Reporting and Analytics Optimizing the Reporting Process AND Creating Actionable Analytics for Nurses
A Reporting and Analytics service synthesizes all the alarm, alert and aggregated event interruption data into manageable pieces. It turns the data into actionable information for nurses or administrators. This includes both the long-term retrospective reports and short-term assessments for current situations.
What Data is Necessary for Reports?
There are typically two types of data that hospitals most often request to review and analyze – Filtered and Unfiltered. It is important to understand that both are necessary for a complete analysis of interruption fatigue.
Filtered: This is the data typically processed and reported from alarm management systems like Extension Engage. This is the most critical data caregivers expect to be sent to phones. This should be thought of as the most critical 5-10% of alarms or alerts.
Unfiltered: This is the data used to measure the actual “noise” in the room. This is ALL alarm AND alert data, which is typically important for a complete analysis, These are the noises the patient hears from a medical device. This is the metric that may closely correlate with customer satisfaction scores. When nurses refer to “alarm fatigue” this is typically the reason and the number they want to review and understand.
What Actionable “Interruption Information” is Necessary for Nurses?
Specific needs and information views vary depending on department, medical devices, and communication system. Each vendor will have their own report, metric or procedure for gathering data but only a middleware vendor will be able aggregate ALL data sources and continue to keep the integrations current. There are two styles available for presenting the interruption information – Retrospective Interruption Reporting and Situational Awareness.
Retrospective Interruption Reporting
This “historical” data is used for comparisons or assessments of policy changes. This is the before/after measurement of long-term progress. It could span days, weeks, months or years but the capability to compare times and departments are a few of the possible report types.
There are three typical reasons for these types of reports:
- Alarm Baseline – Safety Committees and/or Biomedical Engineers need to establish a baseline alarm assessment (e.g. “I just need a number of alarms for the TJC.”). This typically spans 30 days.
- Impact Assessment – Patient Safety or Quality Committees are reviewing and comparing the impact and assessing alarm/interruption progress, Examples are:
- Are we improving since “X” policy change was implemented?
- Are nurses reacting to more or less interruptions since “X policy” or “Y workflow” was implemented?
- Root Cause Analysis – This is specific research for root cause analysis regarding and clinical incident/episode for a specific patient and a thorough understanding of why something happened.
Situational Awareness (Current Metrics)
Actionable information that nurses and nurse managers can use during a shift is an essential aspect for helping to improving patient safety. These are often displayed as dashboard metrics and may be thought of as a “safety net” when all the data and department noise becomes overwhelming. These metrics are not only used for direct patient care but also will assist in clinical training for new staff. These metrics are simple and easy to read. They might be graphical or visual in nature and should have the most impact on patient care for a specific department.
There are many opportunities available to provide a review of the current situation. Three examples are outlined below:
- Organizational Metrics:
- By department: Staffing situations and trends
- Is your department experiencing too many alarms for current staff?
- Is a specific nurse overwhelmed? I.e. Alarm flood scenario
- By hospital staffing situations: Overall comparisons to hospital goals
- Departmental Specific Situations (Alarm Floods or Predictive Situations):
- Is a specific nurse overwhelmed?
- Are specific patients regressing?
- Comparative Metrics (Regional, National or IDN):
- Are comparisons against industry norms important?
- What about your IDN comparisons? As a community?
- How does a similar department compare to other “like” departments in a region or to a national standard or best practice organization?
It is recommended that you start small and identify your baseline with a retrospective report. It is important to have a comparison point. By picking a single department, a single device or system the amount of data available should be manageable. It can be overwhelming if all sources and data are reviewed at once.
One common starting point is physiologic alarms followed closely by nurse call systems and then other medical devices. After evaluating all systems individually, hospitals can then review possible advanced contextual alarming situations where alarm data sources are combined. This leads to specific dashboard metrics and actionable information, which, if used correctly, should improve patient care and alarm safety programs.