Two prototype technologies designed by Johns Hopkins Medicine clinicians, patient and family advocates, and JHU Applied Physics Lab (APL) engineers are being tested at Johns Hopkins University medical facilities.
For the past few months, researchers have been testing a new interface designed to improve the usability of large-volume medication infusion pumps. These devices are among the most widely used technologies in healthcare today but infusion errors and pump failures have harmed or even killed patients.
In 2011, APL and Johns Hopkins Medicine received a $1 million grant from AHRQ within HHS to improve the safety of the devices. “After consulting with pharmacists, nurses, physicians, anesthesiologists, engineers, patient safety analysts and human factors experts, APL and JHU zeroed in on the human machine interface,” explained Alan Ravitz of the Research and Exploratory Development Department. “Healthcare workers were often adapting their workflow to the designs of the infusion pump, as opposed to having the machines designed to their needs.”
Ravitz and his team including healthcare workers at Johns Hopkins Hospital and the Hopkins Armstrong Institute for Patient Safety and Quality, have developed a tablet computer interface. The simulation testing involved 40 intensive care unit nurses at the Mount Washington Pediatric Hospital in Baltimore, an annex of Hopkins Medicine and was successful. The initial grant wraps up in April, but Ravitz says the team’s next steps are to publish their findings and transition the software so that others can use it.
A custom-made tablet computer is involved in another prototype designed as part of a larger effort to improve patient care. In 2012, APL and the Armstrong Institute teamed up on Project Emerge, an $8.9 million effort funded by the California based Gordon and Betty Moore Foundation. The goal was to design and deploy integrated tools and techniques to reduce medical errors in intensive care units.
Studies show that at least one out of every five of the estimated four million patients treated in intensive care units each year are harmed during their hospital stay. This occurs largely because the medical devices commonly used in ICUs such as infusion pumps, ventilator systems, defibrillators, and electrocardiogram analyzers are not integrated or interoperable.
The team has developed software that is now able to coordinate and integrate the data and information on each ICU patient. By using a tablet to access information, healthcare workers can determine a patient’s risk for preventable harm that can include delirium, ventilator-associated infections like pneumonia, bloodstream infections, or deep vein thrombosis. Using the tablet, healthcare workers are able to receive information on how to reduce the risk and use embedded alarms to alert staff members to possible problems.
According to Ravitz, “After fine tuning the system, we plan to test it on a wider scale at Johns Hopkins Bayview Medical Center’s ICU and at the University of California at the San Francisco Medical Center which is partnering with Hopkins on the project.”