Caregiver staffing shortages and the future of clinical surveillance

As the healthcare industry continues to face challenges related to staffing shortages, the way care is administered and received must shift to better complement both clinicians and patients – especially when it comes to the way clinicians monitor patients across different care settings.

Dr. John Zaleski, head of clinical informatics at Philips, believes emerging clinical surveillance technologies have the power to revolutionize the way clinicians care for these patients, helping them make the right interventions at the right time based on comprehensive data.

We sat down with Zaleski to discuss the state of clinical surveillance, gaining more holistic data to prevent adverse events, assisting clinicians in efficiently determining patient care pathways and less-invasive technologies to expand care across settings.

Q. What do emerging clinical surveillance technologies look like? How are they working differently than past technologies?

A. Emerging clinical surveillance technologies generally will be comprised of a vendor-neutral system that allows for device integration across a health system, as well as vital signs monitoring and streaming clinical data that can be transformed into actionable information, particularly when combined with laboratory information such as arterial blood gas and chemistry assessments.

As health systems continue to evaluate care pathways and processes to ensure and maintain high quality of care for patients, clinical surveillance technology is becoming a critical element to improving patient safety and advancing quality of care by providing a technological means of detecting patients who are deteriorating, thereby enabling earlier and more rapid intervention.

More traditional patient monitoring plays an important role here as well, helping to gather vital sign measurements like heart rate, respiration, blood pressure and SPO2 levels.

Clinical surveillance technology takes these patient’s vital sign measurements and trends and brings an additional layer of integrated analytical capabilities that reveal insights and alert clinicians to a potential need for intervention, so they know when to act.

Q. You suggest gaining more holistic data can help prevent adverse events. How so?

A. The healthcare industry is shifting from reactive care to a mindset of preventative care, aiming to catch signals of an adverse event earlier before they occur. This makes having the right tools to continuously track and monitor a patient’s health extremely necessary. You can’t control something you can’t see or measure, so gaining a holistic view of a patient’s status based on comprehensive and real-time data is key to preventing adverse events.

Today’s monitoring technology is successful at continuously tracking the state of a patient through vital signs measurements. However, surveillance-level data enables providers to take these measurements to the next level and determine the state of the patient’s health to identify what’s physiologically meaningful.

This surveillance-level data provides an added layer of deep analysis necessary for more clinically meaningful insights into the physiologic state of the patient. For example, an elevated heart rate alone may not prompt an intervention but when paired with an elevated respiratory rate and decreasing blood pressure, this could signal that something more serious is occurring and requires attention.

Consequently, this in-depth information provides helpful insights and alerts clinicians so they can intervene in a timely and effective manner, increasing the likelihood of catching a significant event that could potentially be life threatening.

Q. How can emerging clinical surveillance technologies assist clinicians in efficiently determining patient care pathways?

A. The issue of patient safety is top of mind for health leaders worldwide, especially with current staffing shortages and higher patient-to-staff ratios. Clinical surveillance technology can help clinicians draw a conclusion as to whether patient intervention is necessary at a specific moment, which can help clinicians analyze the best care pathway to allocate and maximize their time with the patients that need it.

With innovative technologies and informatics solutions that provide insights across varying care settings and throughout the hospital, practitioners are provided with the right information at the right time.

The ability to access specific data that can indicate when, where and how a life-threatening event may occur provides clinicians with a continuous view of the patient and helps them identify trends, indicating when intervention is necessary. This not only enables clinicians and hospitals to better allocate staffing and resources, but also helps to prevent potentially life-threatening events.

Q. What do you mean when you say there should be less invasive technologies to expand care across settings? Why is this important?

A. Clinical surveillance allows clinicians to monitor patients in a variety of clinical settings ranging from emergency and operating rooms to intensive care and other healthcare settings. We’ll continue to see recovery evolve from an inpatient-only setting to a more holistic one that includes outpatient settings, as well as into the home where they are often more comfortable.

With this transition into lower-acuity areas and into the home, these solutions will become less bulky and invasive – and therefore less burdensome to patients. However, for patients to access care and be effectively managed across all care settings – while utilizing fewer hospital resources – these solutions must also be backed by sophisticated surveillance analysis software.

Contrary to the belief that clinical surveillance may minimize bedside interaction, the value lies in being able to detect necessary interventional care. This will help alert clinicians to when their attention is needed on a patient, making these interactions much more meaningful and efficient.

Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
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