San Juan Regional Medical Center, a 198-bed acute care hospital and Level III Trauma Center in Farmington, New Mexico, is the second largest trauma provider in the state. Its emergency room treats more than 50,000 patients each year and with nearly 10,000 admissions, coupled with the fact that its physicians perform thousands of inpatient and outpatient surgeries each year, the hospital has received recognition for its commitment to and success in implementing a higher standard of care for its patients.
In fact, the organization, a health care safety net provider for the entire Four Corners region, received the Healthgrades Distinguished Hospital Award for Clinical Excellence™ in 2014, and is ranked among the top five percent in the nation for overall clinical excellence. In addition to this national recognition, San Juan Regional Medical Center is also the only hospital in New Mexico and the Four Corners Region to receive this distinction.
According to the World Health Organization, despite spending more on healthcare than any other developed country, the U.S. has consistently ranked poorly on measures of health outcomes. Ultimately, healthcare costs arise from doctors’ decisions about which services and treatments to prescribe. However, doctors generally lack clear insight into the data they need to improve outcomes and reduce costs.
Many hospitals and health systems across the country have the technological pieces in place to drive efficiencies and improve both care and the patient experience, but they still have room to further integrate systems and processes, to conduct disease surveillance and to collect necessary data from and about the patient population, among other tasks. San Juan Regional Medical Center was no exception.
“We first started looking for data mining technology four years ago because we didn’t have the resources to hire more people to help with surveillance,” explained Penny Hill, RN, MPH, CIC, Infection Control/Employee Health Manager for San Juan Regional Medical Center and APIC NM President 2017. “With a half-time nurse and half-time secretarial support, we had too much to do to keep up and do a good job. It was a struggle.”
Hill and her staff knew they needed outside help to surveil because they didn’t have the manpower to do it on their own. Through research, they found technology from VigiLanz that would automatically screen and monitor every patient in the hospital based on its own internal guidelines. With the capabilities to conduct more thorough, continuous medication oversight to anticipate and prevent Adverse Drug Events (ADEs), increase clinical pharmacy productivity and improve patient care SJRMC staff could spend less time gathering data and more time on clinical interventions that optimize outcomes.
San Juan Regional Medical Center (SJRMC) initially implemented VigiLanz solutions to help its staff conduct efficient, broad surveillance. From hospital surgical site (SSI) infection rates to flags for isolations, it’s a technology used every day, a tool that picks up anything that might not be reported or captured through manual methods.
“VigiLanz flags any irregularities, which is a lifesaver right now,” explained Hill. “If we don’t get something printed or if it’s not resulted correctly in the lab, VigiLanz finds it. What’s more, it’s very rare that there isn’t a rule already written to capture the data we need but if we need something added, it’s easy to customize.”
SJRMC also re-evaluated their pharmacy rules and implemented VigiLanz’s pharmacy module, which helps, among other things, identify suboptimal drug/bug combinations by immediately alerting staff when the culture results are finalized. This allows pharmacists to evaluate the antibiotic therapy and recommend narrowing the antibiotic spectrum or changing antibiotics if a resistant organism is identified much sooner.
“By having the conversation with our pharmacy department and showing them all of VigiLanz’s capabilities, our staff now know exactly where any drug bug mismatches are,” said Hill. “One clinical pharmacist we have on staff, who works with VigiLanz daily and speaks with providers, told me this technology has helped streamline his daily tasks because the alternative involved Excel sheets and a lot of manual work.”
With a small department and limited resources, Hill and her staff rely on VigiLanz to handle much of the heavy lifting and burden when it comes to disease surveillance for the hospital. Knowing San Juan Regional Medical Center needed a solution to help it report outcomes and results to the government, VigiLanz became the natural choice to fill in when manpower is lacking, so much so that Hill says she and her staff can’t operate at their highest level without it.
“When our CIO said hospital-wide we were going to get rid of a lot of our third-party solutions when we converted from one large EMR solution to another, that we’d be moving to one platform, I told her that we couldn’t possibly do the work we do, to the extent we do it, without VigiLanz. It’s critical to patient care.”
VigiLanz’s offering is so specialized and customized that if a radiologist dictates a CAT scan and sees an intraabdominal abscess, hospital staff receive an alert. San Juan Medical Center’s new EMR didn’t have those capabilities so while it did replace dozens of the hospital’s other technology products, VigiLanz remained in place.
Through automated, continuous surveillance of every patient at San Juan Regional Medical Center, Hill and her staff can rapidly identify Healthcare-Acquired Infection (HAI) threats and resistance patterns, control emerging infection risks and prevent further infections in real time. VigiLanz quickly identifies conditions needing attention, enables rapid reporting of state and federal requirements – including direct NHSN reporting – and facilitates robust and intuitive analysis and simplified report generation so staff have more time to spend working with patients and other clinicians on prevention activities.
“I do have to say we probably have one of the most robust surgical site surveillance programs around and I attribute that to VigiLanz,” noted Hill. “We’ve participated in a lot of validation studies and there is rarely anything that’s not picked up by VigiLanz and/or our manual lab reports that we get. I feel confident we are getting the information we need and not getting information we don’t need.”
San Juan Regional Medical Center still does a lot of work manually, on paper, but hopes to transition away from a paper system once its EMR transition is complete. Once Hill and her staff have validated all of the data and analysis and made any corrections, they hope to ultimately report everything directly through VigiLanz to NHSN, bypassing the current manual workarounds.
“With VigiLanz, we can validate C.diff and CAUTI in the ER and all inpatient areas, in addition to capturing all positive urine and blood cultures without having to wait,” explained Hill. “We’re able to validate 100 percent of our data with what’s in NHSN and what we’re able to extract out of VigiLanz. That’s significant and it’s why I’d love everyone in New Mexico to have VigiLanz!”