Bernoulli Launches Respiratory Depression Safety Surveillance Solution

/in , /by

Revolutionary New Analytics Application to Address Significant Patient Safety Threat

Milford, CT—April 3, 2017—Bernoulli, the leader in real-time solutions for patient safety, has announced a revolutionary new application for the continuous monitoring of patients at risk of respiratory depression. Bernoulli’s Respiratory Depression Safety Surveillance (RDSS) solution utilizes comprehensive real-time data to help clinicians quickly recognize and respond to signs of respiratory distress. RDSS includes exclusive analytics with multi-variable thresholds—adjustable by the care facility—to identify clinically actionable events while significantly reducing the overall number of alarms communicated to remote and mobile clinicians, mitigating the risk of alarm fatigue.

A Solution to a Growing Patient Safety Threat

More than half of medication-related deaths and 20,000 incidences of respiratory depression-related interventions annually are attributed to the delivery of opioids in a care setting, at a cost of approximately $2 billion per year to the U.S. healthcare system.1

Current monitoring practices are neither adequate nor comprehensive. For example, one of the most common methods—periodic physical spot checks by direct-care clinical staff—can leave patients unmonitored up to 96% of the time.2 Additionally, the adoption of continuous respiratory surveillance is beset by significant challenges, including reduced visual and audible oversight due to single-patient rooms and high nurse-to-patient ratios in many care areas with at-risk patients, and limitations of stand-alone respiratory monitoring devices that can have high rates of false and non-clinically actionable alarms. The disruption of direct-care clinical staff workflow also is a major barrier to continuous monitoring.

Bernoulli’s RDSS solution mitigates many of these clinical, technical and operational challenges. The platform provides connectivity to a hospital’s existing fleet of pulse oximeters and capnographs from a wide range of vendors, including Medtronic, Masimo and others. RDSS also integrates with mobile clinical communication tools to deliver the right alarms and alerts to the right caregiver at the right time.

Proven Clinical Results

In a forthcoming clinical study of patients diagnosed or at risk of obstructive or central sleep apnea, to be published in the Journal of Biomedical Instrumentation & Technology3, the use of Bernoulli’s RDSS analytics reduced 22,812 alarms generated by bedside capnographs and pulse oximeters to just 209 respiratory depression alerts delivered to mobile clinicians—a reduction of 99%. More importantly, the RDSS analytics distributed alerts for every patient that experienced an actual respiratory depression episode.

“The risks inherent in delivering opioids or patient-controlled analgesia to post-operative patients increase the possibility for sentinel events, particularly in patient populations managing chronic illnesses or co-morbidities, such as sleep apnea and obesity,” said Janet Dillione, CEO of Bernoulli. “Bernoulli’s RDSS solution effectively delivers on the recommendations of The Joint Commission, AAMI Foundation and ECRI Institute that hospitals implement continuous respiratory monitoring for these at-risk patients.”

References

  1. Overdyk FJ, Carter R, Maddox RR, Callura J, Herrin AE, Henriquez C. Continuous Oximetry / Capnometry Monitoring Reveals Frequent Desaturation and Bradypnea During Patient-Controlled Analgesia. Anesth Analg. 2007;105:412-8.
  2. Wong M, Mabuyi A, Gonzalez B. First National Survey of Patient-Controlled Analgesia Practices. Physician-Patient Alliance for Health & Safety (PPAHS), October 2013; Web page: premiersafetyinstitute.org/wp-content/uploads/PPAHS-national-survey-patient-controlled-analgesia.pdf.
  3. Supe D, Baron L, Decker T, Parker K, Venella J, Williams S, Beaton K, Zaleski J. A pilot study in middleware-filtered capnography alarms of continuously monitored obstructive sleep apnea patient in a medical-surgical unit. BI&T. May/June 2017. Manuscript in preparation.

