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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 meeting april 18 19 2002
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

mercy at a glance
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
mercy at a glance3
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
mercy at a glance4
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
iowa heart hospital at mercy cardiac service line
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
cardiac service line
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.
telemetry project implementation
Telemetry Project Implementation
  • History
  • Timeline
  • Project Goals
centralized telemetry initiative
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
our conversion from decentralized to a centralized telemetry monitoring system
Our Conversion from Decentralized to a Centralized Telemetry Monitoring System

Terri Hockins, BGS, RNC

Director, 9 South and Central Telemetry

our conversion from decentralized to a centralized telemetry monitoring system10
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
communication challenges
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
critical success factors lessons learned
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
using v link on a post cath lab unit
Using V Link on a Post Cath Lab Unit

Coleen Waage, Director

W3 Cardiovascular Care

post cath lab unit west 3 cardiovascular care unit
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
patients are attached to pro pak portable monitors
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
remote viewing station
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
communication staff education challenges
Communication / Staff Education / Challenges
  • Staff on W3CC concerned with giving up autonomy
    • did not see full value of having Scope Techs
on the patient care area
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
at central scope room
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
general issues both groups
General Issues – Both Groups
  • Development of trust relationships between both groups
  • Assurance of the value of each group to the patient care
future developments and goals
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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