EDITOR'S NOTE: Earlier this month, Pulsara's Founder and CEO, James Woodson, M.D., co-authored the following piece with Stein Bronsky, M.D. This piece originally appeared in JEMS. Download the full article here.
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Medical errors, or preventable adverse events, are estimated to cause somewhere between 250,000 and 400,000 deaths in the United States every year.1
Experts say the most common causes of medical errors are communication problems and inadequate information flow.2
As nurses, we have an interesting challenge: We need to make sure we are doing our jobs as quickly and efficiently as possible while still making sure to carefully pay attention to and make note of every detail in the care process. This can be especially tricky when it comes to conditions like stroke where every second makes a difference.
I sometimes pick on ER physicians for hesitating to give tPA for stroke despite data that supports administering, but the responsibility isn't 100% theirs. Our nursing skills play an important part in ensuring that a patient stays within the guidelines. As hospital systems, sometimes we push a little too hard to go straight to CT, for example. In general, I think pushing to go directly to CT is a good thing ... but problems arise when we get tunnel vision and forget the little things that can make a difference down the line. John Wooden, the legendary basketball coach of the UCLA Bruins, has a famous quote that I love: "Be quick, but don't hurry."
Silly pager, emergencies are for modern technology!
I've written on this topic before, but I heard a story a few days ago that made it worth revisiting. The following is an all-too-familiar scenario to anyone still trying to use outdated systems of patched-together technology to coordinate critical care.
The nurse in the Emergency Department at a level II Trauma Center was receiving report from EMS. To be honest, I don't know if this was a telephone called report, or one given over the radio. At the end of the day, the point is that the information shared by EMS wasn't received by the ED due to a poor connection. The nurse heard wrist injury, with a list of other seemingly minor injuries. Though there was a period that the connection was abysmal, she thought she captured all the information.
When EMS arrived, they were told to go to room 10 which isn't one of the major trauma rooms. When the nurse walked into the room to take report "again," the medic vented his frustration about the Trauma Team not being present. Upon taking the bedside report, the nurse realized that during that poor connection, the MOA was high-speed roll-over with partial ejection.
What if you could get inside the mind of a Stroke Program Consultant who helps hospitals and EMS systems get ready for certification (through the Joint Commission, for example)? You'd probably want to know what things she commonly sees hospitals doing wrong. What tricks does she have for making sure your facility is ready?
Shane Elmore, Pulsara's Vice President for Clinical Innovation and Development, recently sat down for an interview with Debbie Roper, RN, MSN, President and Founder of Strokes R Us. Debbie is a consultant who travels across the country and advises hospitals that are going through the stroke certification process.
You chose this career.
Why?
Why did you go into public safety? Why did you go into healthcare? Why did you choose your specialty?
There are a number of possible reasons: Money. Prestige. Honor. Love. Fear. Anger. Hope. Adrenaline. Desire. Pressure. People.
Many of us in public safety and healthcare are just wired differently — especially those of us who deal with time sensitive emergencies. Imagine a group of people witnessing an emergency - a house fire, a car crash, a mass casualty event, a cardiac arrest, a sudden collapse, a STEMI, a stroke. If you were to watch their responses, you would see three types of people:
Is your job in healthcare to focus on and serve only the patient or is it also to serve others on the TEAM who are caring for the patient?
Patient centric healthcare as we currently practice it is a failed philosophy. We focus on serving the patient for a finite moment in time even though the patient's journey extends well beyond our specific tasks.
In this mindset, we have a system where we — yes, you and I — cause 400,000 deaths per year and 10,000 serious medical complications every day, costing the U.S. an estimated one trillion dollars a year. Additionally, 80% of these errors occur secondary to miscommunication during transitions of care.
Patient centric healthcare is not enough. We need to realize that just serving the patient is not enough — we ALSO need to serve the fellow clinicians who are serving the patient. We need patient- and people-centric healthcare.
