Clinical Systems Integration with Alarm Notification

The use of an appropriate mode of communication among the multidisciplinary care team members regarding coordination of care is an extremely complicated yet important patient safety initiative. Effective communication among the team members (nursing staff, medical staff, respiratory therapists, rehabilitation therapists, patient-family services team, etc.) becomes essential to develop a culture of trust and collaboration to deliver the highest quality care to patients are their families.

The inpatient post-acute pediatrics, where children and their caregivers come for continuity of care, is no exception to the increasing use of text messages as a means to communication among clinicians. One such platform is the Vocera Communications (Vocera Smart Mobile App called Vocera Edge) that allows the teams to use the application and share sensitive patient information through an encrypted platform using IOS company-provided shared and assigned mobile devices. This poster discusses the quality initiative of implementing the transition from Vocera Smartbage to Vocera Edge Mobile App, technology advantage, using case expansion and lessons learned about a secure alternative modality that allows sending and receiving secure text messages in a pediatric post-acute setting using an IOS device.

This implementation process included all direct care staff, ancillary teams, and administrative teams on the clinical units. Our institution launched this transition from voice prompted hands-free Vocera Smartbage to Vocera Edge mobile-based app for secure care team texting using a big bang approach during the first PDSA cycle. The pre- and post-implementation data was gathered using a qualitative survey of about 500 multidisciplinary team members to determine the ease of use of the application and its efficiency in care coordination. The technology was further expanded in its use by implementing clinical alerts and alarms notification using middleware integration with patient monitoring (Masimo) and life safety (nurse call) systems. Additional use of the smart mobile iPhone use include pushing out apps like Lexicomp and Up to Date to have it readily available for users for evident-based practice in medication and disease management.

A secure texting option using a mobile device is a safe and efficient mode for care team communication and collaboration using technology in real time. This allows for the settings like post-acute pediatric care areas to be in line with the widespread use of mobile apps and technology our mainstream healthcare. The results show an overall number of non-actionable alarms on the clinical units decreased over a 4-month period. We noticed an increased collaboration among medicine, nursing, and respiratory therapy. Successful implementation of the communication system occurred in a shared and assigned model with all of the multidisciplinary teams in our pediatric post-acute setting. In just a 3-month period post implementation, we noticed a 14% increase in from 7,993 messages in 6 days in December 2020, to 9,116 messages in March 2021. This confirmed that all clinical and non-clinical teams were using this mode of communication for coordinating the care for their patients. System generated data analytics used in addition to the pre- and post implementation staff survey for process evaluation.