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The Saint Luke’s-Shawnee Mission Health System (SLSMHS) in Kansas City, MO, has been able to save approximately $180,000 per year while improving the quality of patient care through the installation of an enterprisewide monitoring system.
Since 1998, a team of technicians at the Mid America Heart Institute, located within the 650-bed Saint Luke’s Hospital tertiary facility, has been able to monitor patients throughout the hospital and at remote facilities in the system via real-time data input in a centralized "war room."
"About five years ago, we were at a point where we had to replace some of our telemetry monitors, which were anywhere between eight and 15 years old," recalls David Zechman, BSE, MPA, RRT, vice president of cardiovascular services at Saint Luke’s. "We had to replace the oldest monitors because they were not making parts for them anymore, and they did not let us set alarms and parameters," he explains.
But Zechman says he wanted more than that; he wanted to be able to access each patient through a central database. That, he contends, would provide for more effective monitoring of adverse events. In addition, the decentralized system in place at the time called for technicians to be responsible just for their floor. "This resulted in a varied level of quality," says Zechman. "Also, there never seemed to be centralized accountability, and there was inconsistency in training as well. We wanted to manage care consistently across a continuum of levels."
Zechman says that new technology was just beginning to be employed that would offer him the standardization of training and care that he sought. "There were really only two major vendors. One was a large, national firm. The other was smaller, but [it] had been around a long time."
Zechman selected the second firm, Tustin, CA-based VitalCom, because of the advantages its system offered in patient safety, ease of use, and flexibility. Once set up, any provider in the 202-bed heart institute could log onto a workstation and see a patient’s rhythm in real time. "In addition, the in-house training was excellent," he notes. "And they had just developed the SiteLink technology, which enabled us to monitor patients at the other facilities."
To date, three other facilities in the system have been linked to the centralized monitoring service. Patients’ vital signs are monitored at Saint Luke’s South and Saint Luke’s Northland Hospital, both 30 miles away, and at Wright Memorial Hospital, 100 miles away. In addition, Shawnee Mission Medical Center, a 383-bed hospital, operates its own mission-control center with 48 channels.
With the installation of the enterprisewide system, patient monitoring has been increased and made more consistent, while enabling SLSMHS to reduce its technical monitoring staff at Saint Luke’s by 4.3 full-time equivalents. Zechman says he’s currently looking to expand the system’s cardiac business. "It has picked up at the other facilities we are monitoring, so we’re looking to expand our centralized war room," he says.
In addition, Zechman envisions providing fee-based services to hospitals outside the SLSMHS network. "We’ve had some initial discussions [with other facilities]," says Zechman, noting that the intent is not to create a new profit center. "We see it as a way to enhance or to build relationships with providers outside of the system."
Not content to rest on his laurels, Zechman is constantly looking to keep his monitoring system on the cutting edge of technology. "We recently installed VitalCom’s wireless Medical Telemetry Service software, which utilizes state-of-the-art cell and wireless LAN technology," he reports. "This enables us be on a newly protected FCC band, as well as being able to monitor 1,000 patients at a time."
On the old VHF band, Zechman explains, the theoretical maximum channel number was 480, "assuming none of them was being used by a TV station." Using the VHF band, there is the potential for a new TV station to crash a hospital’s telemetry system. "We’re one of the first systems in the country to use this micro cellular technology," says Zechman. "But all hospitals will have to make the same choice over the next few years."
• David Zechman, Saint Luke’s-Shawnee Mission Health System, 4401 Wornall, Kansas City, MO 64111. Telephone: (816) 932-2000. E-mail: firstname.lastname@example.org.