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Innovation improves patient safety, teamwork and training

Stony Brook University Medical Center has become the first hospital on Long Island to implement a new technological system in its Operating Rooms to improve patient safety, efficiency, teamwork and communication.

The system provides real-time information about patients to staff and physicians in the Operating Room during surgeries. Information is displayed on 42-inch flat-panel displays mounted on the walls in 10 new Operating Rooms at Stony Brook. Information on the displays is pulled directly from the hospital's Information Technology system. It includes the patient's allergies and lab results, information about blood products available to use, and information about tissue specimens that have been collected for analysis. The system also includes the standard surgical checklist used before, during and after surgery, including the "time-out" procedure required to verify the correct patient, correct procedure, correct surgical site, etc.

During surgery, the system prompts the OR staff and physicians when it's time to provide additional antibiotics, and when to reposition the patient to maintain proper blood circulation. A "progress bar" across the bottom of the screen indicates the time remaining for the surgery. If a procedure requires more time than anticipated, an alert prompts the staff to notify the OR Scheduling Desk, so that the next OR team scheduled to operate can be informed of the delay. The next team can often be rescheduled to use another OR, expediting care and avoiding unnecessary delays.

Once the case is complete, the system starts a "countdown clock" to give housekeeping and nursing staff 35 minutes to prepare the room for the next case. The system has been in development for the past two years at Stony Brook. The OR staff and physicians named it "SAFE": Situational Awareness For Everyone.

"The goal is to create a team environment where everyone can see what's happening in one place," said Kenneth Rosenfeld, M.D., Associate Professor of Anesthesiology, Vice Chair for Clinical Affairs, and Medical Director of the Operating Room at Stony Brook. "Having all this information on the screen and providing reminder prompts for all to see throughout the case should improve safety and efficiency in the operating room."

According to Allan Katz, CEO and President of VTS Medical Systems, LLC, SAFE demonstrates the key value proposition associated with employing technology in the healthcare industry รข namely improving Patient Safety and Operating Room Productivity.

"While the underlying technology of SAFE is relatively simple," he said, "the return in terms of patient safety and OR productivity is huge." SAFE requires no additional work on the part of the OR nursing staff, since information is automatically pulled directly from the patient's medical record in the hospital computer system. It is also a big source of satisfaction for physicians since it improves their workflow and efficiency in using the Operating Rooms with fewer delays.

The SAFE system arose from a larger project to integrate audiovisual systems in the Operating Rooms. Through the integration project, two additional flat-panel displays were installed on booms beside the operating table, with another located behind the patient for anesthesia. The new displays replaced more traditional TV monitors on carts with wheels.

Now the nurse in the Operating Room sits at a desk facing the operating table and uses a touch panel to route images electronically to the screens surrounding the sterile field. To encourage teamwork, all the Operating Room staff names are displayed on the wall monitor.

The AV system allows pathologists to share images of tissue specimens with the surgeons on the monitors beside the operating table, so they can discuss their findings without the surgeon ever leaving the OR. This improves efficiency and workflow for both pathologists and surgeons. The system can also be used to connect to lecture halls at Stony Brook and to external video teleconferencing systems to provide images for education and training purposes .Officer. "It complements other efforts already under way, such as our Patient Safety Fridays, our electronic medical record, and early warning systems in place for patients who are at risk for their medical conditions to deteriorate," he said.

The technology is provided by VTS Medical Systems, LLC, of Melville, NY. It will be available for sale to other hospitals in the spring of 2011, according to Stacey Persky, Project Director for VTS. Other hospitals from around the state and nation will be visiting Stony Brook over the next several months to learn more about the system's capabilities.

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