Under a pilot program, some visitors to the emergency department (ED) at Vanderbilt University Hospital (VUH) are now receiving wireless physiologic monitoring.
The new rechargeable wireless technology is from medical device company Masimo. The device’s central unit, the size of a bath-sized bar of soap, attaches to the patient’s lower arm. Sensors run to the hand, upper arm, chest and neck. Besides displaying vitals on a small screen on the device’s central unit, the device connects to the VUMC network using the local wireless Wi-Fi network protocol. Data flows to the patient record and is displayed on centrally located electronic boards where clinicians can keep an eye on the patient’s status. When vital signs change, automatic alarms are triggered.
Patients can get up to use the bathroom without having to unhook from a monitor.
“Wireless monitoring promises both to enhance support for our care teams and to elevate care for patients placed in our nontraditional spaces and in our waiting room,” said Ian Jones, MD, associate professor of Emergency Medicine and a clinical director with HealthIT at Vanderbilt University Medical Center. “This is an innovative measure aimed at improving vigilance, efficiency and satisfaction for patients and staff.”
The pilot extends to continuous wireless monitoring of blood pressure, blood oxygen level (pulse oximetry), heart rate, and, in selected patients, continuous cardiac rhythm.
Patients in standard ED beds at VUH are tethered to plug-in monitors that are wired to the VUMC network, allowing continuous central monitoring and automatic alarms when vital signs change. Those beds and their patients are outside the scope of the ED’s wireless initiative.
The ED at VUH happens to be perennially oversubscribed. To help make the best of this situation, hallway beds are used for arriving patients who may be less in need of a standard ED bed. While these patients may generally be more stable than those in standard beds, care standards still call for periodic checking of their vital signs. And for that, a nurse retrieves a bedside monitor, rolls it up to the patient, plugs it into the wall and places sensors on the patient. And later, having unhooked the sensors and stowed the monitor, the nurse manually types the patient’s vitals into the system.
Recently the pilot expanded to include wireless monitoring on an as- needed basis for waiting room patients who have been triaged but are still waiting for an ED bed.
“Throughout VUH the acuity of our patients has over recent history risen such that we need to strategically elevate our care infrastructure,” said Neal Patel, MD, MPH, professor of Clinical Pediatrics and chief informatics officer for HealthIT. “In bringing wireless physiologic monitoring to the ED, we’re providing more surveillance, more vigilance to each patient’s physiologic status. Technology such as this forms part of the solution as health care systems such as ours seek to make care better and more efficient.”
