Patient Flow Helene Marley
Objectives • Describe Perioperative Patient Flow. • Describe hardware and software utilized with patient flow. • Describe the information system used with patient flow. • Assess the role of the nurse informatics when working with patient flow. • Examine legal/ethical issues. • Discuss the advantages/disadvantages from nursing perspective.
Perioperative Patient Flow • Real time communication • Facilitates smooth, well-coordinated patient flow from arrival to discharge • Utilizes software based technology • Multidisciplinary involvement • Multiple views for every area including family view ( IHI, 2007 )
Perioperative Patient Flow Schedule Vue
Hardware Utilized • Work Flow System (WFS) • Data Storage Device • WFS Client Personal Computers (PC’s) • Server • Routers • Back-up Power Systems • Microprocessors / Minicontrollers • Programmable Logic Controllers
Hardware Description • Microprocessor-Chip that integrates the processor onto one circuit, incorporates functions of Central Processing unit (CPU). • Server-Central computer where files are stored.
Software Utilized • TeleTracking XT Management Suite • Electronic Bedboard • RadarFind • Vocera • Ascom Telephony & Messaging System (Tele Tracking, 2007)
Software Description • TeleTracking XT Browser based Client user interface Unprecedented flexibility Unprecendented configurability Real time status
Usability of Software • Ease at which nurses can access information - a click of the mouse. • User friendly interface. • Supports multiple users logged in. • Access one or multiple screens. • Locate, move, view, or request transport of patients. • Real time notification status.
Patient in Operating Room Operating Room Icon
Incision Operating Room Icon
Closing Start Operating Room Icons
Dressings – End Surgery Operating Room Icons
Information System • Clinical Information System Real time collection of patient data Track patient flow throughout hospital stay
Who Accesses the System • Admissions • Medical Secretary • Technicians • Nursing • Physicians • Anesthesia • Transport • Perioperative Assistants • Environmental Services
Function of System • Patient tracking in real time • Streamline Patient Flow
Configuration • Created/set-up prior to going live • Each unit/area has individual vue • Vue is defaulted to chosen screen • Each unit/area has specific privileges unique to their area • Individual privileges based on need
Data Standards • Health Level 7 (HL7) • Joint Commission of Accreditation of Health Organizations (JCAHO) • Health Insurance Portability and Accountability Act (HIPAA)
Recommendation of System • Improves quality & safety of patient care • Eliminates patient flow barriers • Improves communication throughout • Increases team collaboration • Increase staff, physician, & patient/family satisfaction (Nurse Leader 2007)
Advantages of Patient Flow • Enhanced care coordination • Improved communications with less phone calls • Improved patient/family satisfaction • Increased revenue generated • Support staffing needs • Perfect fit for patient-centered culture
Disadvantages • User error • Over reliance on system causes false security, i.e., system crash, no back-up • Computer hiccup loses patient data
Ethical and/or Legal Issues • Patient Privacy – protected by HIPAA Screens in public areas use - last initial followed by a comma then first initial (ex. K.,M.) - procedure not listed - real time status from one area to another indicated on screen by initials
Informatics Competencies • States definition for the usage of the icons • Utilizes the icons appropriately • Locates patients • Identifies the patient flow - preop vs postop and IP vs OP • Accurately describes purpose and functionality of each unit
Functions and Responsibilities • Informatics Nurse (IN) • Resource & Educator for staff • System administrator for Patient Flow- provides access, determines type of access, adds staff to system • Scrubs the data to ensure accuracy • Informatics Nurse Specialist (INS)
Functions and Responsibilities -Pulls data for reporting purposes i.e., length of time in Admissions, Day Stay Unit -Test Patient Flow upgrades -Ensures accurate functionality of icons ( A.Terry, personal communication, July 30, 2010)
Patient Flow Summary • Integrating people, work processes and technology • Ensure superior care, safety, and service for all patients • Data provides evidence to anticipate budget, staffing, bed capacity and areas for improvement
References • Institute for Healthcare Improvement. (2007). Patient Flow. Retrieved June 3, 2010, from World Wide Web: http://www.ihi.org/IHITopics/Flow/PatientFlow/ • Rich,V., Garcia Sullivan,P., & Kirby,A. (2007). Pioneers in Patient Flow Improvement: Combining People, Process, and Technology. Nurse Leader, 52-56.
References • Tele Tracking, Inc. (2007). Patient Flow Automation. Retrieved June 14, 2010, from World Wide Web: http://www.TeleTracking.com/