Sharp Grossmont Hospital Uses VigiLanz for Fast, Accurate Patient Recruitment in Clinical Trials

Customer Profile

Sharp HealthCare, a not-for-profit health system based in San Diego, is made up of four acute-care hospitals, three specialty hospitals, three affiliated medical groups, and a full spectrum of other facilities and services. Sharp Grossmont Hospital, the largest healthcare facility in East San Diego County with 536 beds, is known for outstanding programs in emergency and critical care, cardiac care, orthopedics, rehabilitation, neurology, women’s health, children’s health and hospice care.

Challenge

Sharp Grossmont Hospital is dedicated to expanding scientific knowledge and supporting medical advancements by serving as a clinical trial site. However, recruiting and enrolling patients in clinical trials is a challenging, labor-intensive, and time-consuming process. Industry research suggests that 11% of clinical trials never enroll a patient and 68% of sites fail to meet enrollment targets. When Sharp Grossmont Hospital began participating in a complex clinical trial in early 2020, it quickly became apparent that they were going to face similar challenges.

The trial was designed to evaluate the safety and efficacy of a new drug to reduce the risk of major cardiovascular events in patients with acute coronary syndrome and had a complex protocol that made clinical trial enrollment extremely difficult. Sharp Grossmont Hospital’s clinical research team, who at the time relied on a manual review process to identify eligible patients, found that the workflow was extremely inefficient.

“Screening for clinical trials with extensive and specific inclusion and exclusion criteria is very time-consuming,” said DeAnn Cary, PhD, Director of Research at Sharp HealthCare. “Manually screening for a trial like ours means casting a wide net to find potential subjects since they can be in multiple areas of the hospital.”

Solution

Sharp Grossmont Hospital knew there had to be a better way to approach clinical trial enrollment, and in 2020, partnered with VigiLanz to explore an alternative model. VigiLanz Research facilitates a more efficient recruitment process by continuously reviewing EHR data to find patients for clinical trials in real time.

Kyra Rashid, BS, MCR, Clinical Trial Specialist at Sharp, said the solution helps the organization identify eligible patients more quickly, including patients who might have otherwise been missed.

“The technology alerts our team as soon as eligible patients are identified, based on the study-specific inclusion and exclusion criteria,” she said. “It screens the entire hospital patient population, which saves us a significant amount of time that can then be reallocated to other initiatives.”

In addition to screening patients for the clinical trial, the solution provides:

  • A dynamic worklist that coordinators can use to view or modify patient eligibility status in real time
  • Automatic alerts that notify coordinators anytime an eligible candidate is located within the hospital network
  • Enterprise-level reporting that coordinators and leaders can use to evaluate study performance and easily evaluate potential clinical trials.

How VigiLanz Research Works

  • VigiLanz leverages study-specific inclusion and exclusion criteria to automatically review all patients across a hospital network.
  • VigiLanz screens the entire patient population to identify eligible patients in real time.
  • VigiLanz provides automated alerts and notifications to key team members when it identifies eligible patients.
  • Coordinators can track eligibility status, run timely reports, and manage the recruitment process in a customized worklist.

Outcomes

As a result of the VigiLanz Research partnership, Sharp Grossmont Hospital reduced the time needed to screen and enroll patients in the clinical trial. The time savings and workflow improvements also positively benefited the clinical research team.

“The coordinators’ time is now focused on a more narrowed pool of potential subjects, which allows more time to continue additional screening and accomplish more tasks in our day,” said Cary E. Murphy, BSN, CCRC, Clinical Trial Specialist at Sharp Healthcare. “This makes the team happier and more productive.”

Overall, the partnership:

  • Increased the number of patients screened. VigiLanz Research increased the number of patients screened to include all ED patients and all patients admitted in all 20 hospital departments.
  • Cut the time spent screening patients in half. The technology solution reduced the time needed to screen patients, freeing up the clinical research team to work on other high-value tasks.
  • Identified eligible patients faster. VigiLanz Research helped the team identify eligible patients in real time, which was vital to this time-sensitive study.

Another key benefit, Cary said, is the positive impact the new approach brings patients. “VigiLanz Research has improved our team’s efficiency and helped us ensure more eligible patients can participate in the trial. VigiLanz also helps ensure no potential study participant, regardless of department, is missed. As we work to advance drug and treatment development, we’re excited about how this approach will support those efforts.”

To learn more about how VigiLanz helps hospitals with efficient patient recruitment for clinical trials, visit https://vigilanzcorp.com/ today.

