The Winner

Mon Health System (Morgantown, WV): Providing Opportunities for Innovation at Mon Health System: An Award-Winning Collaboration Advances Technology Solutions from Concept to Patient Care. Mon Health System has received our 15th annual award for its proactive approach to innovation: partnering with an innovation lab to provide a pathway for its staff and clinicians to pursue novel solutions as a way to improve patient care.

The process of developing a 3D-printed prosthetic finger augmentation—starting with a physician's idea for improving patient outcomes and concluding with the production of a new device—illustrates how an innovation lab with health system support can serve the unique needs of the local patient population.

ECRI's 14th Health Technology Excellence Award is shared by two organizations from Vancouver, British Columbia, Canada: Lower Mainland Biomedical Engineering, which is part of the Provincial Health Services Authority, and Vancouver Coastal Health. The organizations were honored for their joint effort to identify the root cause of overinfusions involving a commonly used brand of infusion pump—an effort that had a global impact on patient safety.

Along with the winning submission, we note two additional entries that deserve special recognition. In this collection of articles, we describe each of these projects to highlight their successes, as well as to share best practices and techniques that may benefit other healthcare facilities. 

The Winner

Lower Mainland Biomedical Engineering and Vancouver Coastal Health (Vancouver, British Columbia, Canada): Investigating Overinfusions—Award-Winning Joint Effort by Lower Mainland Biomedical Engineering and Vancouver Coastal Health Has a Global Impact. Through persistence and sound investigative practices, a team representing two Canadian healthcare organizations identified the cause of overinfusions involving a commonly used brand of infusion pump. The team discovered a dimensional defect in the infusion tubing, a fault that could explain years of unexplained overdeliveries of medications with this brand of infusion pump. The team's findings led to a global recall of the defective tubing, and thus had an impact on patient safety worldwide.

The Finalists

Listed alphabetically:

• Memorial Healthcare System (Miramar, FL): Automating Patient Weight Documentation—Memorial Healthcare System's Project to Reduce Weight-Based Medication Errors. Motivated to reduce weight-based medication dosing errors, Memorial Healthcare System implemented tools and processes to automate the capture and documentation of patient weights in the electronic medical record. The changes have led to more accurate documentation of patient weights, resulting in more efficient patient care throughout the health system. The project illustrates that a focused change, targeted at the right problem and well executed, can have a significant impact.
• NewYork-Presbyterian Queens (Flushing, NY): Transforming Pharmacy Compounding Practice—NewYork-Presbyterian Queens Improves Medication Safety through Technology Implementation. For years, NewYork-Presbyterian Queens has been on the path to building a state-of-the-art pharmacy, working to close gaps that could lead to medication errors. A recent addition to that effort—implementing a gravimetric-based IV workflow management system (IVWMS)—demonstrated the value of taking a thoughtful approach to change management. The pharmacy department's well-conceived implementation transformed pharmacy practice in a manner that led to workflow standardization improvements, more efficient and compliant IV room medication management, and production of reliable and accurate compounded medications for patients.

The 13th winner of our award is Penn Medicine, for its development of a dashboard and clinician alert system that uses electronic health record (EHR) data to promote more rapid ventilator weaning and reduced sedation. Along with the winning submission, we note six additional entries that deserve recognition.

The Winner

Penn Medicine (Philadelphia, PA): Penn Medicine App Promotes More Rapid Weaning from Mechanical Ventilation and Sedation—An Award-Winning Initiative. Stakeholders from across the organization collaborated to develop an app—a computerized dashboard and clinician alert system—that uses EHR data to promote more rapid weaning of patients from mechanical ventilation and sedation. Use of the app has helped reduce the duration of mechanical ventilation by more than 24 hours compared with baseline data, and it has led to a corresponding reduction in ICU and hospital lengths of stay.

The Finalists

Our judging panel has determined that entries from the following organizations likewise deserve recognition. Three of the entries are honored as Finalists for this year's award. (Organizations are listed alphabetically.)

