The patient tracking and operating room management system, which was developed as part of a surgical centre redesign project, follows each patient to each point of care, from admission until they are checked out of the hospital. As surgery patients enter the hospital doors, medical centre employees known as "greeters" log them into the system using a wireless iPAQ Pocket PC, immediately notifying each station in the surgical care cycle that the patient has arrived. By accessing the surgical schedule, the greeter is also aware of the time that the patient's surgery is scheduled, which operating room is to be used, and who the patient's doctor is. This information allows the greeter to get the patient to the correct area of the hospital to be prepared for surgery.
Once the patient is logged into the system, the medical staff updates the patient's status as they proceed through pre-op, the surgery itself, the recovery room, the move into the patient room and continuing until the patient leaves the hospital. Constant updating of the patient's records ensures that doctors and nurses get the latest information on the patient's location, condition, and the progress of their treatment.
The capabilities of the iPAQ Pocket PC bring advantages over other handheld devices in meeting the requirements of the Health Care Insurance Portability and Accountability Act (HIPAA), federally mandated regulations that take effect in 2003 governing the privacy of medical records and patient information. The iPAQ has the capacity and capability for secure, wireless exchange of patient information through an Intranet Web browser between the care provider and Vanderbilt's systems. Wireless Intranet Web access will comply with HIPAA regulations and avoids the need to actually store patient data on the iPAQ Pocket PC itself, a big plus for confidentiality and data retention, should one of the devices were to be damaged, lost, or stolen.
According to Dr. Michael Higgins, an anaesthesiologist and vice chairman for Adult Perioperative Services at Vanderbilt, getting surgery patients into the tracking system quickly is key to keeping the process moving efficiently. "Our research showed that a number of our surgery patients were late going into surgery because they simply were not where they needed to be when they needed to be there", Dr. Higgins stated. "We discovered that most of the delayed patients were actually at the medical centre on time, but had simply gone to the wrong waiting area or otherwise could not be located right away."
Dr. Higgins noted that using the new system, greeters enter information on exactly where pre-op nurses can go to find the patient. According to Dr. Higgins, that improvement alone has reduced the level of delayed patients by more than ninety percent. "All of that is good for the hospital's bottom line and means better care for the patient", added Dr. Higgins. "But there is a terrific intangible benefit as well: our patients are greeted by name at the door and everywhere they are taken upon admission. Compare that to having to re-introduce yourself at each stop along the way and wondering if you are even in the right place. On the day of his or her surgery, every patient wants to feel like they are special. This system helps us make the patient feel exactly that way."
Operating rooms are the single largest source of revenue for most hospitals. Getting surgical patients into the operating room and into recovery in a timely fashion means more efficient use of the operating room, maximising return. Vanderbilt's new system even helps cleaning crews be better prepared to move in quickly to clean and prepare both the operating and recovery rooms for the next patient. This level of efficiency reduces overtime costs for operating room staff that otherwise would have to stay late to complete procedures. These efficiencies are realised all the way into the hospital room.
The new system has also increased patient satisfaction by keeping waiting to a minimum. In addition to all of that, the programme can better serve referring physicians and communicate with them at critical times in their patients' care. Goals of the surgical system redesign project were to improve the delivery of patient care, to maximise patient safety by making up-to-the minute information on the patient's status available to physicians and nurses at the moment and point-of-care, and to improve efficiency in the use of the centre's operating rooms.
"Vanderbilt's surgical patient and operating room management system is an excellent example of the sophistication and yet the simplicity of the iPAQ Pocket PC", stated Jim Weynand, Compaq vice president, government and education markets. "It is sophisticated enough to handle critical tasks, yet simple enough to operate that it can be easily used by workers whose primary skill sets lie in a different area." Physicians at Vanderbilt say the success of the surgical model has prompted them to begin investigating ways to expand the patient information and tracking system to other areas within the medical centre.
Vanderbilt University Medical Center has built a strong reputation as a leader in medical education, research, and patient care throughout the Southeast and the nation over the course of its 127-year history. The medical centre includes Vanderbilt Hospital, Vanderbilt Children's Hospital, Vanderbilt School of Medicine, and the Vanderbilt School of Nursing. Each year, VUMC physicians treat 32.000 inpatient admissions in its hospitals and treat over 800.000 adult and paediatric patients in its outpatient clinics. At its heart, Vanderbilt University Medical Center is driven by discovery and the immediate incorporation of new knowledge into innovation in patient care and physician and nurse education.