9 reasons why providers need a clinical surveillance program

9 reasons why providers need a clinical surveillance program

While continuous clinical surveillance of patients in the intensive care unit is common, there is a good argument for extending continuous monitoring of patients in units such as med-surg, critical care, step-down and telemetry, according to Bernoulli Health, vendor of a real-time medical device data and patient safety surveillance platform that uses real-time patient data to form actionable insights. In a new report, the company walks through the ways technology-assisted clinical surveillance increases safety, lowers costs and offers timely and accurate clinical decision support to identify patients who are developing problems.

Recognize crisis early

An inability to recognize early onset of hospital-acquired conditions is the most significant business and clinical challenge facing the healthcare industry, according to Bernoulli. Opioid-induced respiratory depression accounts for more than half of medication-related deaths, yet published research finds nearly all cases of respiratory compromise could be prevented with appropriate surveillance practices.

Improve vital signs checks

Improved monitoring processes, training and use of screening tools can reduce adverse outcomes from hospital-acquired conditions. However, common practices such as episodic vital signs collection can leave patients unmonitored as much as 96 percent of the time during hospital stays. These spot vitals checks result in data gaps that don’t capture important vital signs activity that take place in seconds or minutes with some patients.

Get updates of current conditions

The Centers for Medicare and Medicaid Services and the Joint Commission, among other entities, recommend continuous surveillance as a best practice to assess a patient’s current condition in real time and identify signs of deterioration before emergency intervention is necessary. There’s an increasing amount of literature that supports surveillance for all patients, not just those who are in high-acuity settings. For many healthcare systems, a surveillance program can be achievable with modest new technology investments backed by the electronic health record as the center of the program.

Get quicker answers

In contrast to electronic monitoring, continuous surveillance detects physiological changes in patients early, interprets clinical implications of the changes to provide an estimate of whether the patient’s condition will get worse over time, and alerts clinicians so they can rapidly intervene if necessary.

Understand the EHR's role

The electronic health record is the foundation of an approach to developing a surveillance program. The EHR is a natural starting point because it stores data on patients that are relatively static, such as history, observations and treatment, rather than moment-to-moment changes. Clinical surveillance and analytics can collect and aggregate retrospective data from the EHR, such as demographics and lab values, and correlate it with real-time streaming data that includes temperature, heart rate, oxygenation levels and blood pressure.

Address alarm fatigue

The big challenge for alarm management is separating clinically relevant alarms from non-actionable alarms—many of the latter require no intervention, yet these alarms can still overwhelm clinicians. Bernoulli suggests use of “smart alarms” that reduce the effect of alarm signals to achieve a balance between communicating patient-specific safety information and minimizing non-emergent events that do not represent a threat to patient safety.

Stop drowning in data

Continuous monitoring from multiple data sources including the EHR, as well as from EKGs, vital signs and lab tests, among others, will deliver better predictive models. However, at the same time, it is easy to drown in all that information. Analytics can find interrelationships that seem to be unrelated measures and data sources to detect the onset of an adverse event that would normally not be visible.

Assess affordability

The new technology that comes with a new continuous surveillance program can be relatively inexpensive because hospitals with critical care units already have a continuous surveillance structure in place. However, optimizing the infrastructure’s capability and incorporating it into existing clinical workflows can be challenging.

Enhance decision support

All sources of data, from episodic to real-time, provide a rich source for clinical decision making and are becoming the new tools for clinicians and informaticists. The combination of high-fidelity data with EHR information provides a complete source of objective information on a patient that can be used for predictions and clinical decision making.