Related Resources: VigiLanz Research

VigiLanz Announces Launch of New Clinical Trial Patient Identification Solution

VigiLanz Research will help hospitals and clinical research staff increase the number of patients identified for clinical trials, while reducing time and staff effort needed for manual screening

MINNEAPOLIS – October 11, 2022 – VigiLanz, a clinical software surveillance company, has announced the launch of a new solution that will empower researchers to accurately identify more eligible candidates for clinical trial enrollment in near real time. By automating the patient identification process, VigiLanz Research will provide help for clinical trial sites seeking to accelerate patient recruitment, meet time-sensitive enrollment targets, and gain insights on patients screened for eligibility.

Clinical trial screening is often an inefficient, costly, and labor-intensive process for clinical trial sites. More than half of all clinical trials fail to meet their enrollment targets, and nearly a quarter close because of insufficient patient enrollment.

“VigiLanz Research is streamlining the clinical trial recruitment process,” said Dr. David Goldsteen, Chief Executive Officer at VigiLanz, noting that for years clinical research sites have struggled to enroll enough patients. “This new solution leverages our two decades of clinical surveillance expertise into a system that empowers researchers to screen more qualified candidates. For hospitals, this increases the likelihood for clinical trial success, and for sponsors, this potentially saves millions of dollars and helps get products to market faster. Most importantly, it also connects people with opportunities for life-changing treatments that could help them live longer, healthier lives.”

VigiLanz recently partnered with Sharp HealthCare to implement VigiLanz Research for an acute cardiac clinical trial, which has a complex protocol and challenging patient enrollment requirements. VigiLanz Research automated screening processes using data in Sharp’s electronic health record (EHR), vastly increasing the number of patients screened to include all patients in all units, and reducing staff time needed to screen patients by 50%. This not only led to more patients being successfully enrolled in the study, but also improved staff satisfaction by giving them more time to focus on other high-value tasks.

“VigiLanz Research has not only improved our team’s efficiency but also has helped us make a difference in patients’ lives. This solution solved the biggest challenges we had in screening patients for this study – the short enrollment windows. With near real-time updates, we can now identify and enroll subjects who may have otherwise been missed,” said DeAnn Cary, PhD, Director of Research at the Outcomes Research Institute at Sharp HealthCare.

Sharp HealthCare and VigiLanz will be presenting an overview of the research process and the results at the WCG MAGI West 2022 conference in Las Vegas in mid-October. To learn more about VigiLanz Research, visit vigilanzcorp.com/research.

 

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About VigiLanz
Founded in 2001, VigiLanz is a privately held, rapidly growing provider of SaaS-based clinical surveillance, safety, quality, and risk solutions. The organization is focused on transforming the delivery of quality care by aggregating disparate EHR transactional workflow and documentation data across health systems to identify real-time clinical issues that avoid or minimize harm, optimize clinical outcomes, and support preventive care. VigiLanz is a clinical partner to a large and growing community of hospital CMOs, CMIOs, CIOs, quality and safety teams, infectious disease and control specialists, pharmacists, and other clinicians dedicated to innovative, real-time inpatient care.

 

For More Information
John Gonda
(616)-309-4888 
jgonda@sage-growth.com

Freeman Health System Pharmacy Uses VigiLanz to Improve Care, Workflows, and Costs

Background

freeman health system logo

Freeman Health System, a 485-bed, three-hospital system in Joplin, Missouri, serves a population of 450,000 people across Missouri, Arkansas, Kansas, and Oklahoma. Ranked one of the top hospitals in Missouri by U.S. News & World Report, Freeman continually seeks out new and innovative ways to improve patient care.

Within Freeman, the pharmacy department is known for its commitment to exploring new tools that improve efficiency as well as patient safety. Since implementing VigiLanz in 2018, Freeman’s pharmacy team has created over 650 VigiLanz rules that aid in pharmacy department interventions. These rules use dashboards and real-time notifications to alert team members whenever information pulled from the electronic health record (EHR) meets rule criteria. 

“This approach has made a significant impact on patient care, pharmacy workflows, and costs,” said Adrienne Carey, PharmD, BCPS, Clinical Pharmacist and Data Mining Program Manager at Freeman Health System. “Because of the improved capabilities within VigiLanz’s rule engine, we’ve been able to identify more opportunities for intervention more quickly than before.”

Here are five examples of how the Freeman team used VigiLanz’s pharmacy workflow solutions to support key initiatives that improved patient care and safety while reducing costs.

Initiative #1: Rule-building to inform discharge counseling

Each year, Freeman Health System residents use VigiLanz to build rules or create data mining searches to identify patient populations and gather data for a 12-month research project. This year, residents used VigiLanz rules to identify cardiology patients who were being discharged with a new medication not listed on their home medication list.

When the rule was triggered, pharmacists received a real-time alert. Pharmacists then educated patients about their new medication(s), documented them in the activation, and followed up with patients to assess the effectiveness of the education and its impact on readmission rates. Since these cardiology patients typically had a short length of stay, the VigiLanz rules were especially helpful in quickly identifying appropriate patients for education.