 

About Bernoulli

Bernoulli is the leader in real-time solutions for patient safety, with more than 1,200 installed, operational systems. Bernoulli One is the market’s only real-time, connected healthcare platform that combines comprehensive and vendor-neutral medical device integration with powerful middleware, clinical surveillance, telemedicine/virtual ICU, advanced alarm management, predictive analytics and robust distribution capabilities into ONE solution that empowers clinicians with tools to drive better patient safety, clinical outcomes, patient experience, and provider workflow. For more information about Bernoulli One, visit www.bernoullihealth.com. Follow us on Twitter and LinkedIn. Visit our Resource Center to download case studies, white papers and articles.

Why continuous monitoring will challenge CIOs and their IT systems

/in , /by

CEO Janet Dillione published in Health Data Management

hdmThe successful implementation of scalable, real-time patient safety initiatives have long been a goal of hospitals and health system CIOs, which is why understanding the value proposition of alarm and notification platforms is essential familiarity of health system CIOs, writes Bernoulli CEO Janet Dillione in Health Data Management.

“The ability to track patients throughout the hospital, continuously add new devices, and distribute real-time patient monitoring to centralized dashboards and mobile devices should be a major consideration for CIOs tasked with implementing real-time healthcare solutions,” Dillione writes.

Health system CIOs should evaluate medical device integration middleware capabilities, precision alarms, and real-time analytics driven by a rules-based engine.

Dillione concludes that health systems that can establish continuous electronic monitoring are creating a foundation real-time healthcare innovations, including clinical surveillance modules, medical device integration in an EHR and virtual ICUs.

Follow Bernoulli on LinkedIn and Twitter for the latest news and updates.

Jeanne Venella’s Alarm Fatigue Commentary in AAMI Horizons

/in , /by

jeanne VenellaAlarm signals are disrupting patients’ recovery and exhausting clinical staff, according to a commentary published by Bernoulli Chief Nursing Officer Jeanne Venella, DNP, MS, RN, CEN, CPEN, in the Spring 2017 issue of AAMI Horizons.

“Drawing Up a New Game Plan to Reduce Alarm Fatigue” notes that 85 percent to 99 percent of alarms require no intervention on the part of clinical staff. In addition to alarm fatigue, this growing problem represents a significant risk to patient safety if caregivers arbitrarily adjust threshold settings on devices or shut them off completely.

The problem has become so severe that the Joint Commission made clinical alarm management a priority with its National Patient Safety Goal (NPSG.06.01.01), mandating that hospitals take definitive steps to implement policies and procedures to safely reduce and prioritize clinical alarms.

Venella explores the logical steps hospitals and health systems should take to get their alarm issue under control, including:

  • Assessing the current state of the clinical alarm environment, identifying and developing targets for reduction, and evaluating appropriate interventions, policies, and standards.
  • Performing a baseline alarm management study to separate clinically relevant alarms from non-actionable alarms and managing the ever-growing number of alarm-enabled medical devices.
  • Devising standards and strategies for executing on a clinical alarm management program

Writes Venella, “Alarm management is a classic example of interdisciplinary leadership, involving clinical, IT, biomedical engineering, and other departments. Alarm management is also much more than simply reducing non-actionable alarms; it’s a gateway for more seamless care and a way for hospitals to leverage hard data to make continuous improvements to its care and response processes.”

 

The Spring issue of AAMI Horizons is now online for AAMI members and subscribers. Follow Bernoulli on LinkedIn and Twitter for the latest news and updates.

Continuous Monitoring of Patients at Risk for Respiratory Depression

/in , /by

Bernoulli CNO and CAO co-author article on continuous monitoring of patients at risk for respiratory depression published in AAMI Horizons Spring 2017 issue

AAMI Horizons 2017The use of middleware for the continuous monitoring of patients at risk of respiratory depression was the subject of a paper just published by Bernoulli Chief Analytics Officer John Zaleski, PhD, CAP, CPHIMS, and Chief Nursing Officer Jeanne Venella, DNP, MS, RN, CEN, CPEN, in the Spring 2017 issue of AAMI Horizons.

