'Smart' patient monitoring needed to improve workflow

In the operating room, a surgeon typically is surrounded by 11 different medical devices, « and they all keep beeping at us, » complains Dr. Martin Schuster at Charité University Hospital in Berlin. «Which one of these alarms is important, » he asks, adding that blood pressure, oxygen saturation and ventillator alerts can sound between 10 and 12 times during each case.

«We need smart alarms, and I know that some manufacturers are sensitive to this problem, but it is really a work-in-progress.» he said.
For example, loud alarms are effective, but only for being turned off more quickly, not because the information is more important. Adding a rising tone for an alarm according to the severity of the patient condition would be smarter, he said.

As for visual alarms, a blinking light is difficult to notice these days when everyting is flashing, but a more useful visual is a graphic display showing a clinician the critical state in relation to the past few minutes.

Responsible for five ORs at Charité Hospital, Dr. Schuster led a presentation on « Patient Monitoring : Friend or Foe of OR Workflow, » at MEDICA Nov 18.
His key theme was the challenge that complexity in the OR presents for productivity, and ultimately for patient safety. « We counted 81 diferent types of medical devices in the Charité OR, » he said, including 15 anesthesia machines, 9 respirators, 16 infusion pumps and 13 cardiovascular monitoring devices, all from different manufacturers.


Yet for any given type of device, the downtime in OR was found to be an average of 40%. Devices dedicated to a single location and the redundancy among devices are two areas where this problems needs to be addressed, he said. Dr. Schuster asks why a patient can not be continually monitored, for example, by the same device throughout the perioperative pathway, a device that is as transportable as the patient.


Integration of devices with hospital information systems would also help anwser the most frequently asked question in the OR, « Where is the next patient? »
Just over 14% of OR time is unused, and half of this is because we do not know where the patient is located, at what state the patient is in preparation., » he said. « Since the patient is connected to a patient monitor in these spaces, why can we not know from this monitor the location and the patient's status? » asks Dr. Schuster. Sometimes it would allow us to improve workflow. Or sometimes it simply would let us know that we can take a break for 15 minutes. »

 

18.11.2009

Read all latest stories

Related articles

Photo

Patient Safety in Anaesthesiology

Step by step, the Helsinki Declaration is being implemented: Great Britain and the Netherlands have made it law. In Germany, it is voluntary.

Report: Susanne Werner

Photo

Human error – or a fault in the system?

Medication errors sit among the top ten causes of harm to patients. They can, of course, occur in any department, but it’s still a surprise that they happen as frequently in anaesthetics…

Photo

Hitachi’s all-in-one data management system

A mix of hardware, software and services, the Hitachi Clinical Repository (HCR) system draws together all patient data from many information sources, thus providing quicker and better use of records.…

Related products

Beckman Coulter – DxONE Command Central Workstation

LIS, Middleware, POCT

Beckman Coulter – DxONE Command Central Workstation

Beckman Coulter, Inc.
Canon – Xario 100G

Ultrasound

Canon – Xario 100G

Canon Medical Systems Europe B.V.
Intermedical – "New" Radius XP with flat panel

Surgical Flat Panel C-Arms

Intermedical – "New" Radius XP with flat panel

INTERMEDICAL SRL
JVC – CCL196

Displays – Color

JVC – CCL196

JVCKENWOOD Deutschland GmbH
JVC – CCL650i2

Displays – Color

JVC – CCL650i2

JVCKENWOOD Deutschland GmbH
JVC – CL-R211

Displays – Color

JVC – CL-R211

JVCKENWOOD Deutschland GmbH
Subscribe to Newsletter