Introduction
Unlike many EHRs that are designed primarily to maximize billing, Bluebird was specifically designed to make patient care safer and clinical documentation easier. Clinicians (including nurses at handover) are quickly orientated by Bluebird’s intuitive User Interface. Doctor’s orders are converted into nursing work lists (WL) and the timely completion of each WL item by the nurse responsible is monitored and managed to conclusion. Where useful, embedded checklists (guardrails) help ensure that the baseline of clinical care is consistently raised. This is particularly important if the nurse has less experience on a specific unit (think agency nurses). Checklists are embedded into medication administration, surgical management, ICU and general nursing care as well as specialty modules such as ER, Labour & Delivery and Care of the Newborn. Both Admission and Discharge are standardized processes. Real time vitals drive the Bluebird early warning system (EWS), while various standardized risk profiles (fall, pain, pressure sore…) evaluate and drive enhanced individualized care. Clinical decision support (CDS) for both doctors and nurses is available as required.
While the Bluebird Hospital EHR is at it's most powerful as an integrated platform, modules may be purchased individually. As an example, the infection control and antibiotic stewardship modules were purchased by Netcare and very successfully run as stand alone modules for a decade.
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This is the innovative interface that makes Bluebird intuitive and easy to use. The WWB organizes clinical information. Patients (in a specific ward/unit) are listed in the order that clinician’s do their rounds. Critical information is shown on the primary screen and detailed information available “with 1 click”. -
An API is available which allows EMS notes to be shown on the first tab of the ER interface. New arrivals are efficiently triaged using the South African Triage Scale. Colour coded priority and ‘target times to treat’ are assigned and shown on the WWB. The length of time that that patient has spent in the ER is clearly shown and colour coding (plus optional alerts) indicate when individual target times are exceeded. Both ER and Diagnosis specific clinical notes (and orders) are available. Disposition is also colour coded and clearly shown on the WWB. -
For practices NOT using the Bluebird Doctor’s Office EHR, an API is available which allows third party practice management systems to electronically send admission notes into the Bluebird Hospital EHR. For practices using the Bluebird Doctor’s Office EHR detailed pre-admission information is seamlessly transferred into the hospital EHR. Both these mechanisms greatly assist admin clerks as well as admitting nurses in Bluebird hospitals. -
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Automated input of device data is available in Bluebird and manual capture is facilitated. Instead of vitals being dead and buried in paper records, e-vitals drive the Bluebird Early Warning System (EWS) which is based on the Royal College EWS and which has been shown to save lives! -
Every clinical interaction is documented in sequence. Bluebird provides multiple unique interfaces that allow clinicians to effortlessly document detailed clinical information. Core clinical information is clearly shown on the WWB and detailed information is available “with 1 click”. All documentation can be filtered to allow very rapid access to detailed information collected by the care team. Notes are medico-legal records which cannot be altered later. -
Doctor’s Orders (computerized physical order entry - CPOE) as well as Hospital Standing Orders are powerful yet easy to use and perhaps more importantly, they drive the individual nurses work lists (WL) which help ensure that every order is completed in a reasonable time frame and nothing falls between the cracks. Bluebird provides intuitive ordering interfaces for nursing orders, labs, blood bank and radiology requisitions, as well as new drug orders. Order Sets (for specific conditions) aid order entry as do Hospital Standing Orders. -
Each order is translated into one or more items that appear on a nurses WL. For example if vitals were ordered q4 hly, the relevant nurse will be prompted every 4 hours to take that patients P, BP, T and RR. If not performed within that time an alert will be raised and these alerts can be escalated up the management tree. Complex orders (such as the management of an epidural catheter) have guidance built into the interface that help nurses understand when an observation is outside the norm and what to do in each specific case to optimize patient safety. -
Safe and clearly documented administration of medication is essential in any modern medical facility and when done meticulously protects patients from harm and hospitals from litigation. The Bluebird MAR helps ensure safe medication administration and automatically creates a detailed medico-legal record of each drug administered. Bluebird helps manage the inventory of drugs on each ward for each patient and notifies the hospital pharmacy when stock falls below critical levels. Specialized submodules of the Bluebird MAR facilitate safe blood transfusion and safe chemotherapy administration. -
Bluebird optimizes antimicrobial prescribing while minimizing the potential for drug-resistance and adverse events.ePrescribing combined with Bluebird’s sophisticated unit specific antibiograms help doctors prescribe appropriately at the point of care. Timed, prospective antibiotic audits (generally performed by pharmacists) provide tight feedback to prescribers. Feedback helps improve antimicrobial prescribing in the longer term. Bluebird also enables selective reporting of susceptibility testing (consistent with a hospital's antimicrobial treatment guidelines) even if the labs servicing that hospital lack that capability.
