Michael Boroch- SmartRoom: The Naked Truth About Quality and Errors on the Front Line
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Transcript of Michael Boroch- SmartRoom: The Naked Truth About Quality and Errors on the Front Line
SmartRoomTM
The Naked Truth about Quality and Errors on the Front Line
August 26, 2010
Michael Boroch, CEOSmartRoom
Agenda
• Challenges of Caregivers at the
Bedside
• SmartRoomTM Overview and Value
• Questions / Answers
2
Policy vs. Reality
• What should be done and what “does” get done are often two (or more) different things.
• Example: Observed nurses using bar code medication administration and recorded all of the different steps (both actions and sequence of actions)
3
START
Obtain meds
scan self enter pt room
check med vs device
scan self
scan med enter pt room
enter pt room
scan pt ID band
doc admin
give med to pt
scan pt ID band
give med to pt
doc admin
check med vs device
scan med
scan pt ID band
give med to pt
doc admin
scan self
obtain meds
check med vs device scan med
scan med
enter pt room
scan pt ID band
give med to pt
doc admin
doc admin
give med to pt
give med to pt
scan pt ID band
doc admin
doc admin
double check
enter pt room
scan pt ID band
give med to pt
doc admin
doc admin
give med to pt
scan pt ID band
doc admin
enter pt room
give med to pt
double check
scan med
scan pt ID band
give med to pt
doc admin
enter pt room
scan pt ID band
give med to pt
doc admin
enter pt room
scan med
scan pt ID band
doc admin
give med to pt
check med vs device
enter pt room
scan pt ID band
give med to pt
doc admin
enter pt room
scan pt ID band
doc admin
give med to pt
Process of Medication Administration – Task Sequences
Evaluation of Nurse Interaction With Bar Code Medication Administration Technology in the Work EnvironmentCarayon, Wetterneck, Hundt, Ozkaynak, DeSilvey, Ludwig, Ram, Rough, Journal of Patient Safety March 2007 4
Bar Code Medication Admin
There are 4 unsafe pathways and 6 most frequent workarounds
5
START
Obtain meds
scan self enter pt room
check med vs device
scan self
scan med enter pt room
enter pt room
scan pt ID band
doc admin
give med to pt
scan pt ID band
give med to pt
doc admin
check med vs device
scan med
scan pt ID band
give med to pt
doc admin
scan self
obtain meds
check med vs device scan med
scan med
enter pt room
scan pt ID band
give med to pt
doc admin
doc admin
give med to pt
give med to pt
scan pt ID band
doc admin
doc admin
double check
enter pt room
scan pt ID band
give med to pt
doc admin
doc admin
give med to pt
scan pt ID band
doc admin
enter pt room
give med to pt
double check
scan med
scan pt ID band
give med to pt
doc admin
enter pt room
scan pt ID band
give med to pt
doc admin
enter pt room
scan med
scan pt ID band
doc admin
give med to pt
check med vs device
enter pt room
scan pt ID band
give med to pt
doc admin
enter pt room
scan pt ID band
doc admin
give med to pt
Process of Medication Administration – Task Sequences
Bar Code Medication Admin
Healthcare’s Major Problem
Many new innovations, projects, safety devices, computer systems and
improvements require more time and effort on the part of the front line. We
have to stop adding work….we must to find a way to take hard work away and make success easy for the front line.
6
With all the advantages of EMRs, the last mile to improve productivity, reduce errors and improve quality has not been reached.
SmartRoom helps leverage the large EMR investments.
7
Mind Clutter & Distractions
36 Hospital Med/Surg Nursing Time and Motion
Source: A 36-Hospital Time & Motion Study: How Do Medical-Surgical Nurses Spent Their Time? – Hendrich/Chow-The Permanente Journal/ Summer 2008
8
What is SmartRoom
A “smart” patient room that…– Organizes and simplifies the workflow of front-
line staff– Makes retrieving the right patient information at
the right time as simple as walking into the room– Pushes information to direct and indirect
healthcare workers in context of situation - who, what, where
– Solves problems at the point of care
9
SMARTROOM VIDEO
10
Subtraction
• Study – 30 tasks in 10 rooms…– Batch at end of day– Chart between rooms using mobile COW– Chart using Smart Room real time
0
100
200
300
400
500
600
700
Batching Mobile cart Smart Room
589 612
255
57% reduction in time spent
charting + real-time
documentation
57% Reduction in Tasks69% Reduction in ADLs82% Reduction in Vital Signs
11Batching Mobile Cart SmartRoom
SmartRoom Value
Value Drivers Examples of Benefits
Cost Reduction •Real time bedside documentation•Compressed Workflow and dynamically balancing workloads•Reduced OT, Agency Staffing, Turnover and Better Recruiting
Increased Reimbursement
•P4P with Core Measures•Minimize losses from Never Events•HCAHPS Customer Services Reimbursement•Legal fee may reduce as documentation exists
Improved Quality, Outcomes and Decreased Errors
•Tasks done as prescribed and reduced charting errors•More time critical thinking and with patients•Less time at shift report charting and more sharing/educating •Less mis-transcribing numbers
Improved Caregiver & Patient/Family Satisfaction
•More time with patients and less documentation time•More time critical thinking vs. task and documentation•Patient/Family see caregivers more•Wandering management
Perfection is achieved, not when there is nothing left to
add, but when there is nothing left to take away.
-Antoine de Saint-Exupery
13
14
Thank you!