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Patient Flow

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.

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Patient Flow

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  1. Patient Flow Helene Marley

  2. 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.

  3. 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 )

  4. Perioperative Patient Flow Schedule Vue

  5. 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

  6. 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.

  7. Software Utilized • TeleTracking XT Management Suite • Electronic Bedboard • RadarFind • Vocera • Ascom Telephony & Messaging System (Tele Tracking, 2007)

  8. Software Description • TeleTracking XT Browser based Client user interface Unprecedented flexibility Unprecendented configurability Real time status

  9. 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.

  10. Patient in Operating Room Operating Room Icon

  11. Incision Operating Room Icon

  12. Closing Start Operating Room Icons

  13. Dressings – End Surgery Operating Room Icons

  14. Information System • Clinical Information System Real time collection of patient data Track patient flow throughout hospital stay

  15. Who Accesses the System • Admissions • Medical Secretary • Technicians • Nursing • Physicians • Anesthesia • Transport • Perioperative Assistants • Environmental Services

  16. Function of System • Patient tracking in real time • Streamline Patient Flow

  17. 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

  18. Configuration

  19. 8th Floor O.R. Schedule View

  20. All O.R. Schedule View

  21. Anesthesia Read Only View

  22. Post Anesthesia Unit View

  23. Data Standards • Health Level 7 (HL7) • Joint Commission of Accreditation of Health Organizations (JCAHO) • Health Insurance Portability and Accountability Act (HIPAA)

  24. 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)

  25. 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

  26. Disadvantages • User error • Over reliance on system causes false security, i.e., system crash, no back-up • Computer hiccup loses patient data

  27. 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

  28. 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

  29. 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)

  30. 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)

  31. 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

  32. 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.

  33. References • Tele Tracking, Inc. (2007). Patient Flow Automation. Retrieved June 14, 2010, from World Wide Web: http://www.TeleTracking.com/

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