• John Muir Health (Walnut Creek, CA): Developing an AEM Database: John Muir Health's Approach to Establishing an Alternative Equipment Maintenance Program. Biomedical engineering management at John Muir Health created an easy-to-use database that formalizes—and simplifies—decisions about which equipment qualifies for alternative equipment maintenance status in its preventive maintenance program.
• Parkview Health (Fort Wayne, IN): Perioperative Supply Management: Parkview Health Automates Its Inventory Management Process. The organization implemented an automated inventory management system to improve how perioperative supplies are managed. The less labor-intensive system has saved money and reduced clinician involvement in the management of supplies, freeing clinical staff to focus their attention on patient care.
• U.S. Department of Veterans Affairs (VA), New England Healthcare System:Alternative Equipment Maintenance Plan: The VA New England Healthcare System Streamlines Its PM Program. The organization's Clinical Engineering Consolidated Program, which serves eight medical centers and more than three dozen clinics across New England, developed a clear methodology for identifying which equipment qualifies for alternative equipment maintenance status in its preventive maintenance program.

ECRI also commends the following organizations, whose initiatives demonstrate best practices and techniques that we believe deserve recognition. (Organizations are listed alphabetically.)

• Banner Health (Chandler, AZ): Developing an In-House Medical Physics Program: Banner Health's Initiative to Streamline Processes and Standardize Protocols. Recognizing an opportunity to manage imaging equipment more efficiently, reduce expenditures, and improve patient care, Banner Health's technology management department built an in-house medical physics program.
• Memorial Sloan Kettering Cancer Center (New York, NY): Transitioning from a Homegrown to a Commercial Medical Device Management System: Memorial Sloan Kettering Cancer Center Meets the Challenge. The organization details the challenges it had to overcome when making the leap from a homegrown equipment management database to a commercial computerized maintenance management system. The MSKCC team describes the approach it used to clean its data, to sustain data integrity in the new system, and to centralize its recall management efforts.
• St. Luke's Health System (Boise, ID): Credentialing Industry Reps in the OR: St. Luke's Health System Uses EHR Data to Drive Process Improvements. Suspecting spotty compliance with the hospital's vendor credential-checking policy, a team at St. Luke's confirmed its suspicions by comparing vendor visit data recorded in the electronic health record against entries from vendor credentialing check-ins. The team investigated potential causes for noncompliance, prioritized solutions, and ultimately enacted a simple solution that proved to be effective.
   

In May 2018, we announced Boston Medical Center as the 12th winner of our award for its development and implementation of a point-of-care, patient-centric mobile app designed to guide patients through BMC's postsurgical pulmonary care protocol. The app puts resources to improve patients' understanding of the protocol at their fingertips, it sends text notifications to remind patients when actions should be taken, and it offers game-like and social-support features to more fully engage the patient. By empowering patients to take control of their recovery, the app helps improve adherence to the protocol, which in turn has been shown to help reduce postoperative pulmonary complications. Significantly, these benefits accrue without increasing the burden on clinical staff.

Along with the winning submission, we selected five additional entries that deserved special recognition. In this collection of articles, we describe each of these projects to highlight their successes, as well as to share best practices and techniques that may benefit other healthcare facilities.  

The Winner

Boston Medical Center (Boston, MA): An App That Empowers Surgical Patients to Take Control of Their Recovery—Boston Medical Center's Award-Winning Initiative. BMC designed an app to help improve patient adherence to the organization's "ICOUGH" postsurgical pulmonary care protocol—and to do so in a sustainable way that would not overburden clinical staff. Early results from BMC's pilot study are quite promising: Patients and staff really like the ICOUGH Recovery app, and better adherence to the protocol has been demonstrated. 

The Finalists

Listed alphabetically:

• Boston Medical Center (Boston, MA): Identifying and Responding to Clinically Decompensating Patients—Boston Medical Center's EMR-Based Early Warning System. This application, the second from BMC to be honored this year, describes the organization's implementation of an EMR-based early warning system (EWS) to reduce clinical deterioration and preventable death among patients. BMC customized the EWS's scoring system to best suit the needs of its specific patient population, and it established a standardized response protocol to facilitate quick responses from appropriately trained staff.

• Einstein Healthcare Network (Philadelphia, PA): Reducing IV Contrast Extravasations during CT Examinations—Einstein Healthcare Network Validates a New Approach. Researchers at Einstein assessed whether injecting a test bolus of saline using a power injector, instead of injecting it by hand, can decrease the number of subsequent IV contrast extravasations that occur during contrast-enhanced CT examinations. The review of pre- and post-intervention data from thousands of examinations showed a significant reduction in extravasation rates with the new procedure.

