Can High Tech Save Your Life?
It just might: Computer use in hospitals is now linked to lower death rates
Poudre Valley Hospital in Fort Collins, Colo., one of the 100 Most Wired, learned this firsthand when it introduced electronic patient records into its emergency department. "The screens didn't fit how the doctors and nurses worked. They wanted to note vital signs about a trauma patient's condition, but the first screens were asking about next of kin and insurance information," says Craig Luzinski, the chief nursing officer. "There's a standard protocol for stabilizing a patient: Check the airway, then breathing, then circulation. But the circulation screen popped up first. So people just didn't use the system." That's not good if the goal is to input treatment info that will follow the patient through the hospital so other caregivers can use it to make better decisions later on. "It took us a few days to get it to the point where the docs were happy. And now they all use it."
Use of electronic health records by most staff, in most situations, is one factor that distinguishes the 100 Most Wired and may play into better outcomes. "It's not the technology but the culture of using it and getting everyone to buy into that," says physician Scott Thompson, vice president for medical operations at Aurora St. Luke's, another hospital on the Wired list. If a nurse administers an antibiotic, the timing has to be noted in the computer so Rein, over in the eICU, can call up the chart and see whether the patient's heart rate has changed because the patient is still fighting an infection and the drug isn't helping. So the St. Luke's system prompts staff to enter the time a drug was given, and places computers so staff have easy access.
Poudre Valley made sure nurses and doctors are part of the technology committee, so they can quickly spot and fix glitches like the ones that cropped up in the emergency department. And Luzinski's hallways are lined with wireless COW s, or computers-on-wheels, so staff can update records while tending to a patient, as well as get reminders of "best practices" for treatment.
A hospital does not have to be wired to make this effort, of course. Metropolitan Hospital in Grand Rapids, Mich., is not on the list of 100, yet it is one of the nation's leaders in medication safety. "We've done a lot of things with staff education," says Pete Haverkamp, the director of pharmacy services. "But we also cut out distractions for pharmacists. We put colored tape on the floor around the area where they check orders. It signals everyone else to leave them alone." The percentage of patients with problems due to improper narcotic or sedative orders dropped, within a year, to zero. And the place is so unwired that the tape wasn't even electrical.
More information on the Most Wired Hospitals appears at usnews.com/wired .