The patients who received education from pharmacy were 11% more likely to remember their counseling than those who received education through other discharge processes. Patients with the pharmacy education also had a 30-day readmission rate of 5.25% (compared to a rate of 21.25% among those who did not receive the education).

Initiative #2: Validation studies to support antibiotic discontinuation

A negative Methicillin-resistant Staphylococcus aureus (MRSA) nasal screening can help providers determine when to safely discontinue vancomycin, an antibiotic commonly used in patients with MRSA. However, since some providers are reluctant to discontinue the drug based on this test, another Freeman resident used VigiLanz to quantify the probability of disease based on screening results.

The resident created VigiLanz data mining searches to capture MRSA+ screens with positive cultures, MRSA+ screens with negative cultures, MRSA- screens with positive cultures, and MRSA- screens with negative cultures. Results showed a 97.2% correlation that a negative MRSA screen resulted in no MRSA infection. This enhanced providers’ confidence in using the screen to safely discontinue vancomycin, and therefore, reduced the risk of antimicrobial resistance and adverse events.

Initiative #3: Alerts to decolonize patients with positive MRSA screens

Studies indicate that MRSA colonization in the nose could increase the risk of MRSA infection, and that nasal administration of Mupirocin ointment reduces infections in patients with positive MRSA nasal screens. Based on this information, Freeman created a new protocol that authorized pharmacists to order Mupirocin ointment nasally when a patient has a positive MRSA nasal screen.

Freeman then used VigiLanz rules to identify patients with positive MRSA screens and alert pharmacists in real time. Since implementing this rule in January 2022, the facility has ordered Mupirocin decolonization for 162 patients, resulting in $98,000 in estimated cost savings due to less time spent in isolation, lowered risk of infection, and fewer readmissions.

Initiative #4: Tools to monitor drugs and prevent drug shortages 

Freeman’s pharmacy team uses VigiLanz to quickly and efficiently search for pharmacy orders (a functionality not included in their health information system). Examples include:

  • Central staff and buyers use VigiLanz to identify patients on medications in short supply so that pharmacists can alert providers and help prevent drug shortages.
  • Pharmacists use VigiLanz to search for high alert drugs to monitor proactively. Floor pharmacists run a system-wide kinetics search each morning—including vancomycin, heparin, and aminoglycosides—to identify the patients they are expected to manage.
  • Night shift pharmacists use pharmacy orders to identify heparin patients that need to be monitored.

Initiative #5: Rules to guide and decrease antibiotic use

A Freeman pharmacy resident used VigiLanz to conduct a research project comparing Freeman providers’ antibiotic orders (including Zithromax, Aztreonam, Cefepime, Ceftriaxone, Ciprofloxacin, Levofloxacin, Meropenem, Zosyn, and vancomycin) for treating pneumonia according to professional guidelines. The study found that, for each type of pneumonia, some antibiotics were prescribed for longer than recommended. As a result, Freeman created order sets to guide providers about the appropriate number of days to prescribe each antibiotic.

Freeman also created a “Pneumonia Pathway Hard Stop” rule in VigiLanz to ensure the hard stop stays with the antibiotic order, regardless of any dosage changes made that could inadvertently remove the initial hard stop.

As a result, floor pharmacists can more easily determine when patients complete their therapies, and Freeman can reduce its usage of antibiotics consistent with professional guidelines.

 

To learn more about how VigiLanz helps hospitals improve their patient safety and clinical surveillance, visit https://vigilanzcorp.com/ today.

VigiLanz Announces Winners of 2022 Vigi Awards

Award winners recognized for optimal and innovative use of clinical surveillance to support and improve patient care

MINNEAPOLIS – Aug. 15, 2022 –VigiLanz, a clinical surveillance company, today announced the winners of the annual Vigi Awards, which honor innovative hospitals throughout the United States.

The Vigi Awards recognize how hospitals have used clinical surveillance to enhance patient safety. The award winners are selected by VigiLanz based on nominations of individuals and teams submitted by VigiLanz customers. All award winners receive a donation to a charity of their choice.

“We are incredibly proud of this year’s Vigi Award winners, and it is our honor to recognize them for their amazing accomplishments and achievements,” said David Goldsteen, MD, VigiLanz CEO. “Demonstrated improvements in patient safety, outcomes, and cost savings matter to us all and it is our privilege to be able to partner with some of our country’s finest hospitals and health systems to improve lives.”

This year’s winners:

Infection Preventionist of the Year:

Adriana Jimenez, PhD, Infection Prevention Manager  – Jackson Health System, Florida
Recognized for using VigiLanz to track isolation and HAI activations, develop device and analysis reports, and customize real-time alerts.

