Guest Column | May 16, 2019

4 Ways Hospitals Use Clinical Surveillance To Improve Patient Safety

By Karen Biesack, VigiLanz

Focus On True Cost Of Patient Recruitment

Patient safety problems, from hospital-acquired infections to medical errors, occur much too frequently. This year, 800 hospitals will incur reimbursement penalties from Medicare because of high rates of infections and patient injuries, and a recent Johns Hopkins study found that medical errors are the third leading cause of death in the U.S. after heart disease and cancer.

EMRs are a step in the right direction when it comes to curbing safety-related problems. They enable more thorough data capture that can reveal safety issues or potential problems. But healthcare providers need more help in meeting their safety-related objectives. More specifically, they need safety-specific alerts that are sent to them automatically, in near real-time.

More and more hospitals are recognizing that the solution lies in clinical surveillance technology, which pulls information from EMRs and other data sources, sorts and analyzes the information, and when appropriate, sends alerts back to providers.

In fact, 80 percent of healthcare executives say investing in clinical surveillance technology is a high or medium priority at their organizations over the next two years, and 92 percent say it improves care quality, according to a recent survey of 100 hospital executives by healthcare consultancy Sage Growth Partners. When asked to identify the top uses of clinical surveillance technology, “implementing patient safety alerts” was one of the most common responses.

Here’s a closer look at four areas of patient safety in which clinical surveillance is having a significant impact.

  1. Improving opioid stewardship. Each day, more than 130 people die of opioid overdoses, according to the CDC, and opioid prescription abuse and dependence is a key factor. About 25 percent of patients prescribed opioids for chronic pain misuse them, according to the National Institute on Drug Abuse.

Clinical surveillance technology is helping providers address this problem. For example, the technology can alert physicians and pharmacists if a safety issue arises, such as if a patient is prescribed multiple opioids or has been taking an opioid longer than recommended.

Houston Methodist hospital is using clinical surveillance to identify duplicate opioid orders and high areas of prescribing. In an internal study, the hospital found that opioid alerts sent by its clinical surveillance system led to the discontinuation of opioids 53 percent of the time.

  1. Reducing acute-kidney injuries (AKIs). One of the most common patient safety issues is adverse events, or unintended harm due to medical care. Patients experience these events in 30 percent of hospital admissions, according to Health Affairs.

AKI is an adverse event that can result from nephrotoxic medication exposure. To address this problem, Cincinnati Children’s Hospital Medical Center created a complex algorithm to identify patients at risk. The program has led to a 40 percent reduction in AKIs.

The hospital uses clinical surveillance technology to support the program by monitoring patient data with a complex set of exposure criteria, alerting providers in near real-time if a patient has been exposed to nephrotoxins, and letting providers know if injury occurs.

  1. Preventing sepsis. Hospital-acquired infections and disease outbreaks are a critical hospital safety problem, with one out of every 25 patients developing an infection while in the hospital, according to The Leapfrog Group. Sepsis is one of the most deadly infections, affecting one out of every three patients who die in the hospital, according to the CDC.

Clinical surveillance is helping hospitals intervene before sepsis occurs and identify sepsis patients earlier. For example, hospitals can create unique surveillance rules that monitor patients for sepsis risk, and alert providers if the risk increases. Some clinical surveillance solutions also automatically create sepsis reports, so providers can more easily review cases and identify ways to act more proactively in the future.

  1. Enhancing safety surveillance and event reporting. In order to implement safety improvements, hospitals must know when safety problems arise, where they occur most often, and encourage a culture of voluntary event reporting. Effective clinical surveillance solutions can automatically sort data and reports for keywords and information that indicate and document when patient safety-related events occur. This ensures staff time is spent optimizing patient safety in the hospital, rather than attempting to sort data to identify where and when problems occur.

Clinical surveillance can lead to significant improvements for hospitals, but not all solutions are equal. Hospitals must look for solutions that allow them to create customized rules based on their needs, coordinate with EMRs, provide support from a clinical team on the vendor’s side, and pull information from the EMR and other data sources in near real time.

Once hospitals invest in this type of solution, they will experience improved patient care and financial returns. In fact, 80 percent of executives who responded to the Sage Growth Partners survey said clinical surveillance delivers investment returns. Much of that ROI can be attributed to higher reimbursement under value-based payment models and reduced costs due to improved efficiencies for staff and physicians.

About The Author

Karen Biesack, RHIA, CPHQ, is the Senior Quality and Safety Specialist at VigiLanz Corporation, a clinical surveillance provider, and was involved in developing the Dynamic Safety Surveillance system at VigiLanz. Biesack’s more than 30 years in healthcare give her the perspective to understand exactly what healthcare professionals need to effectively monitor quality and safety.