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Get SMART* About Prevention

Monday, October 17, 2016

How do I Spot Potential Health Issues in My Skilled Nursing Building Residents?

“How do I spot potential health issues in my residents—and intervene quickly to adjust medications to prevent unnecessary hospital readmission? With SMART* Alerts from CareConnection,” remarks Gwen Leger, APRN for a Louisiana skilled nursing building (placed through Provider Health Services). “I get daily reports, sent through secure email, that show me the vitals trends of every resident that has experienced those subtle changes which are indicative of potential health concerns. This software is so smart—-it gives me tremendous feedback on how a minor medication change is affecting the resident, or whether a new admit is adapting well and settling in so that we don’t overmedicate without a better understanding of that resident’s true baseline trends. After all, vitals are vital—those measurements are the first indicator of health.”

SMART* Alerts

The SMART* Alerts feature of CareConnection’s telehealth system ferrets out the vitals measurements, hunting for those subtle markers that are indicative of a trend that signifies change in resident condition. A resident might have a slight temperature along with a miniscule reduction in O2 saturation—perhaps not enough to trigger dashboard alerts through the EHR system—but this subtle trend is captured and sent to the nurse practitioner or Director of Nursing. This could be the harbinger of a readmission for a resident with COPD or CHF, but armed with the SMART*Alerts early warning system, the NP is able to intervene to start treatment and medications that will head off unnecessary hospitalization.

What’s the catch?

Leger emphasizes that it’s “all about process control. Nothing works better than responsible people armed with the right information.” She insists that the staff embed thresholds in CareConnection for all residents. “Start with global, then adjust and tighten to trigger an early warning system on any fragile residents, particularly those in their first 30 days.” Teach the caregivers to take action on the warnings that come up on the Vitals CareCart at bedside. “Make it a part of your process to have the CNA call a nurse when there is a threshold breach—don’t just send those readings on the EMR and hope that someone is watching the dashboard.” With CareConnection’s pop up alerts app, those breaches are immediately identified at the bedside, on the med cart laptops and/or nursing station desktops.

Leger is confident that the new SMART*Alerts will play a major role in reducing preventable readmissions in her buildings. “I’m seeing the value every day—we’re keeping our residents healthy and keeping our beds full with the help of this technology. It’s the only way we are going to survive the future of outcomes-based reimbursement.”