Today, it is typical that patients are connected to multiple devices by multiple vendors that have little, if any, connectivity. The lack of standards for device-to-device communication not only makes data tracking a nightmare, but it negatively impacts patient care, too. Earlier this year, the U.S. Department of Health and Human Services (HHS) finalized two long-awaited sets of rules governing how providers, payers and technology vendors must design their systems. These rules aim to fulfill the interoperability and information-blocking provisions of the landmark 21st Century Cures Act. The goal is to standardize product design to create a market in which devices are easily connected to a single interface - reducing alarm fatigue for both staff and patients.
Our teams are ahead of the curve on this journey to interoperability. Check out what some members of our Clinical Design & Implementation team think about alarm fatigue, the lack of device connectivity, these new mandates for system design, and how connectivity plays a huge role in Ronco's healthcare installations:
Examples of Alarm Fatigue from a Former ED RN
"As a former Emergency Department (ED) RN, I can attest to the fact that alarm fatigue is a huge problem and more importantly, a patient safety issue," says Jamie Eden, MSN, RN, a Clinical Design & Implementation Specialist out of our Albany, NY office. "I remember having a central monitoring station for telemetry with no one sitting there to monitor it, leaving staff to only rely on the noise that came from the station in the room. I specifically recall a time that the Ventricular Tachycardia (V-tach) alarm was going off and no one was going to check on the patient. The patient was in fact, in V-tach, but since the alarms would go off all day with no one monitoring the telemetry station, it seemed staff did not hear it anymore."
"From a patient standpoint," Eden continues, "especially in the ICU, rest is vital to healing. It is said that 16%-89% of ICU patients are affected by ICU delirium¹, and noise is one of the leading causes! In the ICU room, some of the equipment that alarms are the telemetry monitor, bed alarm, IV pumps, ventilators, and sequential compression devices. That is a lot of conflicting noise that prohibits rest."
How A Lack of Device Connectivity Impacts Patient Care
It becomes very complicated to provide efficient and effective patient care if a facility's devices do not integrate with one another. Eden shares another experience with us relative to patient safety: "I also remember that our bed alarms were not connected to the nurse call system," Eden explains. "When you'd hear a bed alarm, you would have to search the large, rectangular unit to figure out where it was coming from. Sometimes, by the time you found it, the patient was already on the floor. In the bathrooms, the pull cord station near the toilet was only named “Tlt” with no specific location coming across the nurse console. Due to this, we would have to walk the entire ED, made up of five care teams and more than 60 beds, to find which bathroom the alarm was coming from."
Thoughts on The New Mandates
"It is such an interesting shift in the industry, which I am so glad to see," comments Stacey Dodge, Vice President of Clinical Design & Implementation. "For years, we have dealt with the ‘proprietary’ information that some manufacturers are just not willing to come to the table with to see how their interfaces can integrate together to streamline communications. Ultimately, it does more harm than good."
Christina Romero, Clinical Design & Implementation Specialist out of Ronco's Charleston, SC office, adds with, "It is exciting news to see that the industry is looking to develop something that can be applied across the devices to assist hospitals in providing a more patient-centric care model. The facility's environment impacts patient outcomes, and keeping the patient's room and surrounding areas quiet is at the forefront of the providers' discussions."
"I agree," says Eden, "If all of the devices could become interoperable and sent to a caregiver’s mobile device and/or central monitoring station, the alarm volumes in the room could be turned down as not to disturb the patient, allowing them to heal... The staff would also be less likely to develop alarm fatigue, allowing them to respond to high priority alarms faster."
How Our Team Is Ahead of The Curve
"Ronco has been and will continue to provide solutions that achieve interoperability as technology is catching up," shares Romero. "We work with many vendors and manufactures to develop a seamless workflow to get alarms and notifications to the right person at the right time, prioritizing patient care with every solution... Using an end-to-end approach of consultation, discovery, optimization and implementation we can really partner with facilities to bring these solutions now."
"Christina is right! I am proud to say that our team has been thinking this way for a long time - keeping units quiter and helping to alleviate alarm fatigue," shares Cinzia Chadderdon, Senior Clinical Design & Implementation Specialist out of our Rochester, NY location.
"That is the unqiue value behind Ronco as healthcare systems integrators," explains Dodge. "As Lean consultants, we apply clinical best practices to align strategy to technology. We work to close any potentially critical gaps and eliminate disruptions to ensure a safer environment. In a way, you can say that we've been working around these 'device roadblocks' for years now."
"A great example would be the integrations we did at St. Joseph's Hospital six years ago in Syracuse, NY," adds Chadderdon. "We helped deploy a nurse call solution that integrated directly with a wireless phone system, so that when a patient pushed a nurse call button, the call was directed to the assigned nurse rather than ringing on the console. It completely transformed their ED." Read the Case Study Here >
Chadderdon closes by saying, "Knowing that the industry is looking to standardize this from a technology standpoint just cements the fact that we are forward-thinking with this process from a design aspect."
Check back for more feedback from our team on what's happening in the healthcare space!
¹Arora, N., & Laha, S. K. (2018). The Beginner's Guide to Intensive Care A Handbook for Junior Doctors and Allied Professionals. Boca Raton, Fl: Taylor & Francis Group, LLC. Retrieved May 28, 2020, from https://s3.amazonaws.com/academia.edu.documents/61093098/The_Beginners_Guide_to_Intensive_Care-A_Handbook_for_Junior_Doctors_and_Allied_Professionals__2e20191101-80347-1ry3ym6.pdf?response-content-disposition=inline%3B%20filename%3DTHE_BEGINNERS_GUIDE_TO_