SDS Technology: Technological ‘Big Brother’ increases efficiency
Technological Big Brother’ increases efficiency
Real-time patient tracking improves communications, reduces noise, eases anxiety
Although they may feel like characters in a George Orwell novel, some same-day surgery program staff members merely look at a computer display to see where a patient is in the surgical process. Family members see the same information on displays in the waiting room, which gives them updated status reports on their family member’s location without taking up staff time.
"We wanted real-time patient tracking in our same-day surgery program to help us improve our efficiency and communicate more effectively," says Wanda K. Teply, CRNA, director of perioperative services at Fairview-University Medical Center in Minneapolis.
The product chosen for the health system’s freestanding surgery center was the Health Enterprise Navigator System by St. Paul, MN-based NaviCare. It offers real-time tracking and display screens that communicate a patient’s progress throughout the surgical process.
The system requires little training and relies on each member of the same-day surgery team to push one button to indicate the completion of a task. For example, once the pre-op nurse has completed his or her work with the patient and pushed the button, an icon on the display screen indicates that the patient is waiting on the anesthesiologist. The button can be programmed to indicate whatever data the surgery program wants to communicate, says Teply. The system can indicate when the patient is finished with the admissions process, the pre-op process, the visit with the anesthesiologist, and all other steps of their visit, she adds.
Simple icons on the operating room monitors indicate different parts of the surgical process. For example, a "Mayo stand" in an operating room means that setup for the next case has started and a mop and pail in an operating room indicates clean-up after a case, says Teply. "We also have an icon of a suture line that means closing has started," she adds.
Knowing when a case is nearing completion helps the post-anesthesia care unit staff better organize their time, adds Teply. "They see how many patients will be coming into the unit within a certain time frame, and this helps them determine the best time for breaks."
Improved, easier communication between staff, physicians, and family members results in a more efficient surgery program, says Teply. "Staff members and physicians can simply look at the display screen to see if the patient is ready for the next step. No one has to go find the anesthesiologist, and the physician doesn’t have to ask if a patient is ready."
Because there are fewer phone calls to and from the operating room as people try to find and notify surgeons, anesthesiologists, and other staff, Teply has been able to cut one full-time secretarial position.
The screen in the family waiting area is a simpler version of the detailed screen displayed in the OR areas but does show when a patient moves from one area to another. Icons are not used; instead, a mark is simply placed under the appropriate column headlined pre-op, operating room, or recovery.
"To protect patient confidentially, the patient’s full name is not shown, only the first two letters of the last name and the first letter of the first name," says Teply. No other detailed information such as type of procedure or surgeon is included on the waiting room monitor.
Patient’s family members appreciate the continuous communication, says Teply. "When you have several waiting areas, it is nice not to have to search for family members to update them, and they don’t have to come looking for us."
After the first six months of operating a patient-tracking system, Fairview conducted a survey of family members who used the waiting room monitors, says Ryan Davenport, hospital spokesman. "Ninety-two percent of the respondents felt the system benefited their stay in all of the categories measured," he says. The survey measured the respondents’ opinion on the system’s ease of use, relief of anxiety about family members, and usefulness of information.
The Day Surgery Center, a joint venture of United Hospital and St. Paul Children’s Hospital in St. Paul, MN, also tracks patients within the same-day surgery program. "We had used a patient-tracking system in our main operating rooms at United Hospital, so we knew it would work well for the same-day surgery center," says Leiloni Young, business analyst for the Day Surgery Center. "Our system is linked with the operating rooms at United so surgeons and anesthesiologists working at both facilities can track what is happening with their patients at each location," explains Young. Children’s Hospital hasn’t used real-time patient-tracking systems in their operating rooms, so there is no program with which to link at that facility, she adds.
Computers that enable updates are in each of the eight operating rooms at the Day Surgery Center. This is one thing Teply wishes her program had done differently at Fairview.
"We placed computers outside the operating rooms to be shared," she explains. "This means that that someone from the surgical team has to come outside the OR to update information or check on the progress of other patients for the surgeon," she explains.
Be sure to pick a system that produces reports you can use for benchmarking and quality improvement, advise Teply and Young.
It is easy to be overwhelmed by the data generated by a patient-tracking program, so focus on specific areas that are most important to you, says Teply. "You can use these data to support changes you want to make in your processes such as who sets up the room and also to pat the staff on the back for reducing the length of time in the operating room."
Other software vendors offer patient tracking that produces historical reports, but at least two other companies in addition to NaviCare are addressing the need for real-time communication.
For information on the use of patient tracking systems within a same-day surgery program, contact:
• Wanda K. Teply, CRNA, Director of Perioperative Services, Fairview-University Medical Center, 2450 Riverside Ave. MB338, Minneapolis, MN 55454. Telephone: (612) 672-6490. Fax: (612) 672-6470.
• Leiloni Young, Business Analyst, Day Surgery Center, 333 N. Smith Ave., St. Paul, MN 55102. Telephone: (651) 220-8462. Fax: (651) 220-5073. E-mail: [email protected].
The following is an abbreviated list of companies offering products that help same-day surgery staff track patients as they move throughout the surgical day:
• NaviCare Systems, 4505 White Bear Parkway, Suite 1600, White Bear Lake, MN 55110. Telephone: (877) 628-4227 or (651) 407-6015. Fax: (651) 407-6022. E-mail: [email protected]. NaviCare offers Health Enterprise Navigator System that enables staff members to indicate when patient has completed each step of the surgical process. System also has data-collection and report-writing capabilities. Licensing fees range from $8,000 to $18,000 per procedure room, depending on features chosen. Annual support costs run approximately 15% of licensing fees.
• Camberley Systems, 175 Highland Ave., Third Floor, Needham, MA 02194-3034. Telephone: (800) 886-4325 or (781) 444-1424. Fax: (781) 444-2805. Web: www.camberley.com. Camberley Systems offers SurgeOn, a Windows-based product that includes a number of same-day surgery management tools including real-time patient tracking. The basic system costs approximately $25,000.
• Surgicenter Information Systems, 71 Bradley Ave., Suite 11, Madison, CT 06443. Telephone: (800) 219-7642, ext. 1 or (203) 318-1300. Fax: (203) 318-0095. E-mail: [email protected]. Web: sissystems.com. Real-time patient-tracking system that incorporates use of hand-held technology is in development, with product introduction scheduled for mid-2001.
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