RaulandBorg Corporation Health Care Communications The Complete Solution

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Rauland-Borg CorporationHealth Care
CommunicationsThe Complete Solution

• Responder IV Responder NET
• Features Benefits
• including
• Enhanced Alarm and Bed Management Systems FDA
  Registration

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Enhanced Alarm Management

• What it means to Nurses and Patients

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Demands on Nurses
Charting
Lab Work / Results
Patient Requests
Filling Doctors Orders
Respond to Alarms
Admit / Discharge
Talking with Family
Reporting
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Impossible Demands of Alarm Management

• JCAHO patient safety goal 6 states must be able
  to hear the alarm, but
• Disturbs patients!
• Need to know alarm information, but
• Too many alarms fatigue
• Alarm Desensitization

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Alarm Desensitization

• At night an alarm sounds.
• The Nurse hears it. So does every sleeping
  patient in between.
• She is doing something important but tracks down
  the alarm.
• It was an alarm she could have postponed
  answering.
• This is the third time it has happened.
• The fourth time she ignores it.

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Improving Workflow Increasing Satisfaction

• Patient equipment alarms routed to wireless phone
  
• Better able to respond to patients needs
• IV Alarm
• Ventilator
• Patient Monitor
• No listening for audible alarms
• Quieter floor for patients
• Increasing both staff and patient satisfaction

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Improving Workflow Better Information in Hand

• Better information to access patient
• Routing detailed alarm information to wireless
  device
• High Vent
• IV bag Low
• Heart Rate Low 32

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Rich Alarm Messaging
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Improving Workflow

• Saving Steps with Responder IV
• Routing Nurse Calls to the nurses wireless
  device
• Receives only calls from his / her patients
• More information about the patients needs
• Bath call or Shower call
• Code Blue
• In pain
• Etc.

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Improving Workflow Enhanced Alarm Management

• Rich Alarm information directly to Wireless
  Device
• 201, Pulse Ox, Urgent
• 201, EKG, Lead off
• Waveforms on Cisco phones!
• No cables to plug into nurse call

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Enhanced Alarm Management

• Alarm equipment on hospitals LAN
• Emergin routes information to wireless device
• Unique integration links Responder NET to Alarm
  Equipment via Emergin
• Both Rauland and Emergin products are FDA
  Registered

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Increase Productivity Save Steps

• One step One Sign-On
• Signing on to Responder NET automatically
  routes all equipment alarms to the caregiver
• Eliminates signing on 2-3 places
• Scenario our competitors will have to live with!

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Automates Processes

• Ensures no alarm call goes unanswered
• Automatically sets Service Requests on room
• Configurable per alarm severity
• Example Extremely low heart rate STAT Service

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Monitors Quality

• One place for Alarm Reporting
• All alarm messages documented in Management
  Software
• Critical Information to Responder NET
• Alarm message posted on Patient Whiteboard
• Alarm message alerted on Call Display

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Confronts Alarm Fatigue

• Ability to filter alarms
• Select only relevant alarm types to go to
  caregivers
• Eliminates the concern of caregivers receiving
  too many alarms
• Greatly reduces Alarm Desensitization and fatigue

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Enhanced Alarm Management

• What is an alarm?
• Where do alarms come from?
• Pulse Oximeters
• Infusion Pumps (IV)
• Ventilators
• Patient Monitors
• Why are alarms important to nurses?

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Pulse Oximeters

• Checks for of oxygen in blood
• Measures Heart Rate
• Alarms
• has dropped below set threshold (86-90)

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Infusion Pumps

• Administers a fluid (as of medication, blood, or
  nutrients) intravenously
• Alarms
• Low medication (bag out)
• Flow rate is too fast / slow
• Occlusions (Up or Down)

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Ventilators

• Maintains artificial respiration
• Alarms
• Patient stopped breathing
• High vent too much air pressure in the tube
• Low vent not enough air pressure in the tube

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Patient Monitors

• Observes or measures a biologically important
  condition or function
• Cardiac
• Fetal
• Can encompass many devices/measurements
• Pulse Oximeter
• EKG
• Blood Pressure
• Temperature
• Alarms (depends on features of monitor)
• Heart rate to low / high
• Low / High blood pressure
• Temperature low / high

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Additional Alarms

• Laboratory Systems
• Results of test (Critical Values) can indicate
  the treatment of a patient should change
  immediately
• Examples
• Positive blood cultures
• Cerebrospinal fluid cultures
• Toxic therapeutic drug levels
• lt 5 of critical value telephone calls were
  abandoned
• 71.4 of 623 institutions had no policy on
  handling repeat critical calls

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Improving Nursing Workflow

• Enhanced Alarm Management
• Responder IV / NET is the only nurse call system
  to bring these critical alarms to the caregiver
  seamlessly!

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Rauland vs. Competitors
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Enhanced Alarm Management Benefits

• Raising the Standard of Patient Safety
• Rich alarm information
• Filtered delivered to caregiver
• Meets JCAHO standards
• Confronts Alarm Fatigue Noise Levels
• Increases Staff Productivity

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Enhanced Alarm Management Benefits

• Increases Staff Compliance
• Sign on ONCE to Responder NET
• Automates Processes
• Service request on Responder IV ensures alarm is
  addressed
• Monitors Quality of Care
• Documents alarm messages in Management Software
• Displays alarm messages in Patient Whiteboard

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FDA Registration

• What it Means?