• St. Luke's Medical Center (Quezon City, Metro Manila, The Philippines): Coping with Delivery Delays and High Supply Costs in the Philippines—St. Luke's Medical Center's Medical Equipment Accessories Management Program. The St. Luke's clinical engineering department instituted a program for identifying and evaluating third-party alternatives to original equipment manufacturer (OEM) medical equipment accessories. The program, which focuses on components that require frequent replacement, has helped the organization overcome obstacles associated with obtaining OEM supplies in the Philippines, and it has saved the facility money.

• U.S. Department of Veterans Affairs (VA) National Healthcare Technology Management (HTM) Program Office (Bedford, MA): Improving Cybersecurity Management—VA's HTM Office Implements a Networked Medical Device Database. VA biomedical engineers developed and deployed a centralized database of medical devices that connect to the VA network. The database has become the authoritative method for VA healthcare facilities to document technical attributes for network-connected medical devices. As such, it is a key component of the organization's cybersecurity program.

• U.S. Department of Veterans Affairs (VA) Veterans Health Administration (VHA): Configuring Blood Glucose Monitors to Reduce the Risk of Treatment Errors—A Human Factors Study Conducted by the Veterans Health Administration. A team from several VHA organizations investigated the cause of treatment errors associated with the use of a particular model of blood glucose monitor. The team's work identified results screen configurations that were prone to misinterpretation and led to VA-wide recommendations for the use of a safer configuration.

In May 2017, we announced Penn Medicine's Center for Health Care Innovation as the 11th winner of our award, highlighting the app-development platform that the Penn Medicine team designed to help clinicians better manage specific populations of patients. The platform allows the team's developers to rapidly create and revise apps that bring relevant data to clinicians at the time they need it, enabling continuously improved patient care.

Along with the winning submission, we selected three additional entries that deserved special recognition. In this collection of articles, we describe each of these projects to highlight their successes, as well as to share best practices and techniques that may benefit other healthcare facilities. 

The Winner

Penn Medicine Center for Health Care Innovation (Philadelphia, PA): Designing Custom Apps to Improve Patient Care—An Award-Winning Initiative from Penn Medicine's Center for Health Care Innovation. The team at Penn Medicine developed a platform for creating apps that proactively identify patients who require a particular intervention, using real-time data from multiple IT systems, and then deliver that information to care providers at the time it is needed, thereby leading to better patient care.

The Finalists

Listed alphabetically:

• Norton Healthcare (Louisville, KY): Strategic Planning in the Clinical Engineering Realm—Norton Healthcare's Approach for Improving Health Technology Management. The organization's clinical engineering group developed, and later refreshed, a multi-year strategic plan to establish guiding principles and tactical goals to help the group better meet the evolving needs of the organization.
• Service New Brunswick (Fredericton, NB, Canada): Improving IPM Completion Rates—How Service New Brunswick Used the "Critical Percentage" Concept to Meet Its Goals. The organization used a simple but effective approach to improve completion rates for medical device inspection and preventive maintenance (IPM) procedures throughout the province.
• St. Luke's Health System (Boise, ID): Transitioning to a Highly Reliable Recall Management Program—How St. Luke's Health System Optimized Technology, Systematized Processes, and Mobilized People. The successful implementation of a centralized, automated recall management system at St. Luke's Health System was helped by the organization's well-conceived strategy for achieving effective and lasting change.

In February 2016, we announced Texas Children's Hospital as the 10th winner of our award for its successful "reboot" of the organization's alarm management strategy. Using an organization-designed alarm dashboard, and with the goal of better integrating clinical alarm management decisions into patient care discussions, Texas Children's Hospital not only achieved a sustained reduction in the number of nuisance alarms, but also improved collaboration between the medical and nursing staff and laid the groundwork for an enterprise-wide solution to improve the management of clinical alarms.

Along with the winning submission, we selected four additional entries that deserved special recognition. In this collection of articles, we describe each of these projects to highlight their successes, as well as to share best practices and techniques that may benefit other healthcare facilities. 

The Winner

Texas Children's Hospital (Houston, TX): A Patient-Centered Approach to Alarm Management—Texas Children's Hospital's Award-Winning Project. Efforts to improve the management of clinical alarms at Texas Children's Hospital led to the design and implementation of an alarm dashboard—a technological innovation that allowed the organization to better integrate clinical alarm management decisions into patient care discussions.

