Keep­ing an IT eye on qual­ity

Modern Healthcare - - Information Edge -

Dr. Brian Patty, an emer­gency medicine spe­cial­ist, has served as chief med­i­cal in­for­mat­ics of­fi­cer at the three-hos­pi­tal HealthEast Care Sys­tem in the Twin Cities of Min­nesota. Since his ar­rival in 2005, Patty has led a process of “hard­wiring” the or­ga­ni­za­tion’s qual­ity goals into clin­i­cal de­ci­sion-sup­port tools that make it as easy as pos­si­ble for clin­i­cians to ad­here to best prac­tice.

Con­sis­tently pos­i­tive changes in CMS core mea­sures scores across its three acute-care hos­pi­tals give some sense of the progress HealthEast has made be­tween 2005 and 2010 in ba­sic block­ing and tack­ling—heart fail­ure, scores from 83% to 95%; acute my­ocar­dial in­farc­tion, 96% to 99%; pneu­mo­nia, 87% to 97%; sur­gi­cal care in­fec­tion preven­tion from 87% (for calendar 2006) to 98%.

But a tech­nol­ogy-en­hanced mon­i­tor­ing tool that Patty co-de­vel­oped with the hos­pi­tal’s elec­tronic health-record ven­dor, McKes­son Corp., is the whiz-bang gizmo of the sys­tem right now.

Called the “qual­ity mon­i­tor,” the tool was rolled out at a sin­gle in­ten­sive-care unit in the fall of 2009, then quickly taken up in ICUs at the other two sys­tem hos­pi­tals. Ini­tially, the mon­i­tor was tasked with track­ing com­pli­ance with a com­plex bun­dle of time-sen­si­tive guide­lines to pre­vent ven­ti­la­toras­sisted pneu­mo­nia.

The tool uses em­bed­ded logic to an­a­lyze chart­ing and or­ders al­ready pro­duced in the nor­mal course of prac­tice and then dis­plays ad­her­ence to the best prac­tice stan­dards of care in a sim­ple and fa­mil­iar “redyel­low-green” stop­light for­mat.

“There were about eight or nine things that we put on this score card for each pa­tient,” Patty says. “Here are all of your pa­tients and here’s how you’re do­ing with all of your pa­tients for this bun­dle.”

The qual­ity mon­i­tor can be called up on a desk­top com­puter, but it also runs on a mon­i­tor in the nurse’s break room, where care rounds are held twice a day. Nurs­ing man­agers also check in ev­ery two hours or so, Patty says.

“It helps the charge nurse de­cide if there is some­one that needs some help,” he says.


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