Pharmacy OneSource Blog

Five Ways to Improve Clinical Care and the Bottom Line

Posted on 06/06/18

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Use of clinical surveillance solutions has emerged in recent years as a proven best practice for delivering proactive, quality-focused care that drives tangible outcomes improvement. Hospitals are increasingly leveraging the streamlined, data-driven workflows powered by these solutions to elevate high-level initiatives geared at improving outcomes and lowering costs.

Clinical surveillance solutions stand out in the market due to their ability to aggregate and deliver real-time clinical information in an actionable way to circumvent adverse events and improve delivery of evidenced-based care. Notably, clinical surveillance extends to two areas that a recent Advisory Board report ranked in the top six concerns of today’s health system executives: minimizing unwarranted clinical variation and controlling avoidable utilization.

Yet, the business case for leveraging the rules-based infrastructure of clinical surveillance goes much deeper. By getting patient specific data into the hands of clinicians quickly and helping to eliminate variation, these solutions are helping today’s hospitals and health systems move clinical care delivery from reactive to proactive.

Here are five practical ways clinical surveillance is being used to help improve outcomes and the bottom line.

1) Infection Prevention/Healthcare-Associated Infections

The U.S. healthcare industry is waging a war against healthcare-associated infections (HAIs) by tying reimbursement and reputation to performance. Hospitals can optimize value-based incentive payments and improve performance scores by using clinical surveillance to help address such avoidable problems as central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), surgical site infections (SSIs) and C. difficile infection. Pre-identified data is aggregated from EMRs and other disparate lab and clinical systems to flag potential infection issues in real-time. Actionable, risk-stratified information is then delivered to clinicians, drawing attention to urgent issues and the greatest opportunities for improvement.

2) Antimicrobial Stewardship

In response to heightened regulatory scrutiny and expectations for further oversight, today’s hospitals and health systems face unprecedented urgency to get ahead of antibiotic-resistant strains of microorganisms. Clinical surveillance helps healthcare organizations operationalize antimicrobial stewardship initiatives quickly and provides the foundation for continuous quality improvement. Real-time algorithms streamline workflows by directing staff to high-priority patients by targeting issues such as inappropriate empiric/initial antimicrobial agent selection, “drug-bug mismatch” (wrong antibiotic based on the microbiology culture), opportunities to use less potent antimicrobial agents (“de-escalation”), renal function surveillance (for optimal dosing of antimicrobials) and elevated risk for hospital-acquired infections.

3) Efficient, Effective Medication Management

Medications are the number one method used to treat and prevent disease in the U.S. Optimizing the use of medications results in better health outcomes and can decrease use of other unnecessary health resources (e.g., reduced readmissions). Combining the complexity of medications used in the hospital setting with a severely ill patient population requires diligent monitoring to ensure treatment goals are reached. It’s also no secret that medications represent a significant and growing expense in any hospital or health system. Rules-based surveillance systems targeting medication use provide pharmacists with real-time data to identify quickly patients in need of drug therapy alterations, dosing adjustments and lab tests to guide treatment.

Hospitals and health systems find that clinical surveillance systems streamline workflows in such a way that interventions to improve patient care increase substantially.

4) Patient Safety/Adverse Drug Events

Patient safety is of paramount importance in any health system, and medication safety plays a critical role in elevating strategies. Adverse drug events (ADEs) account for an estimated one-third of total hospital adverse events and approximately 280,000 hospital admissions annually, according to National Action Plan for Adverse Drug Event Prevention.

Rules-based clinical surveillance technology can help hospitals improve patient safety by identifying patients at risk for ADEs and preventing and/or mitigating harm. Surveillance systems are particularly valuable when targeting drug classes that are responsible for the vast majority of patient harm: anticoagulants, narcotics/opioids and hypoglycemic drugs (e.g., insulin). For example, heparin-induced thrombocytopenia (HIT) is a serious immune system-related disorder to a commonly-used anticoagulant that results in a dangerous drop in the platelet count, increasing the risk of bleeding.

The subtle and delayed onset of this reaction can make it challenging for care providers to recognize its occurrence in the early stages. Surveillance tools can monitor all patients exposed to the anticoagulant, track absolute and relative decreases in platelet counts and provide an early notification of the problem, enabling prompt intervention to minimize harm.

5) Quality Measures Compliance

Value-based initiatives are built on compliance and performance across a variety of quality and performance measures, some addressing processes of care and others tied to clinical outcomes, patient safety and financial indicators. Quality improvement professionals can proactively monitor clinical practices related to quality measures and promote more consistent care processes based on the latest evidence through clinical surveillance technology. For example, rules-based algorithms can monitor therapies provided to patients with heart failure, experiencing a heart attack or those with community-acquired pneumonia to ensure care protocols are followed that align with value-based initiatives.

Clinical surveillance technology is transforming care delivery through real-time, actionable data that moves clinical workflows from reactive to proactive, while also ensuring less variation in care practices. When effectively aligned with point-of-care clinical activity, these tools can have a powerful impact on patient safety, the standardization of evidence-based practices, quality of care and ultimately saving lives.

Topics: Infection Prevention, Antimicrobial Stewardship, Clinical Surveillance

About the Author

Steven M. Riddle, PharmD, BCPS, FASHP Steven M. Riddle, PharmD, BCPS, FASHP serves as Director of Clinical Development for Wolters Kluwer Pharmacy OneSource, a company that provides cloud-based technology solutions and evidence-based content to support optimal quality in point-of-care delivery of health services. Dr. Riddle is responsible for overall strategic direction around clinical content and determination of business opportunities for Pharmacy OneSource and Clinical Solutions. He also serves as the Director for the Fellowship Program and as liaison for the company to the healthcare profession.