I was visiting a friend in the hospital a few months ago. She had a medicated IV drip line (an infusion pump) that allowed precise tuning of how much “stuff” was administered. If it knew that it was dosing at, say, 50ml/hour and it had a 500ml bag then it would need to be changed out in 10 hours’ time and would alert accordingly. It would also alert if it detected that something was wrong with the flow rate.
I noticed the device had a clock on it, and its time was many hours’ off. I asked about this, and the nurse actually had one of the equipment techs come and visit. We chatted about this a bit, and the tech said that while the unit wasn’t all that old, the newer ones did a better job of keeping time. I asked if there wasn’t any sort of compliance or data collection issue with this, and was basically told “No, it’s not a big deal – nobody pays attention to the time on these units anyway.” Having spent years working on medical record systems I found this a bit surprising. I would have also thought that somewhere, somebody must have had the need to verify when a bag needed changing, whether or not the infusion pump had alerted, and when the new bag had been hung. My musings were pretty much dismissed.
It seems obvious to me that having accurate timestamps can improve the quality of medical care and also reduce the costs and risks for both the patient and the caregivers.
Some other folks seem to have noticed this as well – an anesthesiologist at The Massachusetts General Hospital noticed this while in surgery, and went on to get a grant for a comprehensive survey of four prestigious East Coast hospitals.
One story I was told had to do with a guy who showed up at the Emergency Room complaining of chest pains. The staff attended to him immediately, and several minutes’ later, let’s say it was 2:15pm, his heart started to beat irregularly – to fibrillate. They grabbed the defibrillator machine and “shocked” his heart back to a normal rhythm. All good. A few days’ later some lawyers contacted the hospital. They said the hospital’s records showed what happened, but the defibrillation machine said that its treatment was not administered until 2:26. The lawyers wanted to know why the patient was denied critical medical care for 11 minutes’ time. The answer turned out to be that the clock in the defibrillator was running 11 minutes’ fast.
Think of all of the “costs” here, just because the time was set incorrectly on a device. Attorney time on both sides. Many hospital staff members were taken away from their other duties to make statements about what happened, and when. There are real and significant costs associated with all of these events, and these costs get passed along. It’s an inefficient situation.
We can do easily do better.