The Role Of Technology And Patients In Patient Safety

By Peter Ziese, MD, Head of Strategy, Philips Patient Care and Monitoring Solutions

Patient safety has been a key priority for all healthcare stakeholders and remains a challenge for the industry. Hospital errors remain the third leading cause of death in the United States, and while organizations have made efforts to decrease medical errors, a recent study showed that one in six hospitals have higher infection rates than expected when it comes to central line infections. The problem is further compounded by the fact that care has expanded beyond the four walls of the hospital and into the home. Research also shows that 15 to 25 percent of discharged patients will be readmitted to the hospital within 30 days or less.

Patient safety is no longer just a problem within the hospital; it’s an issue that impacts the entire health continuum, from healthy living and prevention, to diagnosis, treatment and home care. While the challenge is ongoing, making changes within the hospital alone will not solve the problem. Providers have to turn to the power of health technology to find longer-term, sustainable ways to tackle preventable deaths caused from patient safety issues. Here are some ways that providers can leverage health technology:

• Detect Problems Before They Escalate — Earlier detection and intervention is a critical tool for improving patient safety. Clinical Decision Support is centered on patient data that supports predictive and preventative care. On average, there are 40 percent more unexpected deaths in the general ward than other units, and are often a result of a problem that went undetected for an extended period of time. Many times, subtle signs of deterioration are present 6-8 hours before the adverse event, but are generally missed in random spot checks. For example, a hospitalized patient suffering from chronic lung disease has a higher risk of developing sepsis, and may show early signs of distress such as changes in body temperature or respiration rate. If these symptoms are caught early, clinicians can prevent the infection from turning into sepsis or septic shock. Today, measuring with patient vital signs and combining these with other patient data via smart algorithms allow for early identification, enabling clinicians to intervene and provide timely treatment.

• Use Non-Invasive Tools to Reduce Infections — Today, one in 25 patients in the U.S. suffer from hospital acquired infections, and while there are several points of contact where a patient can be vulnerable, hospitals can control the use of invasive technologies. Take the example of ventilation – typically, during intubation, the tube bypasses the nose, throat and tonsils, and delivers air straight into the trachea, exposing the lung directly to a potential infection. A non-invasive ventilation uses a mask that is simply placed on the nose, limiting exposure to infections. It also reduces patients’ dependency on the ventilator, avoiding sedation and allowing them to breathe on their own, mobilize and potentially recover faster.

• Improve Clinician Workflow With Data — A key patient safety concern is alarm fatigue. On an average, clinicians are exposed to hundreds of alarms within an hour, ranging from patient calls, monitor alarms, battery changes, etc. and it is difficult for a single nurse or clinician to be able to respond to all of these alarms at one time. Technologies that can help clinicians triage and prioritize alarms are critical to enhance patient safety. By setting smarter alarm limits, clinicians can reduce non-actionable alarms, drastically decreasing stress for both patients and clinical staff. Furthermore, early warning scoring (EWS) technologies navigate a number of real-time patient vital signs – blood pressure, heart rate, respiratory rate and body temperature – and produce a single benchmark that alerts clinicians if the patient is showing signs of distress. Instead of managing several separate alarms, the clinician could rely and prioritize on a single alarm. Mobility can further enhance the use of these technologies to improve clinician workflow. By allowing clinicians to access and respond to these alerts on the go, it can further support earlier response and intervention.

• Connect Care to Bring Safety to the Home — As more care moves into the home, remote monitoring technologies are continuing to play a critical role in home monitoring, potentially preventing readmissions. For example, upon discharge, a patient may wear a connected sensor to ensure their vital signs are being monitored regularly. If a few days after discharge, the patient begins to show signs of respiratory distress, clinicians at the hospitals may be alerted. A nurse could then proactively call the patient to address their breathing problem or schedule a quick check-up. This may not only improve the patient’s chances of a full and timely recovery, but may also prevent readmissions and further cost to the patient and hospital.

While technologies are the driving force behind improving patient safety, success also depends on the patients’ engagement in their own care. We are continuing to see improvements in providers’ efforts to engage and keep their patients more informed and at the same time, patients are also taking a more proactive approach by focusing on prevention and learning about their risks. To make a real dent on improving patient safety numbers, providers, patients and other healthcare stakeholders will have to work together. There may be a long way to go, but with access to the right technologies, more awareness and patient engagement, the healthcare industry is geared for success.