Appropriate Utilization

Prevent Pain and Organisms from Skin and Catheter Entry and Radiology

Every time a line, drain, tube or airway (LDA) is placed in a patient, blood is drawn, medication is administered, there is increased risk for hospital acquired infections, pain, and opportunity for blood loss. These are all considered POKE-R events and they can greatly reduce clinical outcomes and impact patient experience.



POKE-R events increase risk of hospital acquired infections and anemia. As a result, this has adverse effects on Length of Stay and increased readmissions. All POKE-R events may not be clinically required, cost of care increases and quality of care is impacted. Pediatric patients are especially vulnerable to blood loss (anemia) and radiation.

Our configurable solution help organizations decide and customize events based on what is considered meaningful, invasive, and painful. Aligns with performance improvement initiatives, thus improving patient experience. POKE-R analytics, when embedded within EHR, provides flexibility to physicians, specialists and nurses - prior to and during rounds - on optimizing clinical care. POKE-R is a methodology of delivering clinical care that improves patient safety and experience. There is a strong clinical need to produce the necessary data to optimize clinical care and minimize patient intrusion. POKE-R encompasses a wide variety of health system and hospital activities including:

    • Line, Drains, and Airways
    • Medication Administration
    • Specimen Collection
    • Invasive Procedures
    • Surgery
    • Radiology

Benefits of Fusion Solution include:

  • Identify clinical events that are POKE-R events. Supports ability to analyze and reduce number of POKE-R invasions performed.
  • View POKE-R events in front end reports and patient's charts. Improve Patient Outcomes, Satisfaction, and Clinical Costs.

Return On Investment from Fusion Solution

  • Our client (Children's Hospital on the West Coast) implemented POKE-R Analytics and documented a 5 year cost savings of $11.1M. This success has prompted rolling out POKE-R program to 260 beds.
  • Savings are projected to increase significantly with more patients and beds having access to POKE-R analytics.

Vancomycin

Reduce adverse clinical outcomes associated with Vancomycin toxicity such as acute renal failure. Improve times to pharmacist with Vancomycin dosing management.



    • Vancomycin therapeutic level monitoring to improve drug efficacy
    • Improve times to pharmacist Vancomycin dosing management if uncontrolled therapeutic levels
    • Reduce adverse clinical outcomes associated with Vancomycin toxicity such as Acute Renal Failure

Benefits of Fusion Solution include:

  • Integrated with EHR provides real time patient quality management
  • Lab results validation
  • During inpatient encounter, Vanco Pharmacy calculator helps before discharge
  • Various lab results validation across patients for analytics helps manage dosage and troughs better

Sickle Cell Disease

The Sickle Cell Management solution gives insight to a difficult medical condition to manage. It provides a health network with a broad picture of the management of the Sickle Cell disease population.



Including insights into how well patients are receiving care for acute inpatient admissions for Sickle Cell crisis, Pain Management/Opioid Management, Patient Education, Length of Stay, Readmissions, Mortality, and Utilization of Hospital Services.

There are several metrics that comprise the Sickle Cell Management solution. They are made up of overall, process, and medication metrics utilized to improve patient care.

Overall

  • Length of Stay (LOS vs GMLOS) – average Length of Stay per encounter (in days) and Benchmark LOS (Geometric Mean Length of Stay). Adult benchmarks come from CMS and are based on Medicare Severity (MS) DRG. Length of Stay measures can also be filtered by process and medication measures.
  • Mortality – the number of patients who died in-hospital divided by the total number of discharged patients. Mortality measures can also be filtered by process and medication measures.
  • Readmissions – the number of patients discharged from a hospital system and readmitted to the same hospital system within 30 days of discharge divided by the total number of discharged patients. Planned readmissions, same-day-readmits, and discharges to other acute hospitals are excluded. Readmissions can also be filtered by process and medication measures.
  • Discharge Dispositions – the eight most common discharge dispositions by patient volume
Process Measures