Pharmacy Team of the Year:

Pharmacy Team – Freeman Health System, Missouri
Recognized for using VigiLanz to:

  • Build rules to quickly identify patients discharged with a new cardiology medication so that residents could provide appropriate medication education.
  • Create data mining searches to capture MRSA screens and culture results to validate discontinuation of vancomycin.
  • Identify patients with positive MRSA nasal screens that would benefit from mupirocin.

Safety Team of the Year:

Safety Team – Christus Health, Texas
Recognized for using VigiLanz to improve quality of medication error reports, enable error reporting standardization, and aid in the creation of meaningful action plans.

Rising Star (tie):

Pharmacy Team – Benefis Health System, Montana
Recognized for the development of VigiLanz rules to quickly identify the most severe patients that would likely benefit from a thorough comprehensive medical review, saving staff time.

Rising Star (tie):

Dechen Lama, IT Systems Administrator – Mount Sinai Health System, New York
Recognized for putting infection prevention ideas into action, including quickly creating new rules to identify and isolate COVID-19 and monkeypox patients and enable timely care.

5-Star Patient Care:

Pharmacy and Microbial Stewardship Team – Houston Methodist The Woodlands Hospital, Texas
Recognized for using rule-based alerts in conjunction with a pharmacist-driven MRSA protocol to provide timely de-escalation of antibiotics.

Stewardship:

Stewardship Team – Cincinnati Children’s Hospital Medical Center, Ohio
Recognized for enhancing long term health outcomes by using data collected by VigiLanz to identify pediatric patients allergic to Penicillin that may no longer be allergic and would benefit from allergy testing.

They Did What? Wow!:

Laura StinesInfection Prevention Data Analyst – Cone Health System, North Carolina
Recognized for using VigiLanz to automatically populate HAI dashboards, providing more data to drive decision making and analyze trends, and reducing risk of manual entry errors.

Great Catch!:

Continental Division – HCA Healthcare, Colorado
Recognized for using data captured by VigiLanz to investigate care patterns, enable investigations, and catch drug diversions to advance patient safety.

“VigiLanz allows a much more streamlined approach to medication compliance compared to pulling the data from the electronic health record directly. The way VigiLanz collates the information into workable documents means we can also create visual aids, such as graphs and tables, to demonstrate trends or data,” said Holly Monatt, Vice President of Pharmacy Services at HCA Healthcare Continental Division. “The time we spend interpreting and reviewing data is so much more meaningful because of the efficiencies VigiLanz provides us for actual data gathering.”

For more information on the Vigi Awards and award winners, please visit the VigiLanz website.

 

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About VigiLanz
Founded in 2001, VigiLanz is a privately held, rapidly growing provider of SaaS-based clinical surveillance, safety, quality, and risk solutions. The organization is focused on transforming the delivery of quality care by aggregating disparate EHR transactional workflow and documentation data across health systems to identify real-time clinical issues that avoid or minimize harm, optimize clinical outcomes, and support preventive care. VigiLanz is a clinical partner to a large and growing community of hospital CMOs, CMIOs, CIOs, quality and safety teams, infectious disease and control specialists, pharmacists, and other clinicians dedicated to innovative, real-time inpatient care.

 

For More Information
John Gonda
(616)-309-4888 
jgonda@sage-growth.com

Holmes Regional Medical Center Pharmacists Use VigiLanz to Improve Care

Innovative projects improve glycemic control and decrease thrombosis risk

This success story was written in 2021.

Pharmacists across the country face numerous competing demands and priorities—from preventing adverse events to supporting cost-saving objectives to partnering with physicians to ensure high quality care. With so many critical tasks, it can be difficult to implement and pursue new initiatives.

That’s why the achievements of the pharmacy team at Holmes Regional Medical Center (HRMC), part of the four-hospital Health First network in Central Florida, are so impressive. The team continually pursues new and innovative projects, using technology to support their efforts.

“Our department thrives when novel patient care initiatives enable pharmacists to practice at the top of their license,” said Michael Sanchez, PharmD, BCCCP, Pharmacy Residency Coordinator. “We’re always looking for ways to optimize medication therapies, prevent adverse events, and contribute to antimicrobial stewardship.”

Three recent initiatives spearheaded by HRMC’s pharmacy team and supported by VigiLanz have significantly improved patient care while reducing costs.

Initiative #1: Medication optimization protocol reduces hyperglycemia in patients with acute COPD

In September 2019, HRMC pharmacists began collaborating with pulmonologists across the Health First network to identify opportunities to improve care for patients with acute exacerbation of COPD (AECOPD).

“We had seen some small studies describing the benefits of having pharmacists transition IV corticosteroids to PO, and we wanted to see how that could impact our hospital,” said Sanchez. “Oral and IV corticosteroid therapy have comparable outcomes, but oral therapy is associated with fewer adverse events and is less expensive.”

