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Nurses welcome ED tracking system

Tool coordinates ambulances, helps triage patients before arrival at LIJ

Monday October 8, 2012
LIJ Medical Centerís new tracking software and monitor give emergency medicine staff a snapshot of incoming ambulances and patients. ED nurse Debbie Sutton-Williams, RN, discusses a patientís case with paramedics.
LIJ Medical Centerís new tracking software and monitor give emergency medicine staff a snapshot of incoming ambulances and patients. ED nurse Debbie Sutton-Williams, RN, discusses a patientís case with paramedics.
(Photo courtesy NorthShore-LIJ)
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North Shore-LIJís Center for Emergency Medical Services recently installed a new wireless tracking system to better predict ambulance arrivals and collect critical health data in real time before patients arrive at the ED. The new technology has been rolled out at LIJ Medical Center, New Hyde Park, N.Y.

Responding to 911 calls, paramedics and emergency medical technicians begin their assessment and gather critical patient information. Using a laptop computer, emergency medical workers transmit a patientís age, gender, vital signs and brief comments about their condition — for example, "dizziness, seizure, fainting."

Information is displayed at LIJ on a 40-inch monitor on a wall facing the ambulance bay entrance (names are not used to protect patient privacy).

The details give triage nurses and physicians a quick picture of the number of ambulances en route to the hospital and the severity of patientsí conditions, allowing staff to better prepare for patients and manage care. Nurses and physicians also can access patient information on computers in the ED.

"The emergency department is an unpredictable place," said Salvatore Pardo, MD, associate chairman of emergency medicine at LIJ. "The technology is a great tool because it gives the ED team information at a glance to better plan for incoming patients."

From several yards away, staff can see incoming cases blinking on the monitor, with trauma cases in black or cardiac arrests in orange, for example. Previously, Pardo said the ED would get a phone call from staff in the ambulance, and it was nearly impossible to capture all details of a patientís condition before arrival.

North Shore-LIJís CEMS, the largest hospital-based ambulance service in the New York City metropolitan area and one of the largest in the country, plans to introduce the technology at other health system hospitals in the coming months.

In the past year, LIJís ED saw a 36% increase in patient visits, partially attributable to recent hospital closures in Queens, according to Patricia Farrell, RN, senior administrative director of patient care services. LIJís ED receives about 1,400 ambulances via 911 calls each month and approximately 80,000 patient visits a year.

"We know that seconds count in a 911 call for a medical emergency," Farrell said. "The tracking system jump-starts care, and we are able to triage patients before they come through the door." Farrell explained the pre-hospital electronic records technology also helps ED staff to better manage incoming ambulance traffic. Through CEMS, they have the ability to divert an ambulance to a nearby hospital, if necessary, improving hospital throughput.

"If we see an increased volume of patients in the ED and we know their condition, we can notify the operating room or other hospital departments [of] a need for more beds," Farrell said. "This way, we have a game plan that not only enhances patient care and service, but makes the workflow more efficient."

The learning curve for nurses was minimal, according to Helena Willis, RN, BSN, MBA, CEN, LIJís ED director of patient care services. "It is right in front of the ambulance triage nurse, so it is easily accessible," she said. "The information on the patients en route is flashing so it can be easily identified by all staff."

The new system has helped nurses better prepare for arrivals. "The board provides them with the chief complaint and vital signs so they can anticipate what resources the patient will require," Willis said.

The system also has been instrumental in LIJís efforts to quickly identify sepsis patients.

"The triage nurse is alerted to signs and symptoms of possible septic shock and can have a treatment room ready and the physician alerted before the patient arrives," Willis said.

Staff writer Tracey Boyd contributed to this story.

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