A Stanford team has built an automated checklist that pulls data out of EMRs and pushes patient-specific alerts to caregivers. The checklist, along with the dashboard style interface clinicians use to work with it, has caused a threefold drop in the rates of a serious type of hospital acquired infection, according to a study of the solution published in Pediatrics.
The study, conducted by researchers in the pediatric intensive care unit at the Stanford University School of Medicine and the Lucile Packard Children’s Hospital Stanford, was focused on preventing bloodstream infections that begin in central lines.
To create the automated checklist, the research team collaborated with engineers from HP Labs, who programmed the checklist and displayed real-time alerts a large LCD screen in the nurses’ station. Alerts from the system were generated in three different colors, red, yellow and green, each with a specific action to be taken in response to the dot. For example one dot might indicate that it was time for patients central line to be changed, and another if it was time for caregivers to reevaluate whether medications given in the line could be switched to oral meds instead.
Using the checklists created from EMR data it was much easier for clinicians to follow national guidelines in keeping central lines infection free. During the study, researchers reported, the rate of central line infections in the hospital’s PICU fell from 2.6 to 0.7 per 1000 days of central line use.
According to Natalie Pageler, MD, the study’s lead author, these are the kinds of solutions that can transform the use of EMRs by digging into their deeper capabilities. “Electronic medical records are data rich of information poor,” Dr. Pageler said. “Often, the data in electronic medical records is cumbersome for caregivers using real-time, but this study showed a way to change that.”