Change can be slow and painful in many corners of our lives, but perhaps nowhere is change simultaneously feared and welcomed as it is in patient care. Whether it’s in a hospital, long term care or assisted living setting, new innovations in the way we care for people both disrupt our established protocols and improve them.
Chelsea Senior Living, a New Jersey based company with 16 assisted living properties and several more on the way, has phased-in cloud-based record keeping for everything from residents’ prescriptions to their medical history. The electronic Medical Administration Record (eMAR) system Chelsea uses has been implemented over the last three years in all of its buildings. It allows nurses to interactively keep tabs on each resident’s medical profile using a wireless tablet anywhere in the building or off site through a secure internet connection.
“They can instantly see resident’s last vital signs, medications and certain medical assessments,” said Pat Banta, Regional Health Services Director for Chelsea Senior Living. “They can pick up new orders and discontinue old orders without being tied to a desk. If something changes, they can make the change instantly on their tablet.”
The eMAR system has made record-keeping more efficient and cut down on paperwork. An additional asset of the system is the ability to run a report on demand, conduct reviews on use of analgesia medications as well as tracking such use over time. In addition, since the eMAR is a live system, the nurses can check to ensure medications are administered in a timely manner, track resident refusals, and send messages to med passers to keep everyone informed of changes in the resident’s medications. .
“Other companies use eMAR as well, but ours is much more robust when paired with mobile laptops and, perhaps next year, tablets,” said Banta. “This is a change that gives our nurses and aides more time with residents and less time filling out paperwork. It’s also much easier and more efficient to transmit medication information via the internet then by fax machine.”
Another modern innovation Chelsea is testing is telemedicine--having doctors on call via video link for consultations and diagnoses, thus avoiding having to transport an elderly resident to the doctor’s office or even the hospital.
“We have lowered inappropriate hospital transfers for emergency evaluations dramatically,” said Banta. “Instead of automatically transporting a resident to a hospital emergency room, we might get a video consult by a doctor first, depending on the case, and it might well avoid an unnecessary hospitalization. This is good for the resident, obviously, but also for the overburdened hospital emergency room. We’ve been testing this for about a year at our West Milford and Belvidere locations and it seems to be working.”
The video consults are covered by Medicare like any other doctor visit. They will be standard at all newly constructed Chelsea properties.
One of the most recent additions to Chelsea’s cloud-based medical tools is called EarlySense, a sensor placed under a resident’s mattress that monitors vital signs and movement. It’s turned into a tremendous tool to prevent falls in a memory impaired resident who does not call for assistance to get out of bed, a major reason for falls. EarlySense tracks the residents sleep cycles and will transmit a wireless alert to staff allowing the caregiver to arrive to the resident’s room before he/she attempts to get out of bed. Beta testing of the system has identified significant reduction in fall rates in at-risk residents. The EarlySense system is being made available to all Chelsea communities beginning in late 2017.
There is a learning curve associated with each of these innovations, notes Banta. But careful training and support of the nursing staff makes all things possible and brings the patient care process further into the 21st century.