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In This Issue:
Saving Lives and Preventing Errors
Forget about Hollywood. Forget about primetime. This has nothing to do with “ER.” It has everything to do with preventing errors and facilitating high quality patient care. With nearly two years’ worth of experience, the ED tracking system at BWH has already demonstrated its value in a fast moving environment of complex care.
“In the past, the vast majority of orders were issued verbally,” said Ron Walls, MD, chairman, Emergency Medicine. “Now, through this computer based system, we can greatly diminish the opportunity for error.”
The innovative system tracks a variety of patient care variables from waiting times to the severity of patient conditions. It also provides a customized interface with the hospital’s computer order entry system prompting physicians about possible allergies and preventing redundant orders from being entered.
The system also incorporates the BWH-developed emergency severity index (ESI) that monitors the level of care required for each patient and provides an accurate reading on the necessary departmental resources. The ESI breaks patient conditions into five categories and allows providers to plan for the efficient care of many patients simultaneously.
“This is a rather unique system that allows our physicians to manage care far more effectively and with greater safety,” said Andrew McAfee, MD, one of the developers of the order entry software. “In this type of environment, verbal orders can be easily misinterpreted. This system is easy to use and provides us with information that we previously did not have access to in our setting of care.”
In addition to providing for a safer environment for BWH emergency medicine patients, Walls believes that the tool can be helpful in addressing more systematic issues, including ambulance diversions.
“The tracking software provides us with immediate access to medical records, notes from primary care physicians and variations in test readings, allowing us to more effectively and efficiently develop an assessment of the patient,” says Walls, who sits as a member of the State’s Task Force on Emergency Room Diversions. ESI allows comparison of ED volume between hospitals and within the entire state.
This type of early promise already has caught the attention of other hospitals in the nation, as well as the Massachusetts Depart-ment of Public Health, an agency looking to find innovative ways to enhance emergency care. All of the Partners acute care hospitals are currently implementing the ESI system.