Delivering highly reliable care is a challenge throughout the care continuum, but nowhere more so than in the complex environment of critical care. Banner Health recognized these challenges and decided to focus efforts on improving care of high-acuity patients. Multiple studies convinced Banner that daily intensivist involvement with critically ill patients leads to improved survival, shortened length of stay and reduced complications, but Banner knew that more doctors and nurses were not a sustainable answer. To provide 24/7 intensivist coverage across the U.S. would take more than 33,000 intensivists, while there are only 8,000 of these providers available.
Stopping Severe Sepsis Instances
In 2006, Banner implemented its TeleICU program with two-way A/V technology, predictive analytics, data visualization and advanced reporting. Banner not only used this surveillance in the traditional model within the ICU, but also pushed the boundary into other areas of care like the emergency department, recovery unit, acute care and skilled nursing spaces. Banner also leveraged the TeleICU team while working in conjunction with a novel, real-time severe sepsis-screening algorithm. This was embedded within the electronic health record (EHR) to evaluate and monitor patients at risk for severe sepsis.
In 2015, Banner added an automated measurement of lactic acid to the sepsis alert – now rebranded as the SaFE alert (Sepsis and perFusion Evaluation) – to help improve the real-time notification of sepsis or organ failure. The SaFE Alert is monitored on the EHR and is also included in a dashboard view as a byproduct of documentation. These resources are accessible from any location for staff to assist in monitoring, and the alerts can be forwarded to other devices. The TeleCare team plays a key role by monitoring these events requiring documentation, even for patients outside of the ICU.
While real-time automated continuous sampling of EHR data is key to identifying patients at risk for death and enabling prompt life-saving interventions, the ability to drive specialized plans from the EHR is a key component of Banner’s successful measurement of severely septic patients.
As a result of their investment in telehealth, Banner Health
• improved the staff coverage for the critical care units
• extended coverage into other areas where additional surveillance and clinical decision support could be leveraged to provide highly reliable care
• decreased ICU length of stay and hospital mortality for ICU patients
• improved bundle compliance via EHR data
Results observed from 2006–2018 include 297,613 fewer ICU days than expected and an estimated 15,000 lives saved. The conclusion of the SaFE Alert findings indicate that an automated alert system that continuously samples EHR data can be implemented, has excellent testing characteristics and can assist in the real-time identiﬁcation of hospitalized, at-risk patients.
HIMSS Davies Award of Excellence
The HIMSS Davies Award of Excellence recognizes outstanding achievement of organizations that have utilized health information technology to substantially improve patient outcomes and value. The HIMSS Davies Award of Excellence is the pinnacle of the HIMSS Value Recognition Program and highlights organizations promoting health information and technology-enabled improvements in patient and business outcomes through sharing evidence-driven best practices on implementation strategies, workflow design, change management and patient engagement.
“Banner has boldly embraced digital health to improve outcomes, especially for high-acuity patients,” said Jonathan French, CPHIMS, senior director of quality and value-based care at HIMSS. “Banner dedicated themselves to a mission of improved care through being an early adopter of the latest EHR tools, which were successfully deployed with both patient and provider needs in mind. For their focus on continuous momentum in driving the future of health forward, HIMSS is proud to recognize Banner Health as a 2018 Davies Enterprise Award winner.”
“We are truly honored to be recognized with the HIMSS Davies Award. Since the beginning of Banner Health’s journey, high reliability and quality care have been our top priorities,” said William Holland, MD, Vice President of Care Management and Chief Medical Informatics Officer. “With teams of physician leaders, engineers, informaticists, IT specialists and data analysts all working together toward a common goal, we’ve created an integrated EHR platform and achieved sustainable industry-leading outcomes in the care we deliver throughout our entire health system.”
Banner Health will be recognized during the 2019 HIMSS Global Conference & Exhibition, which takes place February 11-15 in Orlando, Florida.
Learn more about how Banner Health has embraced the value of health information and technology: explore three award-winning use cases.