The Finalists

Listed alphabetically:

• Banner Health (Phoenix, AZ): Assessing the Cost-Effectiveness of Approaches for Reducing Retained Surgical Items—Banner Health's Success Story. This case study outlines how Banner Health compared the cost-effectiveness of radio-frequency identification (RFID) technology with that of other alternatives for reducing the incidence of retained surgical sponges.
• Boston Medical Center (Boston, MA): Implementing Alarm Default Changes to Improve Patient Care and Patient and Staff Satisfaction—Boston Medical Center's Ongoing Initiative. Boston Medical Center shares its low-cost, high-impact processes for improving the management of telemetry monitoring alarms.
• Cooper University Health Care (Camden, NJ): A Cooperative Approach to Reducing Supply Costs—Cooper University Health Care's Program to Engage End Users in the Purchasing Process. Forging a partnership between the Supply Chain and Process Improvement functions allowed Cooper University Health Care to reduce cardiology supply costs and lay the groundwork for future cost management initiatives.
• University of Pittsburgh Medical Center (Pittsburgh, PA): Harnessing Data for Medical Equipment Replacement Planning—the University of Pittsburgh Medical Center's "Fleet" Program. UPMC's data-driven approach to planning for medical equipment replacement has helped the health system identify—and efficiently replace—outdated, unsupported, or technologically deficient equipment across the enterprise. 

The Winner

Christiana Care Health System (Wilmington, DE): Preventing the Overutilization of Cardiac Telemetry Monitoring—Christiana Care Health System's Award-Winning Project

The Finalists

Listed alphabetically:

• Banner Health (Phoenix, AZ): How Banner Health Used a Human Factors Usability Study to Improve Its Bed Selection Process
• Cedars-Sinai Medical Center (Los Angeles, CA): Profiling Cedars-Sinai's Initiative to Expand and Centralize Cardiac Monitoring
• The Children's Hospital of Philadelphia (Philadelphia, PA): How the Children's Hospital of Philadelphia Used Video to Better Understand Alarm Fatigue
• Geisinger Health System (Danville, PA): Geisinger Health System's Structured Approach for Assessing Incoming Clinical Technology and Devices
• U.S. Army Western Regional Medical Command (Joint Base Lewis-McChord, WA): A Look at the U.S. Army Western Regional Medical Command's Nomenclature Standardization Initiative

The Winner

Methodist Hospital of Southern California (Arcadia, CA): Equipment Management for the Digital Age—Methodist Hospital's Award-Winning Project

The Finalists

Listed alphabetically:

• Boston Medical Center (Boston, MA): How Boston Medical Center Got a Handle on Telemetry Alarms
• Children's Hospital of Ontario (CHEO; Ottawa, Ontario, Canada): Big-Picture Clinical Technology Management—A Success Story from Children's Hospital of Ontario
• Geisinger Health System (Danville, PA): Geisinger Health System's 360-Degree Approach to Capital Technology Assessment, Planning, and Optimization
• Halton Healthcare Services (Oakville, Ontario, Canada): How Halton Healthcare Services Used Bedside Bar Coding to Improve Specimen Identification
• Novant Health (a healthcare system based in Winston-Salem, NC): How Novant Health Moved Endoscope Repair and Instrument Sharpening In-House
• Parkview Health System (Fort Wayne, IN): Facility Renovations Lead to Supply Chain Renovation at Parkview Health System

The Winner

Johns Hopkins Hospital (Baltimore, MD): A Comprehensive Study of Alarm Fatigue—Johns Hopkins Hospital's Award-Winning Alarm Management Initiative

The Finalists

Listed alphabetically:

• Fletcher Allen Health Care (Burlington, VT): Integration of the Cardiology Life Cycle for Patients—Fletcher Allen Health Care's Approach for Implementing a Cardiology Information System
• Kaiser Permanente (South Bay, CA): Leveraging an Integrated Healthcare System to Reduce Catheter-Associated Urinary Tract Infections—Kaiser Permanente Drives the Design of an Ideal Foley Catheter Kit
• Memorial Sloan-Kettering Cancer Center (New York, NY): Integrating the RFID and Infusion Pump Systems at Memorial Sloan-Kettering Cancer Center
• University of Pennsylvania (Philadelphia, PA): The MyHeartMap Challenge—The University of Pennsylvania's Social and Mobile Media Health Technology Initiative
• West Penn Allegheny Health System, Allegheny General Hospital (Pittsburgh, PA): Improving Hand Hygiene Compliance through the Use of an In-House-Developed Feedback Device—West Penn Allegheny Health System's Innovative Approach

