#04 - Risk of Harm Tile

May 21 · 05:15 min

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In this Episode:

The Risk of Harm Tile provides visibility to track variations in practice versus hospital defined care plans.

Andy: Hi, this is Andy Day from the Command Center Team.

Today we’re going to talk a little bit about the Risk of Harm Tile from the GE Command Center, which provides visibility to track variations in practice versus hospital defined care plans. Right now, we’re at the Tile Viewer which is our landing page. Whenever you log into our system you land here and can pick from a variety of Tiles depending on your installation.

Today we’re going to talk about Risk of Harm so I’ll click on that. Risk of Harm is patterned off of one of our most popular Tiles, Care Progression. The focus in on a subset of alerts that tie to core measures in quality. Before we dive into the individual alerts, let’s navigate the Tile a little bit. Upper left corner you always see the name of the Tile. And then going across to the upper right corner, you see a little ‘i’ or Info Button, that’s where the legend lives.

In this case, it shows the list of all the alerts that are possible in the Tile. And then to the right of that is the little gear, or the Settings Button, and that’s where you can change the way the Tile appears for you the user, just the way you like it. So you can filter, for example, by alert type. Or by the status of the alert. Or by the locations or units that you’re responsible for, depending what type of user you are. So we’ll come back and play with that in a minute. And then in the bottom left corner, you see this little freshness indicator, the flickering bars going back and forth. That tells us that the data’s been updated within the last thirty seconds.

It’s up to date using real time data entered by your users at the point of care. As we look up into the main body of the Tile, you see three categories of alerts. The first category on the left is called Nursing BPO’s or Nursing Best Practice Alerts.

These are where - there’s certain situations where we’re monitoring nursing standards of care, that the hospital likes to monitor compliance to. And again, when I say monitoring compliance to, this is being done in the EMR, at the point of care, by front line care providers day in and day out. So they know all about it, it’s visible to them. What the Tile does, it extracts that information, makes it more visible broadly to people so everyone else can know what’s going on. Now of course, this data is all mocked, but it’s representative of what we see in the real world. So let’s click on any one of those, which is a patient.

By clicking on a patient, we can see more information about what puts them on the Tile. You can see here examples of pain management, a new pressure entry with a diet referral, etc, etc. Again, in each case, there’s an expected time in which that issue will be resolved based on a service level set by the facility. If it’s taking longer than that, it’ll escalate to amber and then to red indicating a higher level of alert. In the middle category, in this case the client was very interested in seeing all things about non-compliance to their sepsis care plan.

And then the right category, other risks. So for example, where a lab is seen to be displaying as abnormal when there’s no action that’s protocoled and expected by the hospital to happen, being seen in the EMR, we would show that as well. So when you click on any one of these, you can see more information about those patients that are alerting, what’s going on and more details so that you can take action. I mentioned before the ability to filter or apply settings to customize the way the user can see the Tile for what they’re interested in. So let’s try one of those. Let’s say that I’m the owner of the fifth floor, or the MRP for that area, and I want to go in and select 5 East and 5 West, the two units that are on the fifth floor, and then I can hit apply. So now this will just filter the Tile down, just those patients that I’m most interested in, in the area that I’m responsible for.

Alternatively, if I’m a functional user… ... So say for example, I’m a neuro-psych specialist and I’m interested in patients that have been identified as being at risk of delirium, I can go in and apply a filter by alert type, and you’ll look across the whole house to just those patients that are alerting for that. And it’ll allow me to help to create my work list. Now, you see here for example, five patients that are alerting for the delirium situation where there’s an elevated CAM score but we don’t see the delirium order set that we’re expecting to see by protocol when that occurs. So I can dive in and make sure I figure out what’s going on.

So again, this is the Risk of Harm Tile. A Tile that’s based upon the backbone of the Care Progression Tile, and many folks have found helpful in addressing core measures. Thank you for your time. Dr. Vanessa Burkoski: Nursing best practice and the delivery of evidence based care are very important to Humber River Hospital. The Risk of Harm Tile, that is part of wave 2 of our Command Centre implementation, supports nursing best practice.

We have found it to be very helpful in increasing awareness of situations where there is a potential safety threat, if delays in care occur based on hospital defined protocols. Now we have both best practice guidelines and a constant, automatic nudging system to support nurses implementation of evidence based care.

The metrics we derive from this Tile are essential in helping us to sustain and elevate nursing practice.

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