Actionable Alerts

Overview

Bluebird's Actionable Alerts are Role Specific and tailored to each hospital in order to avoid "alert fatigue". This is important because the range of possible alerts is extremely broad. Experience has shown that only alerts that require immediate action should fire. Anything else is added to that person's work list. Unnecessary alerts contribute to "alert fatigue" and cause critical alerts to be missed. Comprehensive patient information is immediately accessible from the alert dashboard, along with the ability to makes notes and allocate specific tasks to, for example, a ward nurse. Shortcuts to all labs, (with a separate, specific shortcut to septic focused labs), to antibiotics ordered, to the WWB and to that patient's bed history (with a full contact trace) are well organized and immediately accessible from the alert interface. Closing the alert requires documentation of how the alert was resolved which is available for reporting.

Individual Patient Care

Demonstrating that Stewardship improves individual patient care is the best way to get Physician support for an AMS program. Bluebird's Actionable Alerts are specifically designed to optimise individual patient care.

IC Alerts

Proactive Alerts identify patients who are at risk of acquiring, or transmitting, infection
Specific Organism Alerts such as MRSA, ESBL, ESCAPE, Candidemia
Outbreak alerts indicate that the prevalence of a particular organism has increased above a threshold in a particular ward
Lab Alerts such as abnormal renal function, WBC, ESR, CRP, PCT
Condition Alerts such as a wound infection which was documented in the Clinical Diagnosis section by a clinician
Admission Alerts such admission of a MRSA carrier, CDI readmitted within 30 days, surgical readmissions
Post Discharge Surveillance Alerts Bluebird can alert IC when active cases have been discharged in case post discharge surveillance is required
Post Discharge New Infection Alerts if labs come after discharge and show a critical issue, Bluebird can alert IC at the original hospital

AMS Alerts

Bluebird offers a full complement of Antibiotic Alerts including abnormal Gentamycin levels, ESBL with no carbapenem prescribed, Vancomycin > 3 days without an organism isolated and drug dosage modification alerts because liver or renal function is suboptimal. Alerts can be triggered when the Temp, WBC, PCT and C reactive protein have been normal for 48 hours, suggesting that the antibiotic might be stopped. If the isolate is MRSA or P. Aeruginosa, Bluebird understands that the MIC is critical to prevent Vancomycin failures and to help decide whether continuous IV Rx would be advisable and will raise an alert if the MIC was not returned from your lab. Debbie Goff's paper quoted in the adjoining image outlines organism alerts that we find particularly helpful in getting physician support for Stewardship.

Ward Manager Alerts

Besides the general alerts specific for that ward, the ward manager can also get alerts that have been escalated because a task was not completed by the ward nurse in the allotted time. A good example would be failure to complete a bundle audit.

Ward Clerk Alerts

Lab results are frequently allocated to the incorrect ward (mismatch between the HIS and the LIS). Bluebird alerts the ward clerk and provides a simple interface to merge to the correct ward.

Doctor Alerts

Doctor can choose to be alerted to a range of specific alerts and can also choose if the alert must also be sent by SMS and email (care is taken to preserve patient confidentiality)