Medical operations dashboards always make for excellent case studies because mistakes can mean the difference between life and death. You know those stories about people that write “wrong arm” or “wrong leg” so as to keep medical errors from happening to them? Well, it’s an understatement to say that medical dashboards have to get the data presentation correct. Take a look at this screen shot and I’ll tell you more about it below.
Communication in the perioperative environment is critical for patient safety and effective teamwork. Team members need to know the name of the patient, scheduled procedure, patient precautions and allergies, along with names of team members working together for a given case. Over the past several years, Massachusetts General Hospital (MGH) developed an intra-operative dashboard in collaboration with LiveData (Cambridge, Massachusetts) to aid in the Timeout/Universal Protocol process as well as provide these critical communication elements.
Frontline clinicians imagined this type of communication would be beneficial if extended to the PACU environment to allow easy communication to the PACU staff and improved handoffs. In the typical environment, advance communication from the OR to the PACU often consists of a phone call upon completion of the case. The call alerts the PACU that the patient is nearly ready to leave the OR for the PACU and provides information related to the stability of the patient and any special needs the patient may have. If the patient requires more care than anticipated, nurses may need to reorganize assignments among themselves and find additional resources to provide appropriate patient care.
Accustomed to surprises, PACU nurses are adept at managing resources quickly and efficiently so that patient care is not compromised. Nevertheless, clinicians at Massachusetts General Hospital have continued exploration of creative uses for technology with the design, development, and introduction of an innovative tool to help reduce the level of uncertainty in the PACU and facilitate hand-offs from the OR. A “communication” dashboard that structures and automates the flow of crucial information about incoming patients is currently installed in a dedicated PACU as part of the MGH Best Practice Pod Project. The dashboard automatically provides a real-time global outlook of three operating rooms on a large monitor positioned in a central location on the PACU wall (Figures 2‚4). At any given moment, the recovery team can glance up and see:
Operating room number
Name of procedure
Operative milestone: such as induction, surgery start, emergence
Surgical time: time elapsed since the start of surgery until completion of the surgical procedure
Emergence time: time elapsed from the end of surgery until the patient leaves the room
Turnover time: time elapsed from the patient leaves the room until the next patient enters
Physiologic trends: patient vital signs with indicators for invasive hemodynamic monitoring
Anesthesia, nursing and surgical personnel working in the OR