  • Order Set Utilization – percentage of encounters with the Sickle Cell Crisis order set utilized, broken down by Total (Overall), Emergency Department, Admission, and Nursing.
  • Case Management Consult ordered – Sickle Cell encounters where a Case Management consult ordered within 24 hours.
  • Sickle Cell Discharge Instruction Utilization – percentage of encounters where of using the smart text D/C instructions specific to Sickle Cell crisis.
  • Patients with Completed Follow Up visit within 7 days of Discharge– percentage of encounters where the patient had a follow up visit scheduled within 7 days. We will present two rates one for Follow Up rates and one for No Shows.
  • Packed Red Blood Cell administrations – percentage of encounters where the patient had Packed Red Blood Cells (PRBC) administered and the total PRBC administered for each encounter.
  • ED/Urgent Care Visits within 30 days of Discharge– percentage of encounters where within 30 days of discharge the patient utilized ED or Urgent Care services.

Medication Measures

  • Total IV Opioids – The number of patients who were administered IV opioids during the Sickle Cell encounter.
  • Patient Controlled Analgesics (PCA) Utilization – The percentage of total IV opioid patient encounters where a PCA was utilized during the encounter for pain management.
  • Narcan Administrations – the number of Narcan administrations that occurred each month for the Sickle Cell population.
  • IV to Oral Opioid Transition Prior to Discharge – the percentage of total IV opioid patients that transitioned to PO Opioids prior to discharge. To qualify the patient can not be on both IV and PO concurrently the day of discharge.
  • IV Opioid Utilization – average days of IV opioids for all opioid administrations, average days of PRN opioids administrations only (any PCA/scheduled admin), average days PCA and/or scheduled IV opioids.

Benefits of Fusion Solution include:

Process, Medication, Length of Stay, and Readmission measures help an organization realize if clinical interventions and pathways are helping to improve the overall care of a costly patient population. Appropriate patient education and pain management are paramount to keeping the Sickle Cell disease population healthy.

Lines, Drains & Airways

Management of central lines and foley catheters are important for patient safety. Informatics on how they are managed, trending, volume and utilization by location as well as DRG are critical components to providing better quality.



The Fusion Lines, Drains & Airway Solution helps clinical leadership quickly evaluate and address data documented in the electronic medical record for patients with lines and drains in place.

This solution captures duration, volume and care of lines and drains amongst other key metrics. The Fusion Lines, Drains & Airway Solution includes:

    • Analytics for all patients in the hospital to help manage care better
    • Analysis on volume of each line and drain
    • Duration each line or drain is in place
    • Analysis of documented nursing care for central lines and urinary catheters
    • Analysis of any of these metrics by location and unit
    • Analytics on potential impact on overall length of hospital stay and mortality

Benefits of the Fusion Lines, Drains and Airways Solution Include:

  • Analytics on central lines and urinary catheters in the hospital across all service lines
  • Provides clinicians and healthcare leadership with analytical tools and reports to substantiate or change processes and workflows
  • Customized visualizations designed to provide an efficient overview of the clinical data

Blood Utilization

Fusion's Blood Utilization solution unlocks your organization’s blood products ordering and administration by using your current EHR platform. Our solution is proven to reduce cost, lower risk of hospital acquired infections, reduce readmissions and length of stay.



Integrated with your EHR, our health analytics helps you quickly optimize appropriate blood utilization.

With constant pressure on healthcare professionals to improve quality and reduce costs, scarce and expensive resources such as blood represent an opportunity for hospitals to significantly accrue financial savings while lowering patient risk in critical care, surgery, and emergency.

Fusion's blood utilization solution unlocks your organization’s blood products ordering and administration by using your current EHR platform. Our solution is proven to reduce cost, lower risk of hospital acquired infections, reduce readmissions and length of stay.

Fusion's solution is able to optimize appropriate blood products utilization across your organization based on orders, scans, results, labs and clinical documentation. This leads to improvement in clinical efficacy, reduced hospital acquired infections, cost and length of stay.