To test and evaluate the impact, HRMC implemented a protocol enabling pharmacists to independently change IV corticosteroids to oral prednisone, when appropriate. VigiLanz supports the initiative by sending an alert to pharmacists whenever a patient with AECOPD meets HRMC’s eligibility criteria.

“The VigiLanz alert is highly accurate in detecting patients who would benefit from streamlining to oral corticosteroids,” said Sanchez. “We wouldn’t have been able to implement this new protocol without it, due to the complexities of the eligibility criteria.” The criteria include current use of IV corticosteroids, respiratory rate, blood gas results, allergies, and history of asthma.

The workflow:

  • VigiLanz alerts pharmacists of eligible patients, based on eligibility criteria
  • Pharmacists review patients’ medical records to confirm eligibility
  • Pharmacists switch eligible patients from IV corticosteroids to 40 mg of oral prednisone per day for five days

To assess the impact of the new protocol, HRMC pharmacists compared outcomes for 128 AECOPD patients admitted pre-protocol (November 1, 2018 to February 9, 2019), with outcomes for 134 AECOPD patients admitted post-protocol (November 1, 2019 to February 9, 2020).

“To our knowledge, this is the largest study examining the impact of a pharmacist-led IV to PO corticosteroid conversion protocol for AECOPD, and it’s the only study to examine safety endpoints, such as hyperglycemia,” said Sanchez.

While the study found no significant differences in average length of stay, 30-day readmissions, average blood glucose, or mean cost of corticosteroids per patient, it did find that the post-protocol group had a significantly lower rate of hyperglycemia (62% vs 37%).

“The odds were really stacked against that outcome because the intervention group had

more diabetic patients,” said Sanchez. “In the next few years, I hope we can gather more data to evaluate if there’s also a reduction in glucose related complications.”

The Health First network is considering incorporating the protocol into an AECOPD order set to guide physicians toward oral corticosteroid treatment. Based on feedback from providers, the new protocol would recommend moving from a single 40 mg daily dose of prednisone to two 20 mg doses to further reduce hyperglycemia.

Initiative #2: Kcentra initiative reduces thrombosis risks and cuts

In early 2020, Ted Heierman, PharmD, Clinical Pharmacy Specialist at HRMC, and Brianna Glenn, Pharmacy Resident at HRMC, noticed an increase in prescriptions for Kcentra, the only FDA-approved alternative to plasma for urgent warfarin reversal.

“We suspected that some of the increase in Kcentra utilization was inappropriate, and we confirmed that suspicion with a medication use evaluation,” said Heierman. “We began exploring how VigiLanz could help us address this problem.”

Heierman and Glenn worked with VigiLanz to create a Kcentra alert that is sent to the pharmacy team whenever the medication is prescribed.

The workflow:

  • VigiLanz alerts pharmacists of Kcentra orders in real-time
  • Pharmacists screen patients to ensure they meet Kcentra use criteria
  • If patients don’t meet use criteria, pharmacists discuss medication alternatives with prescribers

“With this new approach, we found that Kcentra was being inappropriately prescribed about 15 percent of the time,” said Heierman, noting that the alert has been in place since September 2020. “This new approach has reduced inappropriate use to nearly zero.”

HRMC’s Kcentra use criteria:

  • Life-threatening bleed
  • Documented warfarin or direct-acting oral anticoagulant (DOAC) use
  • For DOAC use, anti-factor Xa (AntiXa) above 0.5.
  • For intracerebral hemorrhage-Glasgow coma scale(ICH-GCS) above 8 and neurosurgical evaluation and planned surgical intervention

“The initiative has significantly improved patient care and reduced costs,” said Heierman, noting that Kcentra comes with thrombotic risks, so ensuring appropriate use decreases the risk of thrombosis. “With a 15 percent reduction in use and 100 percent appropriate use, our HRMC can potentially save around $105,000 each year.”

Initiative #3: Pharmacist interventions reduce hypoglycemia and cut costs

In 2019, Health First identified that one of the top risk factors for severe hospital-acquired hypoglycemia in its health system was providers not adjusting insulin regimens after patients had episodes of hypoglycemia. HRMC pharmacists immediately began exploring how they could help prevent this problem.

The result was a new protocol, implemented in March 2019, that enables pharmacists to independently decrease rapid and long-acting insulin regimens if a hospitalized patient has had a severe hypoglycemic event after receiving insulin.

When the protocol was first implemented, nurses were tasked with notifying pharmacists of severe hypoglycemic events. However, the pharmacy team quickly recognized that real-time clinical surveillance could improve efficiency and reduce the risk of an error. “VigiLanz ensures we receive timely notifications and can adjust the patients’ insulin therapy sooner,” said Sanchez.

