Real Data Right Now

Taking vital signs is a mainstay of quality healthcare. It’s also one of the most labor-intensive tasks facing nurses and medical staff, who until now, have taken the information, written it on charts and later transferred it to a patient’s electronic health record. In fact, 35% of a nurse’s time is spent on documentation according to a 2009 report by Marilyn Chow. That’s time that could otherwise be spent with the patient.

That’s changing with Vitals Now, a program that began almost three years ago, was tested at several HCA facilities in Florida and is almost fully deployed across all HCA hospitals. Vitals Now uses technology to electronically register patient vital signs such as temperature, blood pressure, pulse, respiratory rate and other patient data elements right at the bedside, saving the writing and transcription time the process has historically involved.

Savings in Many Areas

In addition to reducing time spent on the collection process, it also makes a patient’s data quickly available to doctors, nurses and others, so its’ a double win, says Kelly Aldrich, RN, DNP, Informatics Nurse Specialist and Director of Nursing Informatics with HCA’s Clinical Services Group.

The technology sits atop the blood-pressure machine and transmits data wirelessly into the MediTech system as it is captured. This means that as a physician is doing rounds, or a nurse is passing out medication, a patient’s vital signs are available to them so that they can see what’s going on right then. That’s a major advance on many levels.

“Vitals Now is a relevant and impressive use of technology at the patients bedside,” Aldrich says. “It began when we looked at a publication of evidence of what nurses do with their time that was adopted by the HCA CNO Council. The study followed more than 750 nurses around for 22,000 hours, and found that 35 percent of their time was spent on documentation. That’s a huge amount, and it got our attention.”

A collaborative team of clinical and IT professionals began looking at ways to bring more efficiency, satisfaction and accuracy to the recordkeeping process by automating vital signs capture at the bedside, in real time, within the non-critical care environment and tie it seamlessly into the electronic patient record. Then nurses were asked to step in and vet the available options.

“We have brought a lot of technology efficiencies to critical care, but in the medical-surgical care environment it is more complicated as we rely on wireless technology and innovative concepts not yet standard in healthcare informatics; we were committed to this concept,” Dr. Aldrich said. “We had four vendors come to HCA’s corporate offices, and we sent out one email to local hospitals asking them if they were interested in vital signs solutions for medical-surgical care environments. We had 160 people show up. The nurses took scorecards and interviewed the vendors, and picked the solution that has become Vitals Now. Clinicians partnering with our IT team allowed for the right technology solution to solve the workflow needs of the nurses as a team approach.”

Faster Response Times

“We call them ‘vitals’ for a reason,” notes Dr. Aldrich. “Everyone in healthcare coordinates patient care around their vital signs. Because we now have that information in real time, we have been able to modify our early warning system, which alerts us to patients who are clinically deteriorating, by as much as 6.5 hours. We’re hearing from a lot of facilities about how Vitals Now is saving patients from negative outcomes because the real-time data transmission is allowing for earlier intervention.”

Vitals Now is saving staff about an hour a day that used to be spent writing vitals on paper, and then transferring that information to charts and eventually into Meditech? At a cost of $15 million the project has been expensive, but Dr. Aldrich says the time savings, as well as the boost in effective patient care, has more than allowed for those funds to be recaptured.

“It’s really been something that was done by and for HCA employees,” she says. “The nurses picked it, they led it and it’s all based on evidence gained from the care environment. Our IT partners handled all the tech infrastructure, hardware and software of making it happen, and the CNO Council oversaw the deployment. It’s had a positive impact everywhere it’s been implemented. Everyone really recognizes it as a real game-changing solution for how we record patient data.”