“Using Middleware to Manage Smart Alarms for Patients Receiving Opioids” explores the risks hospitals and health systems are exposed to due to inadequate monitoring of post-operative patients who receive opioids.

Although continuous monitoring of these patient populations is recommended as a best practice by the Joint Commission, Anesthesia Patient Safety Foundation, the Association for the Advancement of Medical Instrumentation, and other healthcare advocates and governing agencies. However, continuous monitoring of these patient populations, particularly outside the critical care unit setting, remains the exception to the rule.

Why? The adoption of this best practice is beset by significant business and clinical challenges, including the implementation of costly physiologic device technology, the possible addition of full-time direct-care clinical staff, and the difficulty of capturing holistic, real-time patient data in order to facilitate early intervention.

Zaleski and Venella explore the viability of comprehensive and cost-effective solutions, including:

  • The use of Smart Alarm technology to provide caregivers with an accurate, real-time picture of a patient’s condition, while attenuating alarm signals that communicate contextual patient-safety specific information and minimize spurious signals that can lead to alarm fatigue.
  • Leveraging multi-parameter physiologic monitors—such as capnography and pulse oximetry—as a sensitive and early indicator of opioid-induced respiratory depression.
  • Assessing the core standards required of device-agnostic middleware platforms for interfacing with bedside devices and combining it with other data from the patient record to create a more holistic and complete picture of the current patient state.

Write the authors: “Combining analysis with real-time data collection at the point of collection creates a powerful tool for prediction and decision support, particularly if this tool can also integrate data from other sources (e.g.: laboratory, electronic health record) to bring more context to bear relative to the patient under consideration.”

The Spring issue of AAMI Horizons is now online for AAMI members and subscribers. Follow Bernoulli on LinkedIn and Twitter for the latest news and updates.

John Zaleski article: continuous monitoring for respiratory depression in HIMSS FutureCare

/in /by

John Zaleski PhDThe use of opioids for treatment of acute post-operative pain is rather commonplace, but patients with obstructed sleep apnea are at risk for respiratory depression and arrest, which can lead to anoxic brain injury or death if left unattended, writes Bernoulli Chief Analytics Officer John Zaleski, PhD, CAP, CPHIMS, in an article published in HIMSS FutureCare.

However, continuous electronic monitoring of these patient populations presents considerable challenges to many hospitals and health systems, including lack of continuous bedside monitoring devices, alarm fatigue and lack of coverage for patients at risk.

Zaleski explores the technology, staff education, and real-time data requirements necessary to improve this patient safety threat.

Follow Bernoulli on LinkedIn and Twitter for the latest news and updates.

John Zaleski article | continuous monitoring for respiratory arrest and depression

/in /by

John Zaleski article: continuous monitoring for respiratory arrest and depression in HIMSS FutureCareThe use of opioids for treatment of acute post-operative pain is rather commonplace, but patients with obstructed sleep apnea are at risk for respiratory arrest and depression, which can lead to anoxic brain injury or death if left unattended, writes Bernoulli Chief Analytics Officer John Zaleski, PhD, CAP, CPHIMS, in an article published in HIMSS FutureCare.

However, continuous electronic monitoring of these patient populations presents considerable challenges to many hospitals and health systems, including lack of continuous bedside monitoring devices, alarm fatigue and lack of coverage for patients at risk.

Zaleski explores the technology, staff education, and real-time data requirements necessary to improve this patient safety threat.

Follow Bernoulli on LinkedIn and Twitter for the latest news and updates.

Physician Advisors to Consult on Real-Time Healthcare & Patient Safety Issues

/in , , /by

Expertise will Provide Valuable Insights on Supporting Clinical Workflow and Driving Improved Quality of Care

Milford, CT—March 27, 2017—Bernoulli, the leader in real-time solutions for patient safety, announced that two prominent physicians will join the company as consultants to explore issues related to real-time healthcare delivery and increased patient safety.

