Critical care settings like the intensive care unit (ICU) has been touted as a complex environment, where approximately 200 steps are implemented to ensure each patient is safe from blood clot formation or ventilator-associated pneumonia. ICUs around the country are occupied with various machines and technologies that are naturally more advanced than technologies placed in acute care settings. The emergence of these tools, however, is not fully integrated to improve the workflow and meet the needs of physicians, nurses and other healthcare workers.

Clinicians need a technology that allows them to gather all data from many machines to monitor a patient’s health progress and ensure patient receives all recommended treatment. Meanwhile, a patient and relatives would feel uncomfortable seeing all the complicated machines with frequent alarm sounds surrounded the patient.

As a means to overcome this issue, The Armstrong Institute for Patient Safety and Quality at Johns Hopkins Medicine came up with a realistic evolution of ‘Project Emerge Tab Apps’ that benefits clinicians and patients as a whole. With this recent advancement, the quality of care in ICU has been revolutionised with the delivery of a more personalised patient experience.

Improved ICU through Project Emerge

Project Emerge is a pilot quality improvement that uses a tablet application to achieve the main goals of eliminating potential harms in ICU and improving patient engagement in their care through personalised care. The smart apps in this tablet improve care coordination by compiling the essential data from monitoring equipment.

Instead of scavenging through patients’ medical records, nurses and other clinicians can directly access the tablet to see all required data and certify that patients receive appropriate care. As for patients and families, Project Emerge benefits them by creating a conducive environment in ICU with fewer daunting or frightening experiences.

As the tablet is placed at the patients’ bedside, it allows them to ask questions directly to the medical team, facilitates active participation in their own care and indirectly improves care outcomes.

What does it take to create ‘Project Emerge’ in ICU?

Project Emerge brings together 18 disciplines, including nurses and other clinicians, systems engineers, bioethicists, human factors specialists and patients and their families. The tablet is well occupied with ‘harm monitor’ that has the capabilities in tracking down each of the task performed and alerting the clinicians when patients are at risk.

These ‘harm monitors’ make use of a coloured chart: red for current actions, yellow for upcoming actions and green for complete actions. With that, clinicians would be able to know the current status of the patient and plan care interventions accordingly to prevent harm.

The components of the tablet also optimise personalised care by offering a family involvement section, as they can choose the care activities they wish to participate in to assist nurses. This may include bed bathing, oral care and grooming. Hence, they can upload photos or music that is related to the patient’s personal background as an alternative way to improve patients’ sensory and allow nurses to get to know them better.

Successes of the programme

Project Emerge has been launched in the Weinberg Surgical Intensive Care Unit at the Johns Hopkins Hospital. With significant improvement in this technology, The Society of Critical Care Medicine awarded the concept of the family involvement menu with the Family-Centered Care Innovation Award at the 43rd Critical Care Congress in January 2014. The award recognises novel, effective methods for providing care to critically ill and injured patients and their families.

All in all, Project Emerge has improved the workflow in ICU. It is hoped that through its efficiency, this transformation can be employed to our local healthcare systems, primarily in critical care settings. MIMS

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