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Why is FDA Registration Important?

• All medical devices sold in the USA require FDA
  registration
• Nurse call systems are medical devices because we
  play a role in the care and treatment of patients
• Code Blue primary notification
• Code Blue failure could result in death
• Alarm management for devices that are Class II
  medical devices
• Future development will increase alarm
  integration

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What Does That Mean to You?

• Rauland Borg and Responder brand products are now
  FDA Class II exempt medical devices
• Another example of commitment to the highest
  quality and performance standards
• Still UL1069 listed
• Rauland must comply with
• Good manufacturing practices
• Covers design, packaging, labeling, and
  manufacturing
• Medical device reporting regulations
• Adverse event reporting program
• Alerts the public sooner of problem medical
  devices

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Bed Management Systems

• Why are they Important?

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Why the need for an efficient bed management
system?

• Decrease in bed availability
• Hospital beds down 18 since 1985 according to
  AHA1
• Hospitals working at or over capacity
• Average hospital occupancy rate is at 64, its
  highest since 19932
• Some hospitals working at or over 100 capacity
  on busy days

• American Hospital Association. Survey released
  April 9th, 2002
• Kaiser Network After Years of Reducing
  Available Beds, Hospitals Struggle to Deal with
  Surprising Increase in Patients.
  http//www.kaisernetwork.org/daily_reports/rep_ind
  ex.cfm?hint3DR_ID10311 Mar 28, 2002

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Why the need for an efficient bed management
system?

• Staffing shortage
• Hospital vacancy rates for RNs and radiology
  techs each exceed 10 according to AHA survey
• Cause delays in admitting and discharging
  patients- slows bed turnover time
• Leads to bottlenecks in patient flow in the ED

1. American Hospital Association. Promises
Under Pressure Strengthening the Workforce
April, 2002
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Why the need for an efficient bed management
system?

• Emergency Department Crisis
• EDs are the primary gateways of Hospital revenue.
• One third of U.S. EDs are so overcrowded they are
  having to periodically divert ambulances to other
  hospitals, diverting revenue.
• 62 of hospitals surveyed said their EDs were
  operating at or over capacity
• Beds are available, however inefficient
  processes/staffing shortage keeps patients in the
  waiting room

• Kaiser Network One Third of Hospitals Divert
  Ambulances Because of ER Overcrowding.
  http//www.kaisernetwork.org/daily_reports/rep_ind
  ex.cfm?hint3DR_ID10521 April 9th, 2002
• The Camden Group Hospital Emergency Departments
  in Crisis Aggressive Planning is Needed
  http//www.thecamdengroup.com/Pdf/Winter202003.pd
  f Winter 2003

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Why the need for an efficient bed management
system?

• The current options are all inadequate
• Manual option
• Time consuming- slow relay of information leaves
  beds open or uncleaned while patients pile up in
  the ED or admitting
• Nurses do not actively seek to fill beds
• Visual system
• Maintenance issues
• Limited to one area
• Does not contact anyone directly
• Telephone Tracking System
• Low compliance due to complexity of system
• The fact that it is being considered is an
  indication of the great need for a solution in
  this area.

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Responder NET Bed Management Solution

• Automates the bed management process
• Removes one more burden from nursing
• Quick and easy-to-use
• Instant notification- anytime, anywhere
• Real-time information available on any networked
  PC
• Could prevent ambulances from being diverted.
• Prevent negative perception

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Responder NET Bed Management Solution

• Increases bed revenue
• CEOs are looking for ways to increase patient
  throughput
• Increasing throughput is increasing the number of
  admits at a hospital
• The means of achieving this is through making
  processes in the hospital more efficient
• The example of Southwest Airlines

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Responder NET Bed Management Solution

• Monitor and Remedy Bed Control Problems
• Report Analysis Capability
• Analyze speed of bed turnover over time
• Identify problem areas
• Where is the bottleneck?
• Transport? Housekeeping?

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Improvements to the Housekeeping / Room Ready
Application

• No longer need a dummy console!
• Both priorities are momentary switches
• Does not show up on the RIV system
• No repeated pocket paging (OT)
• Housekeeping Managers PC displays all rooms in
  need of cleaning
• Real-time information displayed on any networked
  PC

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ED ApplicationChristiana HospitalNewark, DE

• ISSUES
• Maintenance nightmare (bulbs, wires)
• Visual system does not notify staff directly
• Only available in one area
• One of the most active EDs in USA.
• NEED
• An automated, networked bed control system

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ED ApplicationChristiana HospitalNewark, DE

• THE SOLUTION CURRENTLY BEING IMPLEMENTED
• Housekeeping instantly notified of rooms in need
  of cleaning
• Faster turnover results in increased throughput.
• NET solution enables seamless operation of 4
  triage desks over LAN.
• Each desk knows what the other is doing and which
  beds are still available.
• Enables immediate assignment of patient to bed
  without double-booking

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In conclusion

• Increased throughput equals increased revenue
• Driving efficiency through automating processes
• Instant notification anytime, anywhere
• Increased throughput also decreases diversion
• Ease of Use
• No long codes to remember
• Simple buttons pushed by transport and
  housekeeping- not nurses
• Differentiation
• No other nurse call system offers a solution to
  this growing problem!

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