National Institutes of Health Improves Clinical Decision-Making with Blood Volume Tracking Tools: Stage 7 Success Story

Since opening its doors in 1953, The National Institutes of Health Clinical Center (NIHCC) has worked diligently with volunteer patients to create medical innovations. Home to the largest research hospital in the U.S., some of their many accomplishments include the discovery of nitroglycerin to treat heart attacks, identifying the genetic component in schizophrenia and more. Despite a robust history and a clearly demonstrated record of accomplishments, the hospital still faces the same challenges as so many other healthcare organizations. NIHCC has worked to address these challenges by leveraging health information and technology for improved outcomes.

Improving Blood Volume Tracking

NIHCC recognized they needed a better tool to measure and track the total blood volume being drawn from their patients. Research protocols required the center to track total blood volume and provide an estimate before institutional review board approval. Since care at the NIHCC involves both clinical and research activities, the ability to track blood volume totals in each respect was imperative to ensuring safe patient care and supporting clinical research.

In order to address this, NIHCC’s Department of Clinical Research Informatics, Office of Research Compliance and the Department of Laboratory Medicine worked together to determine what to display in the electronic medical record, as well as the best way to obtain the information from the lab information system. A clinical decision support (CDS) tool was developed from these collaborations that could more accurately inform clinicians and researchers of total blood volume. “This is an excellent addition to our CDS toolbox in our electronic health record [EHR] for achieving our patient safety goals!” said Michelle Lardner, DNP, RN-BC; deputy chief information officer of clinical informatics at the National Institutes of Health Clinical Center.

“The Clinical Center has a keen focus on achieving high reliability and delivering safe patient care. This functionality provides a facile tool for our care teams to quickly assess blood volumes drawn and if safe volume limits have been reached,” explained Maria Joyce, MBA, CPA, chief financial officer, NIHCC.

After the tool was developed, it was tested and placed into production. The tool was approved by NIHCC’s clinical information management and medical executive committees, then shared via NIHCC’s communication channels and with all clinician user groups. Since the tool is relatively new, the NIHCC is currently monitoring use and impact on outcomes, but ultimately the NIHCC clinical research team is better prepared with real-time information that can improve clinical decision-making related to patient safety and research protocol integrity.

HIMSS Analytics Stage 7 Validation

HIMSS Analytics is proud to recognize the NIHCC for its validation as a Stage 7 healthcare system, as tracked by the Electronic Medical Record Adoption Model (EMRAM).

“The National Institutes of Health Clinical Center is a very unique care setting where there is no ‘normal,’” said Philip Bradley, FHIMSS; regional director of North America for HIMSS Analytics. “NIHCC’s use of technology aids their extensive research and report cost of services.”

“The success of managing our EHR comes from having an engaged community of healthcare practitioners as well as technical staff,” said Jon McKeeby, chief information officer, NIHCC. “With the use of strong project and change management and governance processes, we have been able to make clinician workflows more efficient while allowing them to provide quality patient care. We are proud to be the first federal facility to have achieved Stage 7 in today’s challenging IT environment, with managing security and privacy requirements, balancing user satisfaction, supporting research and innovation.”

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Read another Stage 7 success story: Innovating for Improved Opioid Outcomes: HIMSS Stage 7 Success Story