Special report: Integration key to ending "communication chaos"

by Diana Bradley, Staff Writer | July 23, 2012
From the July 2012 issue of HealthCare Business News magazine

“We can’t make any particular assumptions, because doing so could put the patient at risk,” he says. “So the industry has defaulted to sending everything, which makes the clinicians say, ‘Wait a minute, I don’t want everything.’ As a result, we can put filters into place, but the final conscious decisions have to be made by the facilities themselves.”

Minnesota-based Maple Grove Hospital’s senior project manager for information technology and new business development, Craig Wolgemuth, was hired to define the technology to support an effective care model. One of his primary objectives: create focused messaging.

“We took a kind of surgical approach to message delivery, as opposed to what I would call a ‘shotgun’ approach, whereby in the traditional model, [hospitals] would overhead page to everybody hoping that the right people would hear,” he explains. “That creates a lot of ambient noise and distraction to a healing environment.”

However, patient monitor alerts aren’t necessarily the primary communication chaos driver.

“If you are looking at your sicker patients, oftentimes the drivers to the chaos are monitor related,” says Wolgemuth. “If you’re looking at less sick patients like moms who have just given birth or someone who has just had a surgery, a lot of what drives communication is nurse calls, patient requests and interactions.”

To manage these issues, Wolgemuth and his team looked at the entire spectrum of patients and their individual needs – from simple requests to life-or-death scenarios. For example, if a patient’s wireless cardiac monitor (or telemetry pack) indicates the heart has stopped beating, the entire unit must receive that message and the patient must be responded to immediately. On the other end of the spectrum, that same device may merely have a low battery warning. A message like this would go to an aid or tech that has the task of tending to that alert. If that person is not available or the issue doesn’t get resolved in a certain period of time, the message is escalated to someone else until it gets dealt with.

“What we are trying to do is target communications to the right person so nurses are doing nurse work, aids are doing aid work, the chargers are only responding to things that are otherwise unfulfilled by other folks, all the while trying never to create a dead-end for a request from a patient,” Wolgemuth says.

Maple Grove uses Amcom Messenger middleware to send critical secondary notifications from patient monitoring and other alert systems to staff carrying wireless communication devices, including smartphones, pagers, and Wi-Fi phones. Walgemuth was able to use this system to create rules for the routing he wanted for certain events. “[It has] allowed us to achieve quietness of hospital scores in the top two percent of the country,” he says. “We have very high nursing satisfaction given the tools in the environment we have placed them in.”

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