FOR IMMEDIATE RELEASE
PeaceHealth Southwest Medical Center is the first hospital on the west coast to use the healthcare communication platform, Pulsara, and the first in the nation to use the company's Prehospital Alerting Package.
BOZEMAN, MT -- SEPTEMBER 12, 2017 -- Stroke is a leading cause of disability and death in the U.S., with close to 800,000 cases each year. The outcome can be devastating, and every delay in care impacts a stroke survivor’s chance at a full recovery. To minimize those delays and make emergency communication more efficient, PeaceHealth Southwest Medical Center in Vancouver, Washington, has partnered with several local EMS services to begin using the healthcare communication platform, Pulsara.
PeaceHealth Southwest is the first hospital on the west coast to use Pulsara for STEMI and stroke communications both with EMS and within the hospital, and the first in the nation to use the company's Prehospital Alerting Package for all EMS-transferred patients.
EDITOR'S NOTE: The following content originally appeared on EMS1.com as paid content sponsored by Pulsara. Special thanks to our guest blogger, Peter Antevy, MD.
Follow these 10 steps when treating pediatric cardiac arrest to save lives.
Easy problems have easy answers – complex problems require complex answers. However, in pediatrics, we’ve taken an easy problem and made it unnecessarily complicated. Pediatric resuscitation isn’t that complex (BVM – compressions – Epi), yet over the last 3 decades we’ve been convinced otherwise. Why? Many have focused on one thing – getting the child’s weight. We’ve been convinced that a single tool or widget will get us through a difficult pediatric call. It’s time to change this mentality.
Pulsara was featured in a news clip and article from Fox 45, a local Miami news station, as a service that could "change the game for stroke treatment." The article pointed out that during medical emergencies, every second matters -- particularly when it comes to stroke. "Time is tissue; brain tissue, that is," stated the authors.
Healthcare systems must continue to adopt mobile-friendly platforms to meet users' expectations and offer high-quality care.
Many industries have overhauled their businesses to meet consumers’ expectations of using their mobile devices to do everything from checking in for a flight to ordering takeout food. The healthcare industry has been slower to adopt mobile-friendly platforms, but it is increasingly doing so to meet patients’ and health professionals’ needs. But simply taking current methods of communication and putting them on smartphones is not sufficient — platforms must capitalize on the many advantages mobile technology offers in order to truly transform and improve healthcare.
FOR IMMEDIATE RELEASE
Bozeman, MT – August 16, 2017 – Pulsara announced today the release of software version 6.2. The highlight of the release is the Flexible Teams feature, which allows hospital admins to create, assign and alert unlimited CUSTOM teams. In addition, users can now go on call for custom teams, with the option of being assigned for MULTIPLE hospitals at the same time. "This feature is a big step in our efforts to make Pulsara work for YOU and your unique system," said Erich Hannan, Chief Development Officer.
Researchers find a significant number of communication failures at hospitals. Could they be contributing to preventable patient deaths and disability?
A study in Toronto found that over a two-month period, 14 percent of all pages went to the wrong physician and nearly half of those were emergent or urgent communications.
A study that examined communication failures at Sunnybrook Health Sciences Centre and the Toronto General Hospital in Toronto, Canada, found that over a two-month period, 14 percent of pages were sent to the wrong physician.[12] That’s an estimated 4,300 misdirected pages each year—half of which are related to emergency or urgent matters.
Physician collaboration is associated with fewer patient deaths, readmissions, and emergency room visits.
A study of patients who underwent coronary artery bypass grafting (CABG) found that when physicians collaborated more, patients had a 24 percent lower rate of emergency room visits and hospital readmissions, and a 28 percent lower rate of death.[10]
Physician groups that worked more closely together in caring for patients who underwent coronary artery bypass grafting (CABG) procedures were able to produce better patient outcomes, according to recent research.[11] The study examined claims data for 251,630 patients who underwent CABG between 2008 and 2011; the patients received care from 466,243 physicians across more than a thousand health systems. At 60 days post-procedure, patients treated by physician teams with higher levels of cooperation had:
Research suggests that medical errors play an even bigger role in preventable deaths in U.S. hospitals than previously estimated, and 80 percent of all serious medical errors involve miscommunication. That amounts to 250,000 - 400,000 deaths every year in the U.S. Tools that help medical professionals communicate more quickly, accurately, and collaboratively are critical to saving lives.