Neil A. Halpern, MD, MCCM, FCCP, FACP, is Director of the Critical Care Center, Chief of the Critical Care Medicine Service and Medical Director of Respiratory Therapy at Memorial Sloan Kettering (MSK) Cancer Center in New York. Dr. Halpern oversees a team of highly experienced doctors, nurse practitioners, physician assistants, respiratory therapists, research and bedside nurses, and critical care programmers who help provide care for patients in MSK’s adult medical-surgical intensive care unit (ICU).

Since 2000, he has co-chaired the hospital’s Clinical Device and Product Evaluation Committee, and since 2014, the Alarm Committee at MSK. Between 2005 and 2007, he chaired the multidisciplinary ICU Design Committee that developed the plan and monitored the construction of MSK’s 20-bed medical-surgical adult ICU, which opened in April 2007.

“There is a clear need in healthcare for greater connectivity, interoperability and comprehensive real-time data to support improved patient safety, enhanced care team collaboration and proactive clinical intervention,” said Dr. Halpern. “I look forward to advising Bernoulli on the applications and services that will have the greatest impact.”

Amar Setty, MD, is the CEO of AnesthesiaStat, a Baltimore-based anesthesia consulting and management company operated by practicing, Board Certified anesthesiologists. In addition to an active private practice, Dr. Setty serves as the immediate-Past President of the Maryland Society of Anesthesiologists, where he continues to be an advocate.

He is working to develop data-centric applications for patient-advocated value-based care, ultrasound/video-based artificial intelligence for medical procedures, as well as an app for patient empowerment in chronic pain. He has a unique interest in the use of technology to improve the perioperative experience and is working to build a new system of surgical risk prediction and management. He hopes to improve the quality and care of patients before and after discharge.

“The complexity and exponential growth of patient-generated data in modern care settings can be overwhelming, and even act as a barrier to real-time patient care and interventions if not properly managed,” said Dr. Setty. “I am excited to sharing my perspectives and experiences as a physician with Bernoulli to better facilitate the use of comprehensive real-time patient data to improve patient safety, quality and cost of care.”

“Many of the challenges facing healthcare providers – including mitigating patient safety threats, embarking on value-based care initiatives, and streamlining clinical workflows – require comprehensive real-time data, surveillance and analytics,” said Janet Dillione, CEO of Bernoulli. “Dr. Setty and Dr. Halpern’s clinical expertise will help uncover valuable insights, enabling us to better align our solutions with the needs of hospitals and health systems.”

 

About Bernoulli

Bernoulli is the leader in real-time solutions for patient safety, with more than 1,200 installed, operational systems. Bernoulli One™ is the market’s only real-time, connected healthcare platform that combines comprehensive and vendor-neutral medical device integration with powerful middleware, clinical surveillance, telemedicine/virtual ICU, advanced alarm management, predictive analytics and robust distribution capabilities into ONE solution that empowers clinicians with tools to drive better patient safety, clinical outcomes, patient experience, and provider workflow. For more information about Bernoulli, visit www.bernoullihealth.com. Follow us on Twitter and LinkedIn. Visit our Resource Center to download case studies, white papers and articles.

ECRI: Top 10 Patient Safety Concerns for Healthcare Organizations

/in , /by

The ECRI Institute released its latest report, 2017 Top 10 Patient Safety Concerns for Healthcare Organizations. The report’s goal is to help hospitals and health systems decide where to focus patient safety initiatives.

We encourage you to read the the entire ECRI on the Top 10 Patient Safety Concerns, but wanted to highlight a few key areas.

Information Management in EHRs (#1)

“Healthcare organizations must approach health IT safety holistically. …Strategies include ensuring that users understand the system’s capabilities and potential problems [and] encouraging users to report concerns and investigating those concerns.”

Quality and reporting in many hospitals and health systems rely on individual recollections after an incident, which can be inaccurate or incomplete. The appropriate technology can provide healthcare organization with objective data to assess any incident and make measurable, team-focused improvements to the reporting and resolution process.