    • Assess patient labs, vital signs, and clinical documentation
    • Evaluate current workflow process and improvement opportunities
    • Examine historical blood product usage from orders, bar code scans and results
    • Estimate cost savings
    • Identify clinical appropriateness and opportunities for performance improvement
    • Targeted and actionable analytics
    • Adopt improvement program & measure progress

Benefits of Fusion Solution include:

  • Ensuring order appropriateness and not just limiting it to EHR features

Return On Investment from Fusion Solution

  • $3.3M Annual cost savings
  • 46% Reduction in blood units administered without medical necessity
  • 23% Reduction in blood units administered annually

Imaging Utilization

Imaging services can sometimes be unnecessary. Many times there is clinical pressure to order an imaging study instead of a face-to-face physical exam. Our solution will help to identify bottlenecks in workflow to reduce waste of ancillary imaging resources.



Our imaging utilization analytics solutions provides data on imaging resource utilization and scheduling as well as operational efficiency in ancillary departments such as CT and MRI.


Benefits of Fusion Solution Include:

  • Manage technicians schedules efficiently and effectively
  • Manage MRI/CT/Imaging schedules efficiently and effectively
  • Track and trend utilization of imaging studies to identify opportunities for alternatives
  • Optimize technician workflow with a series of time based operations metrics
  • Identify cost associated with over/under utilized imaging resources

Ventilators

This solution utilizes a series of metrics to monitor all aspects of mechanical ventilation in critical care settings. Ventilation Management metrics help critical care leadership create protocols for the efficient use of Ventilators by managing hours on mechanical vents, planned vs inadvertent extubations, and re-intubations.



Ventilator management metrics allow critical care clinical leadership to implement new workflows and or policies and procedures that will lead to fewer instances of mechanical ventilation, timely extubations, reduced ventilator days, and faster assessments of ventilator weaning readiness.

The information provided allows decision makers to effectively reduce the number of patient ventilator days thus improving clinical outcomes and reducing the cost of a critical care bed.

Metrics include the following:
    • Calculated mechanical ventilation minutes based from critical care business rules
    • Planned vs Inadvertent extubations
    • Re-intubations counts
    • Assessments for ventilator weaning readiness
    • Compliance of Ventilator Bundle performance

Benefits of Fusion Ventilator Management Solution include:

  • Insight into mechanical ventilation days.
  • Improvement in extubation practices.
  • Reduced mechanical ventilation days.
  • Improved clinical quality practices and protocols.
  • Managing re-intubation cases.

Critical Care

Patients in the ICU are often the most vulnerable and subject to sudden change. Changes in their conditions are difficult to predict, especially if data is not being utilized. Our solution utilizes several reports giving insight into patient's condition and the steps taken to manage their health.



Critical care units cater to patients with severe and life threatening injuries or illnesses. Due to the severe nature of the patient's condition, constant monitoring and support must be maintained to ensure normal bodily functions. The use of analytics and tools can be instrumental in making timely and efficient decisions.

Our solution's reporting also display various cost data such as 30 day total costs and medicare free days. ICU Admissions, Readmissions, Length of Stay, as well as adjusted reports are also available.

    • Measure and Manage ICU Length of Stay
    • ICU Readmissions Rate reduction
    • Reintubation
    • PPI Metrics
    • ABCDE & F
    • Benchmarking each critical care specific to Vizient benchmarks
    • Related health outcomes to be considered include: Ventilator, Sepsis, CHF, POKE-R, Stroke

Benefits of Fusion Solution Include:

  • Retrospective analysis of core ICU metrics
  • Provides Critical Care clinicians and healthcare leadership with analytical tools and reports to substantiate or change processes and workflows
  • Customized visualizations designed to provide an efficient over view of the clinical data
CIE-412-08570 - © - Chris Ryan

Interested In One Of These Solutions?

Click below to start the conversation and learn more about our solutions.
Request A Demo