By Benjamin Kanter

By now, it’s well known that communication breakdowns are behind many medical errors that result in serious harm or even fatality to patients. It is safe to assume, then, that improved communication among care team members can help address many of the top patient safety issues facing healthcare organizations today, such as those recently listed by ECRI Institute.

For example, diagnostic stewardship and test result management using EHRs was the number one issue on the Top Patient Safety Concerns for 2019 by ECRI. When abnormal test results are not properly communicated or are not followed up on, serious patient harm may ensue. Yet all too often, lab results languish in the hospital EHR, with clinicians unaware that they’ve been posted. Or perhaps the lab tech calls to report an abnormal result, yet can’t immediately reach the floor nurse on duty. In either scenario, therapy is inevitably delayed, while frustration and dissatisfaction increase.

With 21st century technology, these potentially dangerous situations need not occur. An advanced communications platform can be used to send vital new information directly to a nurse or a care team, who can immediately evaluate the situation and shorten the time to act.

The use of antibiotics offers another instructive example. As communication platforms offer more systems integrations, clinicians can be instantly informed of the latest microbiology results, which is essential for knowing which antibiotic to prescribe, or if one should be prescribed at all. The ability to obtain this lab data in a timely manner, and make sure that the patient is receiving appropriately focused therapy, can help clinicians fight antimicrobial resistance, the number two issue on the ECRI list.

Two additional concerns on the ECRI list, detecting changes in a patient’s condition and early recognition of sepsis, represent different aspects of the same safety challenge: how to alert clinicians of important issues in time for them to act.

Sepsis can quickly deteriorate a patient’s condition, which, in turn, can spur an unanticipated ICU transfer. Patients who are moved to the ICU unexpectedly represent the highest acuity cohort in the hospital — with the most deaths and the highest costs. The ability to save them may come down to a nurse being able to recognize their deterioration within minutes, coupled with the ability to quickly communicate that information to others on the care team.

Communications software has a major role to play here, one that is often under-appreciated. Users of these systems may think of them as tools that increase efficiency, but may not view them as a vital link in accelerating a clinician’s response to emergencies.

For example, consider a patient who has been admitted to the hospital with a gall bladder problem. After an initial assessment, the patient is moved to the med-surg floor. The patient’s acuity may change from hour to hour, but staffing levels and treatment plans are slow to adjust. However, by leveraging current digital systems, hospitals can track real-time patient status through algorithms that analyze vital signs, lab results and other data to detect patients who are deteriorating or predict those at highest risk. When these clinical systems are integrated with a hospital’s communication platform, contextual alerts can be sent directly to the patient’s nurse, physician or entire care team, depending on the situation and associated workflow.

Several years ago, Gartner pointed out that situational awareness is at the heart of the “real-time health system,” which derives clinical and operational intelligence from real-time knowledge of patient context and care team availability. Such knowledge requires that a hospital transform its data into real-time information about the patient situation. By acting on this data, hospitals can determine the right individual interventions, while improving overall operational and clinical care.

The most important component of this real-time health system: a clinical communication and collaboration platform that provides patient-centric context to caregivers on their device of choice. In one example of such a system’s capabilities, if a nurse receives an alert on his or her wearable device or smartphone about a patient getting out of bed, this clinician would also know the patient’s fall risk and weight when considering what level of assistance is needed. This could significantly reduce patient falls, an all too common hazard in hospitals.

Better communication can also safeguard clinician well-being. Clinician burnout is the number three safety concern on the ECRI list. Given the risk of cognitive overload from alerts, alarms, texts, and calls, clinicians would benefit from systems that aid in determining what information requires action now. Triaging tasks is an ever-present part of a busy physician or nurse’s day. An integrated communication platform that has an ability to prioritize work helps turn data from multiple digital systems into timely, actionable information improving clinical workflows and reducing cognitive burden.

For instance, a nurse may be responding to a code blue alert when she or he receives an urgent request from a patient for Tylenol. In such situations, a hospital can leverage an intelligent communication platform that is “aware” of which clinicians are busy with patient care and should not be disturbed, who is close by and can respond, and even who is licensed to perform particular tasks. By contrast, isolated point solutions or siloed communication systems can create a chaotic environment, placing undue pressure on clinicians contributing to alarm fatigue and burnout.

An integrated communication and collaboration platform has much to offer hospitals trying to create a real-time health system and improve patient safety. A single communication platform can simplify clinical workflows, reduce interruption fatigue and cognitive overload, and improve patient safety. It can also coordinate clinical collaboration across ambulatory and post-acute care environments, making patient handoffs safer and more efficient. In any care setting, effective communication and real-time situational awareness can help clinicians mitigate safety risks, while making their lifesaving work much easier.

About the author: Dr. Benjamin Kanter is the chief medical information officer of Vocera.