As part of an effort to improve information flow to streamline previously manual processes, increase the number of cancer screenings, and vaccinate more patients for influenza, King Faisal Specialist Hospital & Research Center (KFSH&RC) in Saudi Arabia received a 2019 HIMSS Enterprise Davies Award. The HIMSS Davies Award of Excellence recognizes the thoughtful application of health information and technology to substantially improve clinical care delivery, patient outcomes and population health around the world.
“The HIMSS Davies Award of Excellence for KFSH&RC Riyadh & Jeddah shows the maturity and interoperability of our integrated clinical information system (ICIS) since its inception more than 17 years ago,” said Majed Al Fayyad, MD, MMM, Chief Executive Officer. “To reach this level of excellence and, more importantly, to share our lessons with the wider health care community is truly an enterprise-wide achievement and speaks to the dedication, usage and adoption of technology by our staff.”
Improved patient experience helps reduce length of stay
By building a “smart” facility at KFSH&RC’s newest building, the King Abdullah Center for Oncology and Liver Diseases (KACOLD), the KFSH&RC team found a way to improve information flow through an ever-increasing number of medical devices and IT systems. During implementation, multiple aspects of the clinical workflow became automated, and devices including patient TV monitors, vital sign machines and electronic room signage all became integrated. More than 2,500 medical devices and 30 clinical systems worked together to process 35 million transactions a day across clinical and non-clinical systems. The initiative, supported by utilizing Cerner’s CareAware® suite improved communications among care teams and helped KFSH&RC’s efforts to reduce length of stay for patients, which fell by 9%.1
KFSH&RC automated the flow of information with the addition of electronic patient status display, removal of manual whiteboards and installation of digital dashboards. At a glance, the dashboards now provide clinicians quick information about patients and their conditions.
Patients at KACOLD also found it easier to learn more about hospital operations and interact with their care teams. Staff began educating patients on standard safety precautions, while providing personalized education materials. Some of this education came through interactive television monitors in the patient room. Those same monitors allowed patients to alert clinicians to their pain level, request food.
“We have streamlined the flow of communication between patients, nurses, physicians and supporting staff. It really improved patient outcomes and created a significant improvement in patient satisfaction,” said Chief Medical Informatics Officer Dr. Abdullah Alturki MBBS, FAAP.
Increasing influenza vaccination rates
Influenza rates don’t have a high and low season in the Middle East, so the virus infects patients throughout the year. Combined with millions of visitors from around the world, the KFSH&RC team sought to find a way to increase influenza vaccinations as part of a global strategy to minimize potential outbreaks.
“2018 was the 100th anniversary of the Spanish flu which killed 50 million people worldwide. The World Health Organization considers influenza vaccination as a major strategy to combat the next pandemic,” said Dr. Muntazar Bashir, KFSH&RC Jeddah Chairman of Family Medicine. “Moreover, we chose this crucial issue because the Kingdom of Saudi Arabia has millions of pilgrims coming from all over the world, all year round, with the potential to bring infections. As a tertiary care hospital, all of our patients are vulnerable to infectious diseases, and influenza in particular.”
In February 2014, the hospital introduced a health maintenance tab (HMT) within the Cerner Millennium® electronic health record to remind providers to offer preventative services. Upon opening a patient’s chart, physicians received a notice to remind patients to get the influenza vaccine. Over the course of four years, the hospital increased influenza vaccination rates by 304%.2
Cancer screenings for colorectal and breast cancer
With breast cancer as the most common form of cancer among Saudi women, an analysis at KFSH&RC found that mammograms were often ordered too early or too late and not targeted towards the right patients. The analysis also looked at colorectal cancer, one of the most common forms of cancer among Saudi men and found deficiencies in the fecal occult blood (FOB) screenings as well.
KFSH&RC utilized clinical decision support to identify patients as potential candidates for cancer screenings. The information appeared in the HMT, making it easy for providers to quickly see if a patient should receive a screening. In addition, with just one click from the physician, they could enter the necessary order, making the entire process more user-friendly.
The number of FOB screening orders increased 59%,3 while the number of mammograms tests ordered increased 30%.4 These interventions yielded huge increases in early stage cancer detection for impacted patients.
“The minute they see abnormal results in the procedures or in the tests, we go to the second cycle of management,” said KFSH&RC (Riyadh) Chairman of Family Medicine, Dr. Abdullah Alkhenizan.
KFSH&RC is already a HIMSS O-EMRAM 7 for its ambulatory facilities, and HIMSS EMRAM 6 in its inpatient facilities. Winning the HIMSS Enterprise Davies award showcases its steps to innovate patient care delivery, automate the flow of information and eliminate manual processes to deliver safer care.
KFSH&RC Chief Information Officer, Osama Al Swailem, MD, MA said, “I have always looked at the HIMSS Davies Award as being a podium in which health organizations share their experience and knowledge with the greater healthcare community. KFSH&RC is proud to be a national and international healthcare ‘advisor’ in this regard and you will find us to be a very receptive organization. This is how you exponentially improve the quality of care.”
“To summarize the main reason King Faisal Specialist & Research Centre undertook these important patient safety and care quality initiatives, we always reference a verse from the Holy Quran that translates, ‘Whoever saves one life – it is as if he had saved all of mankind’,” said Fahad Bin Dayel, RN, MS, Director, KSFH&RC Applications and Health Informatics Services.
1 From 33 days in 2016, to 30 days in 2018.
2 Comparing 2,304 cases from 2012 – 2014, to 9,299 from 2015 -2018.
3 Comparing 2,992 tests ordered from 2012 – 2014, to 4,743 tests from 2015 – 2018
4 Comparing 1,579 tests ordered from 2012 – 2014, to 2,056 tests from 2015 – 2018.