Springhill Medical Center Sharpens ICU Response

When Springhill Medical Center automated its ICU documentation with Eclipsys Sunrise Critical Care™, the nurses and staff started seeing improvements right away. No longer isolated from the rest of the hospital, ICU clinicians discovered the benefits of an integrated, enterprise-wide electronic medical record (EMR). With critical care flowsheets and automated device interfaces delivering the complete patient story from the Emergency Department and other units, the hospital’s four ICUs have seen improved documentation accuracy and communication. The Mobile, Alabama-based hospital has also reduced the average number of days that ICU patients spend on ventilators and decreased the incidence of VAP, a leading cause of ICU mortality.

In October 2004, Springhill Medical Center launched Sunrise Critical Care as part of a hospital-wide “big-bang” activation of Sunrise Clinical Manager™. Springhill management expected the 75 ICU nurses to struggle with the go-live. Yet careful planning and a flexible interface provided the foundation for success. “The ICU staff adapted almost immediately,” said Pam Shedd, RN, Clinical Systems Manager at Springhill. “They were involved from day one in developing flowsheets to meet their needs.”

Identifying the Window of Opportunity
In the ICU, speed and accuracy are essential to ensure that staff can respond to high-acuity patient needs during the six-to-eight-hour “window of opportunity” when clinical intervention is most effective. To support such rapid response, Eclipsys’ industry-leading CPOE system and embedded clinical decision support provide clinicians with real-time alerts and reminders throughout the care process. Thanks to the integrated Sunrise Clinical Manager platform, clinicians gain a comprehensive view of patient status across venues, no matter where the patient is located. “Having alerts that notify you of potential adverse reactions due to allergies or medication duplication has improved our ability to care for patients,” said Shedd.

Integration Between Devices and Flowsheets Helps Improve Outcomes
Effective decision-making requires up-to-date information, and Sunrise Critical Care delivers extensive device integration from bedside monitors to the system’s vital-signs flowsheet. “With one click, the bedside monitor populates the flowsheet, so ICU nurses can care for the patient instead of writing down vitals,” said Shedd.

The ventilator-to-flowsheet interface enables clinicians to quickly load data from the ventilator, and then rapidly review and save vent settings and patient-values data. According to Shedd, this automation has “reduced transcription errors and improved the timeliness and accuracy of documentation.”

Springhill also leveraged the customizable flowsheets to implement a ventilator-weaning protocol. Clinicians can easily document spontaneous-breathing trial results and the assessment of readiness to wean, and the data is automatically consolidated into the clinical summary view. Physicians can check patient status and enter orders via a Web browser from their home or office.

“We are weaning our patients off ventilators more efficiently and seeing a decrease in ventilator days, which has led to a decrease in ventilator-acquired pneumonia,” said Shedd. In the process, Sunrise Critical Care has brought two disciplines closer together. “Now that respiratory therapists and nurses have access to each other’s assessments, communication and patient care have both improved.”

The Benefits
In addition to reducing the incidence of VAP, Springhill has boosted ICU efficiency and provider satisfaction. “If a patient is coming from the ED, the ICU staff can pull the record before the patient arrives, so they’re better prepared,” said Shedd. “Less time is spent on the phone trying to find information and more time is spent at the bedside, so there are fewer delays in addressing patient issues.”

According to Shedd, Springhill Medical Center has found an optimal balance. “Sunrise Critical Care is flexible enough to allow us to customize it, yet it also provides consistency in documentation,” said Shedd. “Change happens, and you have to anticipate it and adapt quickly. Sunrise Critical Care makes this possible.”