Give two examples of significant innovations that could be made.
Increased use of telehealth and enhancement of real-time telemetry monitoring are two significant innovations that could be made within the hospital setting.
Identify the factors that are driving the need for these innovations.
Increased use of telehealth needs is a result of the backlog from people who have not attended to their regular check-ups, remain behind with an increased risk for adverse events that would increase and prolong inpatient hospital admissions.
Real time telemetry monitoring factors are the increased patient acuity increase with access to records that could substantiate physician outreach by RNs for advisement and consultations.
Explain how the factors that are driving your identified innovations are related to any of the following indicators of innovation: Unexpected success, Failure, Change, Incongruity between what is and what should be, Process needs, Demographic changes, Changes in perception, mood, meaning, and/or new knowledge
Telehealth innovation is needed as our system has moved further for process needs to digital records. There are demographic changes with expected immediacy for information and acceptance of telehealth records by patients and family. Recent COVID-19 pandemic resulted in the awareness of lack of in person access to physicians which remains limited. There is also the change for more relaxed regulatory standards that has aided acceptance to use telehealth to access physicians for outpatient needs while inpatient.
Telemetry (cardiac) monitoring innovation in real time would result in successful awareness for patient needs. The failure by having a central monitoring station overseeing multiple patients is not enough currently with spot checks for strip recordings combined with high patient loads by floor RNs that result in slowed response rates for critical arrhythmias. The demographic changes of older aged populations and higher patient acuity loads placed on mixed use floors, some with and some without remote telemetry monitoring are another point in favor of more real time telemetry monitoring that would be available to the RNs. There is an expected perception that when a patient is inpatient, the care will be total and complete for the patient. This would drive a purposeful change for enhanced real time telemetry monitoring available to the RNs.
Waxman KT DNP MBA RN CNL CENP, (2018). Financial and Business Management for the Doctor of Nursing Practice, 2nd edition. Springer Publishing Company, New York. Pages 327-343
The process needs for the implementation of telehealth for your facility seems like a great innovation. It sounds like there is a process change needed to catch up on the backlogged follow-up visits. Other indicators of innovation could be the changes in perceptions and attitudes (Waxman, 2018). Patients are not always comfortable coming into their healthcare provider offices. With the advantages of the EMR and the other technological driving factors, telehealth and video visits seem to be an expectation for patients. The demographic of these patients can also help to drive this innovation. It seems like more people are online and have access to the internet or cell phones. This means patients might have more flexibility with telehealth or a video visit than an office visit. Meeting patients where they are at is a key indicator of patient satisfaction and can encourage patients to keep up with scheduled visits.
Waxman, K.T. (2018). Financial and business management for the Doctor of Nursing practice (2nd ed.). Springer Publishing Company. ISBN 13: 9780826122063
You make a great point about the need for real time telemetry services in the inpatient setting! This is actually something that the emergency department that I work in is implementing currently. We have a telemetry tech who sits at the nurses stations to watch over the monitors for us! This is also really helpful to watch the patient’s vital signs- like blood pressure and pulse oximetry levels. In the ER that I work in, it is loud and chaotic. Often times, it takes awhile for me to notice if one of my patient’s monitors is alarming.
This telemetry tech will keep a close eye on things like this. They will be able to silence the alarm if necessary or alert me, as the nurse, in real time if I need to go in and see my patient! I think that real time telemetry is a great asset for inpatient nursing floors as well. I remember working the floor and having a phone call about an abnormal heart rate for a patient come in nearly 5 minutes after I had noticed it and was at the bedside of the patient.
Hello Roslyn, I believe two additional drivers of your innovation for the enhancement of real-time telemetry monitoring are safety and efficiency. As you have mentioned, there has been an increase in the acuity of patients requiring telemetry monitoring. Telemetry monitoring is essential in tracking lethal cardiac rhythms instantaneously. By having access to enhanced telemetry monitoring – nurses can ensure the safety of their patients by being able to observe any lethal cardiac rhythms the moment they have them. On the other hand, if a patient’s cardiac rhythm is stable – we can see that and further evaluate the patient for discontinuation of the telemetry monitor or any follow-up by cardiology. This will improve the efficiency of the cardiac department by allowing nursing staff to evaluate their cardiac stability based on the real time telemetry monitoring. The indicator of innovation that is related to this is failure. As you have mentioned, the failure to evaluate these important cardiac rhythms has caused a slowed response for critical arrythmias. By obtaining enhanced telemetry monitoring – the response time for critical arrythmias can improve substantially.
Great discussion post! I really liked your factors that are driving the need for innovation, especially about telehealth visits. Since the Covid pandemic began, I feel like teleheath visits have been becoming very popular and individuals are opting to go virtual rather than in-person. Another driver of the innovations could be changes in perception, mood, meaning, and/or new knowledge. If new knowledge came out about risks of telehealth visits and how in-person visits are better because a doctor can properly assess a client by listening to breath sounds, heart sounds, etc., then this would change how individuals feel about teleheath visits and individuals might become more in favor of in-person visits. Another driver of the innovations could be incongruity between what is and what should be. Lets say that people expect televisits to be one way, but after the televisit they may be left with a lot of unanswered questions and feel uneasy, then this would show that televisits may not be the best option for that individual. Meanwhile, for individuals that are good at technology, they might find the televisit very simple and easy and prefer to go that route. Overall great discussion!
Another driver of innovation that could be applied to the need for increase in tele-health could be “change,” due to the fact that patients still needed to be seen by their physicians, but due to restricted access and safety of workers from covid, this specific innovation had it’s prime time to shine. The tele health innovation was enhanced and became common now because a new vital demand and need for it with the pandemic, a change to the regular status quo had to be made. For the real-time telemetry, the driving force could be incongruity. The tele-monitor is specifically do exactly what its name says and “monitor,” patients. If we are seeing things after the fact, that is not accomplishing what it should be doing. Therefore the real time attribute of it really makes sense and brings it to being a good innovation.
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