The workflow:

  • VigiLanz alerts pharmacist when patients with hypoglycemic events have received insulin in the past 24 hours
  • Pharmacists review patients’ information, and decrease insulin based on glucose value, as follows:
    • 61 – 69 mg/dL = Reduce all meal insulin by 1 unit
    • 51 – 69 mg/dL = Reduce basal insulin by 20 percent daily
    • Less than or equal to 60 mg/dL = Reduce all meal insulin by 2 units
    • Less than or equal to 50 mg/dL = Reduce basal insulin by 40 percent daily

    HRMC had completed VigiLanz activations for 235 patients as of November 2020, and the protocol had decreased severe hypoglycemic events in patients with insulin from 7.14 percent to 5.45 percent.

    The new protocol has also reduced costs, because the Centers for Medicare and Medicaid characterizes certain complications due to hypoglycemia as never events, said Sanchez. As a result, it does not reimburse hospitals for the extra costs associated with these events.

    “On a personal level, my passion for supporting this initiative arose from helping the code response team identify severe hypoglycemia in a coding patient,” said Sanchez. “I’m confident this protocol has, and will continue to, prevent devastating outcomes for many patients.”

    To learn more about how VigiLanz helps hospitals improve their patient safety and clinical surveillance, visit https://vigilanzcorp.com/ today.

Medication Error Spotlight Findings

Medication Error Spotlight Findings

 

The Hospital Patient Safety Report serves as a barometer of safety performance within U.S. hospitals. Based on an annual survey of 100 hospital executives and clinical leaders, the report reveals how safety challenges, initiatives, and priorities are evolving.

 

Antimicrobial Stewardship Spotlight Findings

Antimicrobial Stewardship Spotlight Findings

 

The Hospital Patient Safety Report serves as a barometer of safety performance within U.S. hospitals. Based on an annual survey of 100 hospital executives and clinical leaders, the report reveals how safety challenges, initiatives, and priorities are evolving.

 

Infection Prevention Spotlight Findings

Infection Prevention Spotlight Findings

The Hospital Patient Safety Report serves as a barometer of safety performance within U.S. hospitals. Based on an annual survey of 100 hospital executives and clinical leaders, the report reveals how safety challenges, initiatives, and priorities are evolving. This infographic highlights some of the most noteworthy infection prevention-related survey findings.

 

VigiLanz Releases New Industry Report Highlighting How the Pandemic is Impacting Hospital Safety

Two years after the World Health Organization declared COVID-19 a pandemic, how is the patient, staff, and visitor safety landscape changing, and what might the future bring?

MINNEAPOLIS, March 23, 2022VigiLanz, a clinical surveillance company, today announced the release of its fourth annual Hospital Patient Safety Report.

The Hospital Patient Safety Report, released annually since 2019, serves as a barometer of safety performance within U.S. hospitals and reveals how safety challenges, initiatives, and priorities are evolving. The 2022 report, which also highlights the impact of the pandemic on patient, staff, and visitor safety, is based on an independent survey of 100 hospital and health system leaders conducted in January 2022 by Sage Growth Partners.

Nearly one out of three hospital executives and clinical leaders surveyed reported that their organization is not doing enough to address pandemic-exposed vulnerabilities, and nearly one out of five says pandemic-related challenges such as staff burnout and shortages are putting patients’ lives in jeopardy.

While many hospital executives and clinical leaders see significant safety problems within their organizations, the survey also reveals that most are advancing and prioritizing improvements, with about three-quarters saying the pandemic has made improving patient, staff, and visitor safety a higher priority,” said VigiLanz Chairman and CEO David Goldsteen, MD. “We’re excited to see the positive impact that this commitment to positive change will have on everyone within healthcare organizations.”

Among the report’s key findings and insights:

  • 33% of hospital executives and clinical leaders say their organization hasn’t done enough to address pandemic-exposed safety problems.
  • 86% say burnout has led to a decline in patient safety, while 21% say it has caused patient deaths.
  • 42% indicate their rate of hospital-acquired infections has increased over the past 12 months.
  • 78% say the pandemic has led to new patient safety improvement initiatives, 77% say it has led to staff safety improvement initiatives, and 72% say it has led to visitor safety improvement initiatives.

“Hospital leaders are facing several safety-related challenges, but the good news is they are embracing new initiatives—and allocating more resources—to meet them,” said Dr. Hayley Burgess, Chief Clinical Officer, VigiLanz.

She also noted that 64% of respondents shared that the pandemic has resulted in a higher budget for staff safety improvements, 58% report enhanced budgeting for patient safety improvements, and 49% for visitor safety improvements.

“As hospitals consider various safety improvement initiatives, implementing clinical surveillance technology is a good choice to enhance identification of safety issues which in turn expedites the improvement cycle,” said Dr. Burgess.

Overall, the Hospital Safety Report shows that healthcare leaders agree that clinical surveillance technology positively impacts hospital safety, regardless of whether they are currently using the technology.