The Winner

Grande Ronde Hospital (La Grande, OR): Development of a Telemedicine Network in a Rural Area—Grande Ronde Hospital's Award-Winning Project

The Finalists

Listed alphabetically:

• Boston Medical Center (Boston, MA): Using a Cart-Based System to Provide Patient Monitoring Training at the Point of Care—Boston Medical Center's Hands-On Training System
• Indian River Medical Center (Vero Beach, FL): Implementation of a Remote Cardiac Telemetry Program—Extending Cardiac Monitoring to Other Care Areas at Indian River Medical Center

The Winner

Kaiser Permanente (San Diego, CA): Development of Orthopedic and Cardiac Implant Registries Helps Kaiser Permanente Identify Best Practices and Improve Implant Selection

The Finalists

Listed alphabetically:

• Boston Medical Center (Boston, MA): Standardization of Alarm Defaults for Telemetry Helps Boston Medical Center Reduce Nuisance Alarms
• Memorial Sloan-Kettering Cancer Center (New York, NY): Integrating a Real-Time Locating System with the Infusion Pumps at Memorial Sloan-Kettering Cancer Center Yields Additional Efficiencies
• University of California, San Francisco (San Francisco, CA): Improving the Technology Adoption Process—The University of California, San Francisco Implements a Physician-Led Technology Assessment Program
• University of Pennsylvania Health System and Good Shepherd Penn Partners (Philadelphia, PA): Installation of a Telemedicine ICU in a Long-Term Acute Care Facility—A Joint Effort by the University of Pennsylvania Health System and Good Shepherd Penn Partners

The Winner

Dartmouth-Hitchcock Medical Center (Lebanon, NH): Innovative Application of Pulse Oximetry Monitoring Reduces Failure-to-Rescue Events—Dartmouth-Hitchcock Medical Center's Award-Winning Project

The Winner

Children's Hospital of Omaha, Nebraska: Reducing Unnecessary X-ray Exams and Improving the Efficiency of X-ray Orders for Pediatric Patients—An Award-Winning Initiative from the Children's Hospital of Omaha

The Finalists

Listed alphabetically:

• Beaumont Commercialization Center (Royal Oak, MI): Reducing Tubing Misconnections—Beaumont Commercialization Center's Comprehensive Approach
• Hamilton Health Sciences (Hamilton, Ontario, Canada): A More Efficient Way to Address an Infusion Pump Recall—Hamilton Health Sciences' Time-Saving Solution
• Memorial Sloan-Kettering Cancer Center (New York, NY): A Networked Approach to Managing Critical Alarms—Centralizing Alarm Management at Memorial Sloan-Kettering Cancer Center
• The Methodist Hospital System (Houston, TX): Sequestering Devices Involved in Adverse Incidents—How the Methodist Hospital System Kept Suspect Devices Away from Patients
• Virtua Health (Marlton, NJ): Increasing the Use of Smart Pump Drug Libraries—Virtua Health's Approach for Identifying and Removing Barriers to Compliance

The Winner

Texas Children's Hospital (Houston, TX): Teamwork in Technology Integration and Asset Management—Texas Children's Hospital's Award-Winning Initiative

The Winner

Beaumont Hospital (Royal Oak, MI): Incorporating Human Factors Testing into the Technology Management Process—Beaumont Hospital's Program for Improving Telemetry-Alarm Response Times

The Finalists

Listed alphabetically:

• Christiana Care Health System (Wilmington, DE): "Cohorting" Ventilator-Dependent Patients Outside the ICU—Christiana Care Health System Reexamines Ventilator Alarm Management to Improve Patient Safety
• Norton Healthcare (Louisville, KY): Bringing a Disciplined Approach to Adopting New Technologies—Norton Healthcare's Technology Assessment Committee
• The Ohio State University Medical Center (Columbus, OH):
• Instituting Performance-Based Service Contracting—Ohio State University Medical Center's Approach for Improving IPM Completion Rates
• Local Anesthetic Pumps as an Alternative to Traditional Pain Management Methods—Ohio State University Medical Center's Successful Implementation of a New Patient Care Technology
• Texas Children's Hospital (Houston, TX): Improving Customer Satisfaction—How Texas Children's Hospital Increased Caregiver Confidence in Technologies and the Program Servicing Them