Using technology to improve patient care

Abstract

The current severe shortage of health care workers contributes to an ongoing crisis in medical care that has many consequences, not the least of which is our society’s ability to meet the health care needs of a growing and aging population. The shortage of qualified personnel has a direct impact on the ability of nurses to provide an appropriate level of care in all patient settings. One of the symptoms of this crisis is the increased number of medical errors that occur as stressed caregivers try to manage increasingly complex patient situations with inadequate resources and at high levels of fatigue. Technology holds the promise of alleviating some of these problems. To Err Is Human is the first of 2 reports produced by the Institute of Medicine (IOM) that brought attention to the extraordinary number of patients who die each year as a result of medical and health care management errors. The IOM identified a 4-tiered approach to address these errors, including creating safety systems inside health care organizations through the implementation of safe practices at the delivery level. The importance of information availability at the point-of-patient care was also highlighted. In its second report, Crossing the Quality Chasm, the IOM identified the critical role that technology can provide in promoting patient safety. In summary, the IOM reports recommended better use of human resources and the need to provide health care professionals with appropriate technology to deliver more information at the point-ofpatient care. Another recent report, In Our Hands, by the American Hospital Association’s Commission on Workforce for Hospitals and Health Systems, offers 5 recommendations for health care providers to embrace: ● Foster meaningful work ● Improve workplace partnerships ● Diversify the workforce relative to the general population ● Collaborate with other health care providers ● Build societal support Technological solutions at the point-of-patient care can assist health care organizations in meeting these recommendations. Implementing technologies designed to enhance patient safety and improve nursing efficiency may help health care organizations recruit and retain qualified professionals from a shrinking workforce. Health care organizations that demonstrate enhanced safety, efficiency, and user satisfaction are typically viewed as the employer of choice within the community. Reducing adverse drug events, enhancing clinical decision making, improving productivity, augmenting skills of staff, promoting improved documentation, and providing better communication can positively impact and aid health care organizations in their recruitment and retention strategies. Health care is in dire need of technology that can manage the tasks and activities that disrupt, interrupt, and remove the nurse from providing direct patient care. Too often, the indirect patient care activities lead to nurses’ frustration and dissatisfaction with the profession and health care environment. The increasing amount of time nurses spend on indirect patient care activities must come at the cost of sacrificing some level of patient care. A short but comprehensive list includes change-ofshift or new patient-admission reporting, verification of medication orders, preparation of medications, charting, added paperwork (missing patient-care items, incident reports, environmental work requests, forms, etc.), telephone follow-up (to include orders or test results), dietary ordering, procedure scheduling, patient transportation, housekeeping, ordering and restocking supplies, retrieval of critical items needed on the nursing unit, discharge planning, education, competency training and certification, and communication with the multidisciplinary team, family members, and visitors. Nursing shortages have exacerbated this already untenable situation by shifting responsibilities that were once the province of charge nurses and other supervisory positions (eg, bed flow, patient admissions, and staffing) to staff nurses. Communication and information technologies provide the means to remove these functions from the nurses’ to-do list and allow nurses more time with their patients. Existing nonautomated direct patient care activities also must be reviewed and redesigned with technological solutions that enhance safety, efficiency, and effectiveness. The need for technology is clearly evident in a variety of patient-care activities, including medication administration, laboratory draws, Margie Sipe, Jannie Marthinsen, James Baker, Janet Harris, and Janis Opperman are professional associates for the Pyxis Corporation, San Diego, California.