholic Health Initiatives, Denver, Colorado and Mercy Health Network

  • Accredited by the Joint Commission for Accreditation of Healthcare Organizations


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Mercy at a Glance

  • Employs 4,270 people

  • Medical staff of 770 physicians and allied health professionals

  • One of Midwest’s major referral centers, offering only private rooms


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Iowa Heart Hospital at Mercy Cardiac Service Line

2001 Volumes

  • 169 Beds Dedicated to Heart Care

  • 1,916 Open Heart Surgery Cases

  • 4,697 Cath Lab Diagnostic Cases

  • 466 Electrophysiology Cases

  • 207 Ablation Cases

  • 152 Internal Cardiac Defibrillators

  • 425 Permanent Pacemakers


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Cardiac Service Line

  • 48+% Heart Inpatient Market Share – 3 County Area

  • CHF Case Management, Outpatient Infusion Clinic, and Tele-management Program

  • Automatic External Defibrillator (AED) Program in-house

  • Women’s Heart Program

  • National Registries

    • STS

    • NRCPR

    • GWTG

  • Chest Pain Center in E.D.


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Telemetry Project Implementation

  • History

  • Timeline

  • Project Goals


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Centralized Telemetry Initiative

Project Goals Set and Achieved:

  • Position Mercy for the future by upgrading technology

  • Meet FCC regulations requiring dedicated medical band radio frequency

  • Centralize Monitoring Center for increased efficiency, quality of service and for positioning to expand service

  • Provide telemetry availability to all Med-Surg floors in order to improve patient placement options

  • Expand number of monitored lines to 160

  • Offer Telemetry Monitoring to remote sites


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Our Conversion from Decentralized to a Centralized Telemetry Monitoring System

Terri Hockins, BGS, RNC

Director, 9 South and Central Telemetry


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Our Conversion from Decentralized to a Centralized Telemetry Monitoring System

  • Project Leader

  • Phase I – Traditional Telemetry

  • Phase II – Remote Non-traditional Telemetry

  • Phase III – Remote Telemetry to our Affiliate Hospitals


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Communication Challenges

The biggest fears addressed:

  • Pagers

    • Introduced new pagers to one floor at a time.

    • Introduced the pagers a few months before the “GO Live”

  • Web Browser

  • Phones

  • Education


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Critical Success FactorsLessons Learned

  • Met with each group frequently and asked about their concerns and ideas.

  • Included nurses and scope techs on a site visit to see systems in operation.

  • Utilize everyone’s expertise.

  • Involve Information Technologists and Clinical Engineering


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Using V Link on a Post Cath Lab Unit

Coleen Waage, Director

W3 Cardiovascular Care


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Post Cath Lab Unit (West 3 Cardiovascular Care Unit)

  • 18 Cardiovascular care beds

    • Telemetry beds

  • Patient/s come from the Cath Lab with Arterial Lines in place


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Patients are attached to Pro Pak Portable Monitors

  • Arterial Wave Form --

    • viewed in the room and at the nurses’ station on W3CC

  • Interfaces with Centralized Telemetry

    • also viewed by the Scope Techs

  • On Arrival:

    • Patient is placed on a transmitter and monitored by the centralized telemetry system and W3CC viewing system

      • EKG

      • Arterial Line


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Remote viewing station

  • Interactive to allow nursing staff to adjust alarm parameters as Arterial Line wave forms fluctuate.

    • This helps to reduces multiple alarms to the Centralized Scope Room


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Communication / Staff Education / Challenges

  • Staff on W3CC concerned with giving up autonomy

    • did not see full value of having Scope Techs


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On the Patient Care Area

  • W3CC staff had no previous interaction with Scope Techs

  • Staff had to adjust to new paging system

  • W3CC staff had to learn to communicate with Scope Techs about the patient’s activities


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At Central Scope Room

  • Scope Techs needed to understand about post cath lab patient care

  • Scope techs had to establish credibility with the W3CC staff as knowledgeable in cardiac rhythms

  • Scope Techs had never monitored Arterial Lines


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General Issues – Both Groups

  • Development of trust relationships between both groups

  • Assurance of the value of each group to the patient care


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Future Developments and Goals

  • Expand to remote site hospital with 8 lines

  • Explore expansion to network rural hospitals

  • Establish outcome database with reports

  • Establish indicators for cost, quality, and service


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