Among survey respondents who already use the technology, there is widespread agreement about the benefits. These span from an increased ability to identify and manage safety events to identifying infections or outbreaks sooner. In addition, 92% of hospital executives and clinical leaders whose organizations already incorporate technology indicate that it is supporting their hospital’s efforts to respond to the pandemic.

“The 2022 Hospital Patient Safety Report provides a unique opportunity for the industry to begin measuring how the pandemic continues to impact national hospital safety trends,” said Dan D’Orazio, CEO, Sage Growth Partners. “Staffing shortages, clinical burnout, infection prevention, and pharmacy-related challenges have had an enormous impact on hospital safety, but there is a substantial opportunity to overcome these challenges, and I believe the industry will do so.”

For more information and key takeaways on the survey findings, including how the pandemic is impacting and changing how hospitals are approaching safety within key areas such as infection prevention, pharmacy surveillance, and antimicrobial stewardship, please visit https://vigilanzcorp.com/hospital-patient-safety-report-2022/.

About VigiLanz

Founded in 2001, VigiLanz is a privately held, rapidly growing provider of SaaS-based clinical surveillance, safety, quality, and risk solutions. The firm is focused on transforming the delivery of quality care by aggregating disparate EHR transactional workflow and documentation data across health systems to identify real-time clinical issues that avoid or minimize harm, optimize clinical outcomes, and support preventive care. VigiLanz is a clinical partner to a large and growing community of hospital CMOs, CMIOs, CIOs, quality and safety teams, infectious disease and control specialists, pharmacists, and other clinicians dedicated to innovative, real-time inpatient care.

About Sage Growth Partners

Sage Growth Partners accelerates commercial success for healthcare organizations through a singular focus on growth. The company helps its clients thrive amid the complexities of a rapidly changing marketplace with deep domain expertise and an integrated application of research, strategy, and marketing.

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For More Information

John Gonda
(616)-309-4888
jgonda@sage-growth.com

Northern Arizona Healthcare Uses VigiLanz to Fight COVID-19 and Mitigate Drug Shortages

Customer Profile 

Northern Arizona Healthcare, the largest healthcare system in a region that encompasses more than 50,000 square miles, provides comprehensive healthcare services through clinics, surgical centers, and two hospitals: Flagstaff Medical Center and Verde Valley Medical Center.  The health system serves more than 700,000 people in communities across the region, and is committed to continually improving and enhancing patient safety.

Challenge

Northern Arizona Healthcare’s Flagstaff Medical Center (FMC) is the biggest major medical center in Northern Arizona. The Navajo Nation, the largest Native American Reservation in the country, resides in FMC’s service area. This community was hit hard and early with a significant COVID-19 outbreak. At its peak, the Navajo Nation had a higher per capita COVID-19 rate than all major cities in the U.S. including New York (3.4 percent vs 1.9 percent).

FMC initially bore the brunt of this outbreak, well before the Arizona State COVID-19 Healthcare Surge Hotline was created in mid-May to help balance the load of cases across the state. FMC treated their first COVID-19 patient in mid-March of 2020, and quickly ramped up to more than 30 critically ill COVID-19 patients by the end of the month. They experienced a peak of 51 positive cases (a full third of their census) followed by a second surge in mid-June.

Kristen Bamberg, PharmD, MS, BCPS, BCCCP, Lead Critical Care Pharmacist at FMC, and Andrea Boyce, PharmD, BCIDP, Lead Antimicrobial Stewardship Pharmacist at FMC, were immediately thrust into a fast-paced and highly challenging environment due the influx of COVID-19 patients. They faced constantly evolving therapeutic recommendations, and a continual fight to mitigate critical shortages of medications like sedatives, neuromuscular blockers, and antibiotics.

Solution

Bamberg and Boyce had an excellent team behind them working to overcome the challenges presented by COVID-19, but they also recognized that they needed to fully utilize all of their resources in order to continue to provide optimal care to patients.

“We knew how useful VigiLanz’s alerts and reports already were in helping us care for patients on a day-to-day basis,” said Bamberg. “So we turned to them to help us quickly determine how their alerts and reports could be tailored to help us specifically address the needs and demands of the pandemic.”

Ultimately, Bamberg and Boyce worked with the clinical surveillance provider to implement dozens of new rules and alerts. These rules resulted in three key benefits:

Benefit #1: Real-time alerts that led to a more proactive response to COVID-19 patients and helped conserve PPE

At the beginning of the pandemic, FMC immediately recognized that the earlier healthcare providers could be informed of a patient’s COVID-19 status, the better. If a patient tested positive, that patient could continue to be isolated and contact tracing could begin; if a patient tested negative, staff members no longer needed to use PPE when interacting with that patient (which could help combat the PPE shortage).

