Michigan-based Lakeland Health has lowered the number of cardiac and respiratory arrests by 56 percent through the use of a patient monitoring system, the system said.

Lakeland deployed monitors to collect vital signs at the patient bedside. The patient monitoring system combines software, clinical decision support algorithms and mobile connectivity that help identify patients in need of early intervention.

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The monitoring system uses a configurable early warning score engine that is adaptable to commonly used early warning score calculations and can be customized to support variations of early warning score protocols preferred by Lakeland Health. The bedside monitors upload vital signs data to Lakeland’s Epic EHR via a wireless network.

“In our organization, the nurses and nursing assistants collect the majority of the vital signs,” said Arthur Bairagee, chief nursing informatics officer at Lakeland Health. “The purpose of the integration was to eliminate transcription errors by directly uploading the vital signs data into the EHR in real time to reduce the vital signs collection time and provide an early patient deterioration score and direction on the monitor.”

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The patient monitoring system – IntelliVue from Philips – contains software and clinical decision algorithms that enable caregivers to accurately obtain vital signs and seamlessly integrate validated patient data directly to the EHR, reducing human errors and saving time, Bairagee said.

The process includes scanning a nurse’s ID badge barcode and a patient’s arm band barcode, collecting vital signs, and validating the data. The data then is calculated by the software and displayed on the monitor as a score from 0 to 8 with a set of instructions per scoring algorithm. If the score is 3 or higher, the nursing assistant calls the nurse to assess the patient. If the score is 5 or higher, the nurse assesses the patient and escalates the situation to the rapid response team, as necessary.

“The nurses and nursing assistants are more vigilant and communicate effectively with each other about their patients’ vital signs,” Bairagee said. “When the alert score is 3 or 4, the nursing assistant notifies the nurse and changes the vital sign sequence from four hours to every two hours. If the alert score continues to go up, the nurse escalates the patient’s condition to the physician and provides immediate intervention.”

The cultural change among the health system’s nurses is evident by the number of rapid response and reduced codes, he added.

In March, Lakeland Health completed the integration of the patient monitoring system and training at all three of its sites. So far, time savings for each nursing assistant is about an hour for every eight-hour shift. As a result, the associates can spend more time with patients.

According to Bairagee, the systems has also seen significant reduction in transcription errors and improved quality of vital signs.

“And since we first implemented this technology in June 2016, the number of rapid responses has increased significantly, with the number of cardiac and respiratory arrests decreasing by approximately 56 percent, moving toward our goal of zero codes,” he said.

Twitter: @SiwickiHealthIT
Email the writer: bill.siwicki@himssmedia.com