“In my opinion there should be serious consideration given to the importance of clinical risk management features of any software purchase made in residential care.” Damien Malone
provides resident, employee, maintenance, document control, quality, supplier and financial management systems for an organisation. One of the key features of the software is its integration between various areas, making it easy to trace systems and processes. SARAH has spent a lot of time and effort working with clinical staff and managers to develop risk management tools which support the clinical expert to identify real-time risks. It does this in a number of ways. Clinical observations are one area addressed under the system. All residents have a doctor’s order form completed, which identifies any observation areas that are required to be monitored and allows the general practitioner to identify normal ranges for that individual. When a staff member completes an observation (often a personal carer) and enters it in the system, it generates an on-screen alert for the staff member if the observation falls outside of the normal range – reinforcing the need to escalate it to the registered nurse. Simultaneously, the system generates an alert for the RN, EEN, clinical coordinator or any other staff member the organisation deems appropriate to alert as it is fully customisable. The alert needs to be
actioned by that person, thus ensuring a trail is created to identify strategies to manage these risks.
Tracking movements Two areas of significant clinical risk within an aged care facility relate to bowels – these are constipation and gastroenteritis. SARAH has an in-built alert system to highlight to the clinician if a resident has not had a bowel entry recorded (or no record of bowel motion) for a defined period of time. This is also customisable to each facility’s individual policy and removes the need for someone to regularly go through bowel charts counting days since use and recording it on handover sheets. The program also monitors bowel charts across the organisation and generates an alert if two or more residents are marked as having watery stools. This again gives the skilled clinician information which will enable them to assess if a potential outbreak is imminent. Historically, this information may not have been easily identifiable if the two residents reside in different areas of the facility overseen by different staff. Weight loss is another indicator of risk within residential aged care. Ongoing monitoring and auditing of residents’
weight has been a regular process in most facilities’ risk management systems. In SARAH, the parameters can be set to auto generate an alert based on the loss of an actual kilogram amount (ie 2kg) per period or a percentage of weight lost alert (ie 2%). Again, these alerts are instantaneous for the person entering the result, promoting reporting to senior clinicians but also creating an actionable alert for both clinicians and the dietician which need to be addressed.
Visiting doctors General practitioners visit facilities regularly throughout the week and may encounter many different staff when onsite. One concern often mentioned by GPs is the failure of staff to follow up on their requests, particularly when the staff member they see is not rostered for a number of days. SARAH allows GPs to select a follow-up required alert when making an entry in the system, which again generates an automatic alert for the registered nurse or clinical manager to indicate that some action is required from the visit. The alert remains current until such time as a staff member actions the request. Incident analysis is another important component of risk management. Many of us who have been in aged care for a significant time recall the hours of entering clinical information into tables to generate graphs to assist in the analysis of incident trends. Utilising an electronic system such as SARAH allows instantaneous real-time analysis and charting of incidents. SARAH goes one step further in allowing easy manipulation of analysis to allow you to drill down easily by dragging options around the graph so that factors such as time, contributing factors, or individual residents involved can be considered at
Pulse+IT Magazine - Australasia's first and only eHealth and Health IT magazine.