By Paul Gallese, PT, MBA
Much has been written about the need to establish safe cultures within healthcare organizations to achieve patient safety. Creating a high-reliability environment where few or no adverse events occur is a worthy goal but will be a challenging one to achieve. Reducing healthcare-acquired infections and conditions (HAIs and HACs) is absolutely imperative.
As we travel down the path to better patient safety, it will be important to develop patient safety solutions grounded in robust technological systems that support providers. We can’t ask our caregivers to improve patient safety by simply placing higher expectations on them; workflow monitoring provides insights caregivers can use to work more efficiently and safely (Nour-Omid, 2019).
Many health care workers are already stressed to the point of burnout. We ask caregivers to comply with hand hygiene protocols, to round more efficiently and purposefully, to practice mindfulness, to report unsafe conditions and errors, to respond to alarms, and to do much more. What we ask them to do is achievable, but there is very little room for attention lapses or errors.
Workflow monitoring provides positive reinforcement to frontline healthcare workers
Frontline healthcare workers deserve all the support that can be mustered to keep patients safe. New technological breakthroughs in patient safety – particularly relating to workflow monitoring – can provide this support by providing caregivers with positive reinforcement and feedback on their performance relating to safety measures. Rather than only focusing on improving individual performance, we must take a systemic approach and concentrate on improving the systems that aid workers in doing their jobs. Vitalacy refers to these work environments as “safety spheres” enabled by technology that produce data that help hospitals improve patient safety
Various studies have found that hospitals can track healthcare workers, identify patients, locate inventory and increase operational efficiencies through automated and continuous electronic monitoring (Fisher and Monahan, 2008; Lenz and Reichert, 2007). This monitoring can ultimately improve patient care quality (Gao et al., 2006). Through the intelligence gained by tracking the workflow of staff, we can better understand how to prevent HAIs and HACs.
Workflow monitoring creates ‘safety spheres’ where data provide patient safety insights
Several studies show that these kinds of “safety spheres” are effective. While the following studies focus on hand hygiene compliance, data gained from workflow tracking also can be used to reduce harm from falls, pressure ulcers, venous thromboembolism (VTE), adverse drug events, and nurse fatigue.
Son et al., (2011) describes a workflow monitoring system that empowers healthcare providers within a group or unit with “the responsibility to identify their own obstacles and barriers to proper hand hygiene, create action plans to remove them, and establish their own goals that can lead to sustainable improvement over time. . . They allow for tracking and reporting on an individual healthcare worker’s performance, so they can receive personal feedback . . . Most importantly, electronic monitoring systems tell the truth, better enable accountability, and can drive real performance improvement from an honest baseline. Accurate, reliable, timely, and actionable data is the key benefit.”
Al Salman et al., (2016) describes how a critical care unit was able to improve hand hygiene compliance using workflow monitoring by fostering friendly competitions between teammates. For example, the authors say nurses were constantly asking, during the course of the monitoring trial, if they “were doing well.” In addition, after showing skepticism that the monitoring was being used to spy on them or invade their privacy, health care workers became motivated to participate in monitoring after they understood how the technology would protect patients and workers from infectious disease by improving the environment of care.
Haque et al., (2018) envisions a “smart” hospital reducing HAIs by automatically detecting, tracking and assessing hand hygiene compliance. The system the authors describe detects the health care staff, tracks their movements, and classifies their hand hygiene behavior while increasing operational efficiency and improving patient care with less spending.
Workflow monitoring empowers and motivates caregivers toward better patient safety
These studies mention several important components of a safety sphere in which workflow is monitored. First, the empowerment of caregivers – giving them the tools, support and responsibility to identify challenges, goals and solutions leading to sustainable improvement. This buy-in will increase worker satisfaction and achieve better results. Second, accurate and actionable data – providing a baseline and the information health care workers need to make rapid improvements. And third, patient safety as the overriding goal – motivating providers by communicating that the ultimate purpose of the monitoring is to reduce HAIs and HACs.
Workflow monitoring is the future of patient safety because it helps create highly reliable patient safety systems that support providers in performing their patient care responsibilities. This leads to high patient and staff satisfaction, reduced HAIs and HACs, and improved clinical and financial outcomes.
Learn more about Vitalacy’s patient safety platform, which includes workflow monitoring capabilities.
Al Salman JM, et al. Effectiveness of an electronic hand hygiene monitoring system on healthcare workers’ compliance to guidelines. Journal of Infection and Public Health, March–April 2015; 8 (2): 117-126. https://doi.org/10.1016/j.jiph.2014.07.019.
Fisher JA & Monahan T. Tracking the social dimensions of RFID systems in hospitals. International Journal of Medical Informatics, 2008.
Gao T, et al. Vital signs monitoring and patient tracking over a wireless network. In International Conference of the Engineering in Medicine and Biology Society, 2006.
Haque A, et al. Towards vision-based smart hospitals: a system for tracking and monitoring hand hygiene compliance. Proceedings of Machine Learning Research (PMLR), 2017;68:75-87. arXiv:1708.00163 [cs.CV].
Lenz R & Reichert M. IT support for healthcare processes–premises, challenges, perspectives. Data & Knowledge Engineering, 2007.
Nour-Omid J. Introducing Vitalacy’s latest product updates: workflow monitoring & purposeful rounding. Vitalacy blog, Feb. 20, 2019.
Son C, et al: Practically speaking: Rethinking hand hygiene improvement programs in healthcare settings. American Journal of Infection Control, 2011;39(9):716-724.