2014 HIMSS Davies Enterprise Award of Excellence recipient St. Clair Hospital, an independent, 328-bed acute care facility that provides advanced, high quality health care to more than 500,000 residents of southwestern Pennsylvania, realized a broad range of significant benefits through the use of information technology while serving a patient population that includes the largest ratio of Medicare patients in the United States.
- 100% of at-risk in-patients have received pneumonia vaccinations since December, 2012
- Using clinical analytics, St. Clair identified all patients who experienced hyperglycemic episodes of greater than 180 mg/dl and severe hypoglycemia less than 70 mg/dl. In March, 2011, the incidence of hyperglycemia was 659 per 1,000 patient days. Hypoglycemia incidence was 55 per 1,000 patient days. It was clear that there was room for improvement. With physician engagement, a standardized, evidence-based subcutaneous order set was implemented, accompanied by a revised hypoglycemia protocol. Three years later, in March, 2014, the rate of hyperglycemic episodes dropped to 416 per 1,000 patient days. A refocus of hypoglycemia resulted in revised data collection for severe hypoglycemia, now defined as a blood sugar less than 40 mg/dl. In 2014, the rate of severe hypoglycemic episodes fell from 4.6 to a low of 1.86 per 1,000 patient days. To support this initiative, St. Clair staff implemented an automatic order set that triggers a HgbA1c test for any patient that doesn't have a record of a HgbA1C test within the last 90 days.
- In order to reduce C Diff infections, St. Clair implemented a probiotic automatic order as a standard part of antibiotic ordering. Following implementation of the protocol in December of 2013, St Clair reduced C-Diff incidents by 50%.
- Prior to June of 2014, the daily rate of missing start times reported was averaging over 4.5 per day. Through carefully designed clinical decision support, the system now auto-schedules some medications. This new logic was activated in June 2014 and for the first 6 weeks the number of reported CPOE medication start time errors has decreased to less than 0.088 per day.
- By developing and deploying a dual scanning technology, barcode and RFID, to facilitate change management and technology adoption by nursing personnel and real time automated charting of medication administration into the electronic medication administration record, St. Clair Hospital has avoided 1,100 errors per year on average since 2004.