Anyone who has worked in any healthcare setting can attest what the ISMP and others have documented:
Distractions are a major contributor to medication errors.
Distractions can come from countless directions and have significant consequences. A recent article documented an average of about one interruption every two minutes in the pharmacy. According to the ISMP, the risk of any medication error increases 12.7% with each interruption, and the risk of a harmful medication error is doubled when nurses are interrupted 4 times during a single drug administration, tripled when interrupted 6 times.
Often times, basic methods of communication can actually lead to distraction. The telephone stands as the most prevalent method of communication in healthcare. Voice activated communication systems such as Vocera are also becoming more and more popular.
While these tools serve a fundamental purpose, they have the potential to become significant distractions to any healthcare worker. Phone conversations, with the exception of conference calls, require a 2‐way conversation. No one can predict when the phone will ring or when the Vocera will call your name. The caller has no way of knowing if the person they are trying to reach is in a situation where the distraction could prove to be problematic.
Phone calls or Vocera conversations can be considered a “conversational silo”. In most cases only two people are privy to what is discussed. These types of conversations tend to be repeated over and over again, especially when more than two people or multiple disciplines are involved in a patient’s care. If we don’t want to repeat them, all of the people involved in a patient’s care must have access to prior conversations. For example, if a nurse calls the pharmacy clean room to check on the status of an IV, they cannot know that a different nurse may have just called with the same question. To the IV pharmacist, both phone calls prove to be significant distractions.
Email has proven to be another “conversational silo”. No one, outside the distribution list, has access to previous email conversations. Additionally, most email servers are not secure and fail to meet HIPAA compliance. An email could potentially be forwarded to anyone risking a breach in confidentiality.
RxTOOLKIT developed RxCONNECT for use as a secure internal information sharing tool to minimize distractions and document important communications. It connects users to information and to one another in an easily accessible and HIPAA compliant environment. RxCONNECT offers the accessibility of email but with added convenience and security.
RxCONNECT was designed following the model of social networking websites but within the secure environment necessary in any healthcare setting. Since we introduced RxCONNECT, our observation is that organizations have used the tool in two primary paths:
2. Patient disclosure/flow
Let’s look at an example. The Joint Commission now requires the monitoring of medication refrigerators and also requires the documentation of actions when a refrigerator has an out of range temperature. When an out of range temperature is reported, what was done and by whom? RxCONNECT provides an easy and efficient way of documenting information regarding each and every refrigerator. Each individual refrigerator becomes the title of the post. Any and all information regarding that “post” is then documented. Each entry is time stamped and because users must be logged in to use RxTOOLKIT, the name of the user who enters any post or comment is also documented. There is even a handy email link should you choose to send an “off line” communication to a single user or group.
RxCONNECT incorporates the use of smart text phrases, each designated for a specific function. Entering information such as “Out of Range Temperature – High” or “Checked refrigerator and door was open – Door was closed” can easily be added with just a click. Because RxTOOLKIT is internet based, conversations can be accessed from any PC, laptop, tablet, or smartphone.
Often times, conversations need to include general or logistical information, not clinical information required as part of the patient medical record. Let’s look at an example:
A patient (Mr. Jones) has an appointment at the out‐patient infusion center for 10 AM. The patient is scheduled to receive a Daptomycin infusion that will need to be compounded by pharmacy. The patient has not been compliant on treatment and both pharmacy and nursing do not want to compound the drug unless his arrival has been confirmed. The orders are sent to pharmacy with the instructions “Wait for patient arrival”. Traditionally the primary method of communicating the arrival of the patient is to call to the pharmacy, specifically the clean room where the drug is going to be compounded. This call can easily create a distraction to the clean room staff (who is focused on compounding drugs for other patients).
With RxCONNECT, the patient becomes the subject of the post. Information about the patient can be passed between clinic nurse and clean room pharmacist without the need for distractions. Nurse or pharmacist can document using smart text phrases designed for this specific type of interaction.
“Patient arrival is confirmed – OK to mix drug”
“Drug is mixed and being delivered”
RxCONNECT retains all of the information in a HIPAA compliant and secure environment. Each specific board can be restricted to users or groups within an organization on an “as needed” basis. RxCONNECT is only available to the users you select. Any logged in user, who has been granted access, can review all of the past conversations about a topic. RxCONNECT has a powerful search feature so all of the information is searchable and easy to find. A patient flow board can be customized to require MRN and specific therapy notes for each new patient post. This allows users to search by patient demographic information, specific therapy, or item within the context of any post.
RxCONNECT has proven to be an invaluable and distraction‐free resource for communication. We are excited to see how our clients find new and innovative ways of using this application. Our goal at RxTOOLKIT is to put critical information quickly and efficiently into the hands of team members who need it most. RxCONNECT manages your most important information and optimizes communication between essential staff members. Let us know if you would like more information about RxCONNECT or contact RxTOOLKIT to schedule a live demo.