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2003 Press Releases

'Care-Traffic Control System' Aids MMC Surgery Patients

(January 23, 2003) — Time is precious at Maine Medical Center's surgery unit. On a typical day, as many as 90 patients are prepped for surgery and wheeled into the hospital's 21 operating rooms, where teams of surgeons, anesthesiologists and nurses perform their work - everything from cosmetic procedures to transplants. Outside, family members wait, anxious about their loved ones.

Keeping the unit running smoothly and efficiently takes skill and hard work. It also takes good tools, and among the most powerful is a computerized patient-management system called NaviCare that helps organize the work flow and provides both the medical staff and families with up-to-the-minute information on patients' status.

"It's made us more efficient and much better at what we do," said Martha A. Riehle, RN, MMC's associate vice president of nursing and associate chief nursing officer.

Maine Medical Center was the first hospital in New England to install the system, in February 2001, and has since become a model for others interested in using computer technology to improve care, said David Richter, the chief executive officer of NaviCare Systems, Inc., of St. Paul, Minn. "As a result of Maine Medical's leadership, there has been a lot of interest from other hospitals in New England," Richter said. In all, NaviCare is used at 21 U.S. hospitals.

Richter calls NaviCare "a care-traffic control system," and it does in fact function something like the computers that update flights in airports. At each stage of a patient's surgery, up-to-the-minute case-status information is entered on NaviCare, which keeps track of the lineup of surgeries and displays the appropriate level of information to families and medical staff.

In the waiting room of the Ambulatory Surgery Unit (ASU), for instance, a large flat-screen television allows relatives to follow the progress of the patient — from pre-op to operating room to recovery room and, finally, back to the ASU or their hospital bed. (For privacy, patient names are encoded on the screen so that only family members can recognize them.)

Before NaviCare, relatives who wanted information on the progress of a surgical procedure might ask a staff member in the waiting area, "but they usually didn't know a lot more than the family did," said Riehle. Now, she said, relatives have access to real-time information, and families "consistently tell us this is a great source of information."

Down a corridor, outside the operating rooms, two more big screens provide doctors and nurses with a more detailed status report. All 21 operating rooms are listed, along with the names of the patients and physicians and the types of surgery. Other information is shown by icons — among other things, whether consent forms have been signed, anesthesia administered and IV drips started. As a surgery begins, a small scalpel icon appears on the big screen; when the surgeon is closing the incision, the scalpel changes to stitches. Medical personnel continually update the information using computers in each operating room.

If a procedure runs longer than expected, a nurse at a computer can move the next scheduled surgery by clicking and dragging it to another operating room, and the monitor notifies the surgical team. Before NaviCare, such changes required more time and were "a one-hundred-percent verbal operation," said Riehle.

Such efficiency is one of NaviCare's biggest benefits, Riehle said. It allows a smoother flow of patients through the unit, reduces delays caused by unexpected changes, cuts down on the need for phone calls and pages, and even helps manage the supply of sterilized instruments to the operating rooms.

When patients are taken to the Post Anesthesia Care Unit (PACU), or recovery room, another screen — customized to the needs of the staff there — displays still more information, which is updated on bedside computers. Those changes, too, are reflected on the monitor in the waiting area.

Richter got the idea for NaviCare after being briefly unable to locate his father in a hospital where he was having surgery — an anxious experience for him. "I thought there had to be a better way to communicate real-time information in these settings," he said.

Riehle says NaviCare has accomplished exactly that for Maine Medical. "From the patient's perspective, it's given family members more information and lowered their anxiety," she said. "From the staff perspective, we always know where everyone is and what's going on. It's been a great help."

Added Patricia McGinty, a PACU nurse, "I don't know what we did without it. It helps patients, it helps families, and it helps us."

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