For promoting opioid stewardship, reducing patient falls and decreasing the 30-day readmission rate, Atrium Health, in Charlotte, North Carolina received the HIMSS Enterprise Davies Award, one of the most respected awards in health care information technology.
The 2019 HIMSS Enterprise Davies Award honors organizations that utilize technology and health information to improve clinical care, patient outcomes and population health.
To be considered for the award, Atrium Health leaders submitted three in-depth case studies showcasing their measurable and sustained improvements. Recordings of their presentations are posted here.
Promoting opioid stewardship
In 2017, Atrium Health created a taskforce to focus on the development of standard tools and resources to support the appropriate use of opioids. Atrium Health utilizes clinical decision support alerts within the Cerner Millennium® electronic health record (EHR) triggered by carefully selected risks for opiate use disorder (OUD).
Medical prescribers who prescribe opioids or benzodiazepines (BZD), a class of psychoactive drugs that can be potentially more addictive, are alerted when a patient's history shows a potential for OUD.
Between January and June 2016, when the alert fired, prescribers across all specialties decided against ordering in 13% of cases involving potential BZD prescriptions and 5% of all opioid prescriptions.
“Solving today’s most pressing healthcare issues requires collaboration and divergent thinking,” said Eugene A. Woods, president and CEO of Atrium Health. “This is exactly why we’re so proud of this opioid alert platform and especially this recognition by HIMSS. This is just the start of incredible positive change, and in collaborating with others, we can continue to bring health, hope and healing to this growing epidemic.”
Virtual observation helps reduce patient falls, improves cost
In October 2016, Atrium Health invested in Cerner Patient Observer™ — a patient safety technology solution to reduce the patient fall rate, decrease the number of one-to-one sitter hours, decrease the rental of fall preventing specialty beds and lower restraint utilization. Atrium Health implemented virtual monitoring technology at Carolinas Rehabilitation hospitals.
One-year post implementation, Atrium Health’s Carolinas Rehabilitation hospitals’ unassisted falls rate dropped from 4.36 to 2.10.1 Restraint days, the days hospital staff had to use restraints to restrict a patient, dropped from 260.46 days to 189.91.2 With technology, we can monitor up to 12 patients at a time with one staff member at a centralized monitoring station,” said Becky Fox, MSN, RN-BC, vice president and chief nursing informatics officer. “It has allowed us to put more falls-risks patients under observation while avoiding the cost of additional sitters, and we’ve seen a reduction in patient falls as a result.”
Atrium Health also avoided more than 80 private sitters that would have been required in prior state, saving $85K in sitter fees.
“Following implementation, we saw immediate positive results in several ways. Not only has the number of restraints been reduced, staff productivity has increased, and overall labor costs have been significantly decreased,” said Cindy Sartain, BSN, MHA, LNHA, vice president, chief nurse executive for continuing care services.
Personalized approach to reduce readmissions
To reduce readmission rates, Atrium Health leaders targeted COPD patients. Efforts to drop the rate included developing a transition of service clinic, which provides services to patients who are being discharged from the hospital, and who are at high risk of readmission, such as home paramedic visits, phone check-ins and more. At the same time, technology from Cerner’s HealtheIntent® platform helped leaders to sift through social determinants of health data, to determine which patients were most at risk of readmissions.
By 2017, readmission rates in COPD patients decreased from 21.68% to 16.5%.3
Following the focus on COPD patients, Atrium Health next focused on medically complex high-risk patients for readmission in 2015. In order to transition patients back to their home or next appropriate care location during the first 30 days post-implementation, Atrium Health launched an integrated practice unit.4
Patients participating in transition services also demonstrated a 35% reduction in readmission rates compared to those receiving typical post-discharge care.5
“As a health industry, tapping into technology’s ability to solve long-standing challenges is vital,” said Rasu B. Shrestha, MD, MBA, executive vice president and chief strategy officer. “We’re incredibly proud to be recognized for our efforts with the HIMSS Davies Award and support continued efforts to recognize transformative work in the use of tech in health.”
1 From Nov. 2015-Oct. 2016 to Nov. 2016-Oct. 2017
2 From Nov. 2015-Oct. 2016 to Nov. 2016-Oct. 2017
3 From 2010
5 Comparing 2015 to 2018