By Jordan Messler, MD, SFHM, FACP, Chief Medical Officer, Glytec
LinkedIn: Jordan Messler, MD, SFHM, FACP
X: @Glytec
Health systems never stop looking for opportunities to improve patient safety. Yet, seizing these opportunities is not always easy. Despite decades of research linking patient safety measures to improved financial and clinical outcomes, hospitals often struggle to streamline inefficient workflows at the root of many harmful patient safety events.
Efforts have been made to develop and implement process improvement projects that lead to better patient outcomes, but substantial barriers — from the inherent complexity of healthcare, to a culture that’s deliberately slow and cautious about adopting new things – makes long-term and lasting change extremely difficult. With 70% of process improvement projects across industries failing, hospitals need to pursue solutions that can more readily deliver the change health systems seek.
One way to successfully complete process improvement projects is to supplement the initiatives with decision support technology. Enhancing improvement projects with technology can in turn help hospitals make advancements in patient safety. Here are a few prescriptive steps health systems can take to ensure that clinical decision support technology enables them to advance the change they seek.
Using Real-Time Data to Enhance Patient Care in the Moment
Data is the cornerstone of decision-making in the hospital, and the democratization of data is especially critical for clinical decision support technology. According to the World Health Organization (WHO), more than 50% of patient harm is preventable, reinforcing the industry’s understanding that accurate data is the key to driving patient safety reforms.
Between staff handovers, fast-evolving medical situations, and complex patient needs, real-time data can help clinicians promptly make patient decisions. Without immediate access to accurate data, clinical decision support software cannot complete the job it was designed to do.
Hospitals need to ensure they have robust processes in place to manage the steady collection of data, as well as methods for disseminating that data to different areas of a hospital that will find it useful. In addition to real-time data access that improves patient outcomes in the moment, retrospective reports will also enable health systems to measure the impact of initiatives and determine what is working at a particular facility.
Leveraging Retrospective Reports to Determine Success
Once a hospital has the right data in place to sustain its clinical decision support technology, it must ensure the insights gathered from that data are being used and presented in meaningful ways. The industry has struggled with this since the advent of electronic health records and the passage of the HITECH Act in 2009. For example according to HIMSS analysis, with most health systems using more than 10 EHRs, multiple or incomplete patient records are common. This creates data silos and leaves critical patient information inaccessible to the full care team.
To address these problems, health systems need a thoughtful approach about presenting critical patient data in the right places, to the right people, at the right time. One way to do this is by enabling retrospective reports to better understand how different staff use the technology, and where, when, and how to present data that supports specific process improvement goals. For example, presenting data that provides real-time clinical decision support for insulin dosing in a way that works best with nursing and physician workflows would have a positive impact towards achieving the goals of a process improvement project built around glycemic management. Another strategy to consider is aggregating the most useful data into simplified patient dashboards to ensure clinicians have access to the actionable insights they need to drive change and outcomes that celebrate wins and opportunities to improve.
The Role of Formal Reporting Measures
The work cannot be done solely at the hospital level. Comprehensive federal reporting measures will encourage the promotion of patient safety initiatives and improvements in care. One area where there is room for improvement is the management of blood glucose data. Keeping patients’ blood glucose in the desired range is critical for patient safety and can have measurable impacts on length of stay, readmissions and overall outcomes. Despite this fact, nearly 60% of hospitals do not have automated methods to collect and analyze blood glucose data. Hospitals can’t improve what they can’t measure. This is precisely why the Centers for Medicare and Medicaid Services (CMS) is implementing new measures for hospitals to report rates of severe hyperglycemia and preventable hypoglycemia. The key to improving patient safety and outcomes is to expose this data and be more transparent.
Long-term transformation of processes can be resource-intensive – and that’s why they often fail. But healthcare IT leaders are in a position to make sure the broader goals of their hospital or health system are met by using technology to guide them. Using data and clinical decision support technology in the right way can be the most powerful tool hospitals have for driving lasting change that matters.