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PatientNet Users Group Meeting April 18-19, 2002 Presentation By: Sharon Meadowcroft, BSN, RN Vice President Patient Care Services Iowa Heart Hospital at Mercy Terri Hockins, BGS, RNC Director, 9 South and Central Telemetry Coleen Waage, BSN, RN Director, W3 Cardiovascular Care
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PatientNet Users Group MeetingApril 18-19, 2002 Presentation By: Sharon Meadowcroft, BSN, RN Vice President Patient Care Services Iowa Heart Hospital at Mercy Terri Hockins, BGS, RNC Director, 9 South and Central Telemetry Coleen Waage, BSN, RN Director, W3 Cardiovascular Care
Mercy at a Glance • 931 bed acute care, not-for-profit, Catholic Medical Center located on three Des Moines campuses • Maintains a network of healthcare facilities in 14 rural communities in Central Iowa • Maintains 23 family practice and specialty clinics throughout the Des Moines metro area
Mercy at a Glance • Oldest hospital in Des Moines, founded by the Sisters of Mercy in 1893 • Member of Catholic Health Initiatives, Denver, Colorado and Mercy Health Network • Accredited by the Joint Commission for Accreditation of Healthcare Organizations
Mercy at a Glance • Employs 4,270 people • Medical staff of 770 physicians and allied health professionals • One of Midwest’s major referral centers, offering only private rooms
Iowa Heart Hospital at Mercy Cardiac Service Line 2001 Volumes • 169 Beds Dedicated to Heart Care • 1,916 Open Heart Surgery Cases • 4,697 Cath Lab Diagnostic Cases • 466 Electrophysiology Cases • 207 Ablation Cases • 152 Internal Cardiac Defibrillators • 425 Permanent Pacemakers
Cardiac Service Line • 48+% Heart Inpatient Market Share – 3 County Area • CHF Case Management, Outpatient Infusion Clinic, and Tele-management Program • Automatic External Defibrillator (AED) Program in-house • Women’s Heart Program • National Registries • STS • NRCPR • GWTG • Chest Pain Center in E.D.
Telemetry Project Implementation • History • Timeline • Project Goals
Centralized Telemetry Initiative Project Goals Set and Achieved: • Position Mercy for the future by upgrading technology • Meet FCC regulations requiring dedicated medical band radio frequency • Centralize Monitoring Center for increased efficiency, quality of service and for positioning to expand service • Provide telemetry availability to all Med-Surg floors in order to improve patient placement options • Expand number of monitored lines to 160 • Offer Telemetry Monitoring to remote sites
Our Conversion from Decentralized to a Centralized Telemetry Monitoring System Terri Hockins, BGS, RNC Director, 9 South and Central Telemetry
Our Conversion from Decentralized to a Centralized Telemetry Monitoring System • Project Leader • Phase I – Traditional Telemetry • Phase II – Remote Non-traditional Telemetry • Phase III – Remote Telemetry to our Affiliate Hospitals
Communication Challenges The biggest fears addressed: • Pagers • Introduced new pagers to one floor at a time. • Introduced the pagers a few months before the “GO Live” • Web Browser • Phones • Education
Critical Success FactorsLessons Learned • Met with each group frequently and asked about their concerns and ideas. • Included nurses and scope techs on a site visit to see systems in operation. • Utilize everyone’s expertise. • Involve Information Technologists and Clinical Engineering
Using V Link on a Post Cath Lab Unit Coleen Waage, Director W3 Cardiovascular Care
Post Cath Lab Unit (West 3 Cardiovascular Care Unit) • 18 Cardiovascular care beds • Telemetry beds • Patient/s come from the Cath Lab with Arterial Lines in place
Patients are attached to Pro Pak Portable Monitors • Arterial Wave Form -- • viewed in the room and at the nurses’ station on W3CC • Interfaces with Centralized Telemetry • also viewed by the Scope Techs • On Arrival: • Patient is placed on a transmitter and monitored by the centralized telemetry system and W3CC viewing system • EKG • Arterial Line
Remote viewing station • Interactive to allow nursing staff to adjust alarm parameters as Arterial Line wave forms fluctuate. • This helps to reduces multiple alarms to the Centralized Scope Room
Communication / Staff Education / Challenges • Staff on W3CC concerned with giving up autonomy • did not see full value of having Scope Techs
On the Patient Care Area • W3CC staff had no previous interaction with Scope Techs • Staff had to adjust to new paging system • W3CC staff had to learn to communicate with Scope Techs about the patient’s activities
At Central Scope Room • Scope Techs needed to understand about post cath lab patient care • Scope techs had to establish credibility with the W3CC staff as knowledgeable in cardiac rhythms • Scope Techs had never monitored Arterial Lines
General Issues – Both Groups • Development of trust relationships between both groups • Assurance of the value of each group to the patient care
Future Developments and Goals • Expand to remote site hospital with 8 lines • Explore expansion to network rural hospitals • Establish outcome database with reports • Establish indicators for cost, quality, and service