As a result, Bamberg and Boyce worked with VigiLanz to implement real-time alerts to inform relevant healthcare providers and staff as soon as a COVID-19 test result was available. They also implemented alerts to inform them if a re-admitted patient had a history of COVID-19.

Examples of alerts:

  • COVID-19 results: Alerted pharmacists of a new COVID-19 RNA or PCR test result
  • Patients with a history of COVID-19: Alerted pharmacists if a patient was re-admitted and had a positive result on a previous encounter in the last 90 days

“The support and responsiveness of VigiLanz to our abundance of requests was incredible,” said Bamberg. “It helped us work through countless therapeutic and workflow issues in real time.”

Benefit #2: Real-time alerts for medication optimization and prevention of adverse drug events

Bamberg and Boyce also worked with VigiLanz to implement several new alerts that helped optimize medication safety for COVID-19 patients.

“These alerts were particularly useful since we were dealing with a new disease and treatments that were continually changing,” said Boyce. “Many of the alerts resulted in the discontinuation of certain medications and helped us flag potential problems.”

Examples of alerts:

  • Hydroxychloroquine (HCQ) ordered: Alerted pharmacists to check for drug interactions and assess and follow the risk of corrected QT(QTc) prolongation
  • HCQ and weight > 50 kg: Alerted pharmacists to review based on the hospital’s protocol at the time
  • HCQ patients at high risk for QTc prolongation with higher than normal doses used for treatment of COVID-19: Alerted pharmacists when patients had HCQ + azithromycin + K < 4, HCQ + azithromycin + Mag < 2, HCQ + azithromycin + scheduled ondansetron.
  • Metoclopramide longer than three days: Alerted pharmacists to assess efficacy and potential discontinuation of metoclopramide (which many COVID-19 patients were prescribed due to ileus or significantly reduced bowel motility) in an effort to minimize adverse drug events.
  • D-dimer > 1,000: Alerted ICU pharmacists to assess patients (this rule was implemented after a hospital literature review of COVID-19 and thrombosis indicated that patients were experiencing micro thromboemboli and likely required higher than usual doses of chemical deep vein thrombosis prophylaxis). While the hospital eventually abandoned D-dimer as a sole marker of a need for these higher doses, it initially helped the pharmacists make recommendations to intensivists regarding anti-thrombotic therapy.
  • Enoxaparin 0.5 mg/kg SQ Q12H ordered and no Xa level: Alerted pharmacists to monitor patients’ response to treatment, as COVID-19 patients had a higher propensity to clot, a potentially larger clot burden in the form of microthrombosis, and potentially acquired ATIII deficiencies as a result.
  • Remdesivir ordered: Alerted pharmacists to monitor patients to adhere to new protocols (the hospital had a specific Remdesivir protocol in place due to emergency use authorization requirements).

Benefit #3: Real-time alerts to mitigate drug shortages

In addition to ensuring optimal medication usage for COVID-19 patients, Bamberg and Boyce also used VigiLanz to help FMC manage medications in short supply.

“We always need to make sure that we have the right medications on hand for each patient, but this process became even more challenging when COVID-19 hit,” said Boyce. “VigiLanz helped us manage many of the unprecedented shortages we faced, especially when it came to necessary medications like sedatives and antibiotics.”

Examples of alerts:

  • Ketamine ordered: Alerted pharmacists to determine if a more concentrated bag could be used, or if alternative medications were appropriate
  • IV famotidine ordered: Alerted pharmacists so that, if appropriate, they could recommend an IV alternative or switch the patient to oral
  • Doxycycline more than five days: Alerted pharmacists to assess patients’ antibiotic therapy and recommend possible discontinuation as appropriate
  • Albuterol inhaler PRN, not on isolation: Alerted pharmacists to assess whether a non-COVID-19 patient with an active order for an albuterol inhaler could be switched to nebulization

Outcomes

FMC’s ability to quickly respond to the COVID-19 pandemic is a testament to the dedication and innovative ideas of all of its frontline staff—with Bamberg and Boyce playing a critical supporting role. During a significantly challenging time, they were able to think outside the box and use the information they received from VigiLanz to enhance patient care.

Overall, this led to:

  • Earlier identification of positive and negative COVID-19 tests, which helped conserve PPE and enhance patient treatment
  • Earlier identification of readmitted patients who previously tested positive for COVID-19, which helped the health system protect non-COVID-19 patients and staff
  • Optimal medication usage for COVID-19 patients, which enhanced patient treatment
  • Enhanced monitoring of medications in short supply, which led to more targeted and judicious use of medications

“We were among the first and hardest hit hospitals by COVID-19,” said Bamberg.We worked  with VigiLanz to be proactive in tackling this challenge, and it made a significant difference to our patients and community.”

To learn more about how VigiLanz helps hospitals improve their patient safety and clinical surveillance, visit https://vigilanzcorp.com/ today.