More than fifteen years ago, the Institute of Medicine released a groundbreaking report on the incidence of medical errors in U.S. hospitals. The report suggested as many as 98,000 people die every year from medical errors.[1] Recent analysis from the Johns Hopkins School of Medicine says that report may have significantly underestimated the problem, putting the actual number closer to 250,000 - 400,000.[2] In fact, medical error is now considered the third leading cause of death in the U.S.
EDITOR'S NOTE: The following content originally appeared on EMS1.com as paid content sponsored by Pulsara. Special thanks to our guest blogger, Drew Rinella for EMS1 BrandFocus. Drew is the clinical coordinator for Bonner County EMS in rural North Idaho. He is a paramedic, public servant, and competition shooter. Drew is an advocate for quality in EMS and also blogs his crusade against bad EKGs in product advertising.
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Automatic CPR devices have been available for several decades now, yet they haven’t received widespread acceptance as the standard of care for cardiac arrest management. Here are 10 things you need to know about automatic CPR devices:
FOR IMMEDIATE RELEASE
Pulsara's Prehospital Alerting Package among 30 innovative new products for emergency medical services and prehospital care.
Bozeman, MT, June 6, 2017 -- Pulsara and JEMS (Journal of Emergency Medical Services) are proud to announce the selection of Pulsara’s Prehospital Alerting Package as a Hot Product from the JEMS EMS Today Conference & Exposition, which was held February 23–25 in Salt Lake City.
Pulsara was selected after a team of eight judges consisting of emergency medical services (EMS) product specialists, physicians, educators, managers and paramedics reviewed a host of products designed to not only improve the ability to deliver optimal emergency medical care to sick and injured patients, but also allow EMS agencies to do it safely, more efficiently and with enhanced comfort for the patient.
"Always in Service."
That's the theme of the 2017 EMS Week, which comes to a close on Saturday. But before it's over, we wanted to take a moment to recognize the EMS professionals who whole-heartedly serve their communities, putting their jobs above leisure, family, and self.
The Pulsara team is blessed to have some of the most talented, dedicated, and experienced EMS personnel on our own staff. "Always in Service" describes no one better than this crew who split their time serving in EMS roles while also giving their all to Pulsara and our clients ... all while balancing their own passions. Check out some of the things that make these team members unique -- as well as their SUPER impressive EMS track records -- below.
As an emergency room physician, I experience firsthand the impact of outdated communication systems — how they hamper good patient care and challenge even the most talented, dedicated, and well-trained medical professionals. In emergency situations, when seconds count, fast and accurate communication between care teams can mean the difference between life and death.
Pulsara was featured last week in a news article on Australian news site, The Courier after Ballarat Base Hospital, Pulsara's second international hospital client, began a pilot of the platform. Ballarat will leverage Pulsara to receive real-time information about a patient’s condition from local paramedics to get the entire emergency department, cardiac, neurology and other specialists and departments on the same page.
According to the article, Ambulance Victoria clinical manager Grant Hocking said “Time is of the essence for cardiac and stroke patients. This app puts everyone on the same page, synchronizing our communication not just to the emergency department but specialists within the hospital as well.”
NBC News in Dallas Fort-Worth, TX reported Tuesday evening that a local man, 55-year-old Thomas Moran, was recently treated for a heart attack -- from which he made a full recovery -- by teams using Pulsara.
Baylor Scott & White Medical Center - Grapevine as well as 11 Tarrant County EMS teams are now using the app.