Patient Safety Resource: Case study—Achieving Clinical Clarity from Ventilator Overload. The Hospital for Special Care was able to achieve real-time surveillance of more than 100 patients on ventilation support. In addition, the hospital was able to use collected data for reporting to its audit committee, which monitors ventilator management performance and identifies potential areas of need.

Unrecognized Patient Deterioration (#2)

“Organizations can develop condition-specific protocols for an organized and speedy response and analyze work systems and processes to identify and address barriers.”

Several alarm techniques and strategies exist for identifying at-risk patients, including smart alarms. These allow for the analysis of the alarm signals themselves, but also the high-fidelity physiological data associated with them, including time trends, in-depth alarm sensitivity and statistical and predictive analysis.

Patient Safety Resource: White paper—Clinical Alarm Management & Reduction: Eliminating alarm proliferation in hospitals and health systems. This white paper outlines the current state of clinical alarm management, demonstrate how to establish a baseline of a hospital’s alarms, and explores innovative alarm reduction strategies to promote more efficient workflow, increase patient safety, and put hospitals on the path toward real-time patient monitoring and intervention.

Implementation and Use of Clinical Decision Support (#3)

“On an ongoing basis, organizations should monitor the effectiveness and appropriateness of CDS alerts, evaluate the impact on workflow, and review staff response to alerts. The tool should be redesigned as necessary.”

The truth is that the overwhelming majority of alarms endured by nurses, respiratory therapists and other caregivers have nothing to do with a patient’s medical condition. However, the fatigue and desensitization that results from caregivers responding to hundreds—or even thousands—of alarms every day is a clear and documented threat to patient safety. Technology can help get alarms under control—but it is not enough. Clinical and IT leadership, including nurses, respiratory therapists, biomedical engineers and information technology staff, must come together to develop the policies and standards necessary to bring meaning and action back to clinical alarms.

Patient Safety Resource: Article—“Why it’s time for an immediate hospital alarm intervention” by Jeanne Venella, DNP, MS, RN, CEN, CPEN, Chief Nursing Officer, Bernoulli. Published May 2016 in DOTMed.

Opioid Administration and Monitoring in Acute Care (#7)

“Organizations may wish to evaluate and address work system and process factors that may contribute to opioid administration errors. For certain patients, capnography or minute ventilation monitoring can supplement nurse monitoring.”

Both patient-managed and staff-administered pain medication are necessary for the patient’s well-being in the hospital. However, their use presents real risk of overdosing and death, especially for patients with complex chronic conditions and co-morbidities. Continuous monitoring can help improve patient safety while keeping the patient comfortable, but careful implementation is necessary to avoid a negative impact on the staff and environment the patient depends on for care.

Patient Safety Resource: Article—“Achieving Real-Time Respiratory Depression Surveillance of Post-Surgical Patients” by Jeanne Venella, DNP, MS, RN, CEN, CPEN, Chief Nursing Officer, and John Zaleski, PhD, CAP, CPHIMS, Executive Vice President and Chief Informatics Officer, Bernoulli. Published Feb. 8, 2017 in PSQH.

Inadequate Organization Systems or Processes to Improve Safety and Quality (#10)

“Proactive strategies can be used to examine processes, identify what can go wrong, and make the process less vulnerable to error before mistakes can occur. Strong preventive strategies, such as standardization and automation, should be explored.”

Technology plays a critical role in patient safety, but it is one piece of a larger solution. Achieving measurable progress in patient safety requires that hospitals identify and support internal champions in all relevant departments including, nurses, respiratory therapists, biomedical engineers, and information technology staff. These interdisciplinary experts must come together to assess the current state of patient safety environment—by unit and facility—including reviewing current protocols; identifying and developing targets for improvement; and evaluating appropriate interventions, policies, and standards. Without the input and expertise from hospital leadership, any patient safety solution will fall short of institutional goals and may put full adoption at risk.

Patient Safety Resource: Webinar—“The Threat of Alarm Fatigue on Patient Safety.”