For more information please see these links:
Intelms.com/177 Imperial College Bluebird webinar
Intelms.com/114 Nelson Mandela Children's Hospital Press Release -
Documentation of ward procedures such as central lines, urinary catheters, chest drains, epidurals etc is made easy. Regular audits of those procedures such as CAUTI audit bundles and epidural monitoring is tightly integrated and CDS assists nursing staff escalate care when needed. Billing of materials used in each procedure is facilitated. -
From pre-admission procedures for elective surgery through a detailed in hospital SURPASS process Bluebird raises the bar for surgical care within any OR suite. Comprehensive yet intuitive interfaces for surgical and anaesthetic notes elevate the Bluebird OR module. Automated input of device data is yet another powerful Bluebird feature. As with any procedure, checkboxes allow easy documentation of materials used and those quantities and codes can be sent via an API to the hospitals billing system. -
Prevention of healthcare associated infections (HAI) and the transmission of multi-resistant organisms (MDROs)are generally considered sentinel patient safety and clinical quality indicators. Bluebird is a 21st Century Solution that will enable your hospital to effectively reduce both the reputational risk and the actual cost of infections in your hospital. From rapid diagnosis and active case management to comprehensive, systematic, standardized surveillance and real time audit bundles, Bluebird gives your hospital sophisticated tools to combat HAI’s. Bluebird was specifically designed to improve individual patient safety. Cases that require active management by the ICP (Infection Control Professional) are objectively identified and become a required task in their work list. How that work is completed is standardized to allow for objective measurement. Comprehensive reports are available to management to help ensure that available resources are being optimized in each hospital.
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Bluebird’s wound care module objectively documents healing both with images as well as graphically and converts wound specific doctor’s orders into nursing care WLs. -
Bluebird integrates antenatal care (including risk profiling and scoring to triage high risk mothers) with Labour & Delivery (L&D) and care of the newborn. Hospital L&D prompts timely, appropriate care as well as care escalation when monitoring reveals added risk. CDS assists nursing staff escalate care when needed. -
The Bluebird Oncology module helps co-ordinate both clinical care as well as the planning and safe administration of chemotherapy (either in hospital or in ambulatory care chemotherapy units). Bluebird enhances operational efficiency and helps improve oncology outcomes. -
During an admission Bluebird automatically populates the Discharge Summary in real time as care is given. At discharge the nurse is prompted to review and complete the comprehensive discharge summary which can be printed for the patient or sent electronically to the family doctor (and those doctors involved in the care of this patient during this admission). Core information includes the reason for admission, procedures performed, discharge diagnosis and TTO medication as well as disposition and follow up appointments. -
Bluebird’s data-driven Clinical Command Centre (CCC) with Executive Oversight provides real-time clinical and operational insights that trigger real time feed back to support hospital staff by providing pro-active recommendations to help guide each individual patient’s care. Bluebird’s CCC provides real-time, actionable alerts and predictive analytics with seamless drill down to the local ward/unit.The CCC provides the analysis that is the basis for process re-engineering throughout the hospital to help deliver quality, safe, and optimised patient care across all locations.The analytic wall in the CCC provides advanced real-time and predictive insight, which empowers CCC staff to take action. This senior multi-disciplinary team works together to improve patient care, eliminate delays and resolve patient flow bottlenecks (such as admission of ER patients waiting for an inpatient bed).