Final Thoughts

Bernoulli is dedicated to providing clinicians with the technology-enabled capabilities necessary for improving patient safety in real-time. Our commitment to interoperability and vendor-neutral, open architecture both with regards to device connectivity and delivery of data and analytics to other systems of record enables hospitals and health systems to benchmark measureable, sustained improvements to patient safety.

As always, be sure to review our Resource Center to access real-world case studies, white papers, thought leadership and published papers and articles that will help your team make informed decisions about investing in enterprise-wide medical device connectivity, alarm reduction, patient safety analytics—all based on continuous, real-time data.

Follow us on LinkedIn and Twitter for additional news, tools and resources.

Alarm Management Software Boosts Nurse Response Time

/in /by

HealthData Management article: How alarm management software boosts nurse response time

HealthData Management’s Joseph Goedert talked with The Hospital for Special Care’s respiratory practice manager, Connie Dills, on the benefits of alarm management software.
 


In the article Ms. Dills’ states that with the installation of Bernoulli One™ software The Hospital for Special Care’s  “response time is excellent,… When an actionable alarm goes off, the response time is within 10 to 20 seconds.”
 


“…Alerts are displayed at workstations, on laptops and pagers, on an LED board and via an audible overhead speaker. With the new software, the hospital has seen an 80 percent reduction in the number of alarms for which an immediate response is needed…”
 


To read the HealthData Management article,  “How alarm management software boosts nurse response time”, click here.

To read The Hospital for Special Care’s case study on Achieving Clinical Clarity from Ventilator Overload click here.

Inside the HSC case study the results show that:

  • Bernoulli One™ at HSC enabled real-time
    surveillance of more than 100 ventilated patients.
  • Using Bernoulli’s alarm management capabilities, HSC has reduced the number of ventilator alarms by an estimated 80%.
  • HSC is able to leverage the system to produce detailed reports after any alarm incident, as well as support research and benchmarking studies going forward.
  • Bernoulli allows HSC staff to automate manual processes, reducing the risk of transcription errors and giving clinicians more time for direct patient care.
  • HSC has achieved full compliance with the Joint
    Commission NPSG on alarm management, using the Bernoulli platform.

For more information on how Bernoulli can help your medical facility deliver better patient care click here or call(800) 337-9936.

 

See How Spok and Bernoulli Collaborate on Real-Time Data Delivery at HIMSS17

/in /by

Bernoulli, the leader in real-time solutions for patient safety, and Spok Inc., the global leader in healthcare communications, will be showing HIMSS17 attendees how the companies’ combined capabilities help clinical staff leverage advanced routing and escalation capabilities with unique smart alarms and real-time patient data to deliver actionable alarms that support better clinical decision-making, speed response times, reduce alarm fatigue, and improve patient satisfaction.

Take Action

  1. Visit Spok booth 2671 or visit Bernoulli and Spok at the HIMSS17 Interoperability Showcase (Booth 9000, Hall F)
  2. Learn how Bernoulli and Spok work together to reduce alarm fatigue for staff, improve patient safety, and meet The Joint Commission NPSG.06.01.01 requirements for clinical alarm safety
  3. Engage on social media with Spok (Twitter/LinkedIn) and Bernoulli (Twitter/LinkedIn)
  4. Add Bernoulli to your HIMSS17 agenda
  5. Download Spok Bernoulli Alarm Fatigue pdf

 

About Bernoulli
Bernoulli is the leader in real-time solutions for patient safety, with more than 1,200 installed, operational systems. Bernoulli One™ is the market’s only real-time, connected healthcare platform that combines comprehensive and vendor-neutral medical device integration with powerful middleware, clinical surveillance, telemedicine/virtual ICU, advanced alarm management, predictive analytics and robust distribution capabilities into ONE solution that empowers clinicians with tools to drive better patient safety, clinical outcomes, patient experience, and provider workflow. Visit our Resource Center to download case studies, white papers and articles.

 

Media Contact:

Matt Schlossberg
Amendola Communications