Risk Trigger Monitor Subscription:
EHR-based Patient Safety & Quality Improvement
The Risk Trigger® Monitor Subscription is Pascal’s flagship application service supporting evidence-based and regulatorily-aligned EHR-based patient safety and quality improvement. Specifically, Risk Trigger enables health system clients to monitor, measure, and manage all-cause harm all the time for all patients.
In concert with Pascal PRIME, Risk Trigger® applies evidence-based and enhanced real-time analytics on real-time EHR and health IT data as it streams into Pascal’s outcomes-driven PSO services environment, which is all hosted by Pascal’s cloud-based VPS solution — supporting patient safety and quality improvement across our Community Collaborative of leading hospitals and health systems, as well as specific use cases such as health system-specific command centers.
Pascal’s VPS solution supporting EHR-based patient safety and quality improvement is the result of over a decade of relying on scientifically validated evidence, proven clinical results, and technology shown to scale in very large health system deployment. Now that the field is interested in EHR-based patient safety and quality improvement, there is no need to reinvent the wheel; leading hospitals and health systems are already using this evidence-based and regulatorily-aligned approach to monitor, measure, and manage safety vulnerabilities and quality improvement
The Risk Trigger® application and PRIME infrastructure software services are purpose-built to support EHR-based patient safety and quality improvement. They have been configured by Pascal’s expert clinical team to operate successfully in the most widely tested and clinically effective patient safety event management workflow existing in the field today that supports health system client clinical operations environments.
Many leading health systems amongst Pascal’s client community have adopted the field’s first cloud-based patient safety system using real-time EHR data as a “lens” to see otherwise unidentified safety vulnerabilities and quality variation. Risk Trigger is a comprehensive application suite enabling health systems to monitor, measure, and manage patient safety and quality improvement within the overall 24/7 Pascal VPS solution.
Clinical teams using the continuous surveillance offered by Risk Trigger® as part of this comprehensive virtual patient safety (VPS) solution are enabled to answer questions such as the following:
- Where is patient harm happening and how frequently?
- What is the severity and pattern of the harm?
- Why is this harm happening, and how can it be avoided?
Whether by a standalone hospital or a health system with dozens of facilities, Risk Trigger® is relied upon to deliver analytics in order to support programs moving to EHR-based patient safety and quality, as well as EHR-based risk management, peer review, and much else. Illustrative analytics include:
- Patient Safety Dashboard — visual display of summary metrics being tracked by a healthcare organization
- Adverse Event Analytics — visual display of more detailed reporting and analytics along dimensions such as severity, location, cost, and timeframe
- Enterprise Analytics — visual display of enterprise-level and grade reporting and analytics across units and facilities, ad hoc reporting, and more
Identify & Reduce Harm
Pascal clients identify 10x-30x more times the level of harm that is identified by voluntary event / incident reporting systems. Besides having more visibility into patient-specific harm, as well as the patterns of harm, clients have demonstrated the reduction of 60%-80% of the greater harm identified.
Manage Safety & Reliability
Many clients have shared that, upon starting work with Pascal, their safety leaders saw EHR-based patient safety and quality as the precipitating factor. However, upon seeing the power of this EHR data-based “lens,” multiple clients have reported that Risk Trigger® provides more insight into their care delivery across enterprise domains than any other system they have.
Reduce Harm-related Cost
Data from Pascal’s Community Collaborative shows that approximately US$2 million of harm-related financial opportunity per year per 10,000 admissions, even when considering only excessive length of stay (XLOS), on the top 14 harm types, and only the inpatient setting. Clients are demonstrating the ability to realize over 30% of this US$2 million per year per 10,000 admissions financial opportunity.
Preserve “Culture of Safety“
Unfortunately, even high performing health systems committed to patient safety find their environments risky, and identifying harm for the purpose of “getting to zero” in a spirit of improvement requires a non-punitive “culture of safety.” Pascal was the first federally certified Patient Safety Organization (PSO) using real-time data to be fully audited and offers federal PSO protections to its clients — thereby, preserving a “culture of safety” to support the delivery of safe and reliable care. Assessing and improving a culture of safety and organizational culture generally enhances results from EHR-based patient safety and quality.
Highlights of using Risk Trigger® within the VPS solution includes:
EHR-based Safety Outcome Streaming
Based on a foundation of an evidence-based and regulatorily-aligned clinical method, Pascal’s client health systems stream real-time data (e.g. HL7) from EHRs/EMRs and other health IT into Pascal’s real-time analytics cloud-based infrastructure called our Patient Real-time Interoperable Metrics Engine (PRIME), an infrastructural linchpin for high-performing EHR-based patient safety and quality.
Real-time Triggers & Analytics Firing
As patient data streams into the outcome-driven PSO environment hosted by Pascal PRIME, our multi-tenant Pascal Analytics Library fires triggers and analytics against that real-time streaming data to identify patients who may have been harmed, who may currently be suffering from harm, or may be at risk of harm.
Epidemiologically Sound Clinical Review
Key to scientifically validated EHR-based patient safety and quality, and due to Pascal’s unwavering commitment to evidence-based medicine and sound epidemiology, robust “gold standard” clinical review is used to generate EHR-based clinically validated adverse event outcomes (AE Outcomes), with Pascal holding the largest such outcomes data set worldwide.
Intervention, Concurrent / Real-time
Supporting real-time or concurrent intervention while a patient is receiving care is a core function of Risk Trigger® but not the only function. Using both clinically confirmed adverse events as well as other safety information in the patient safety event management system, action is taken based on the data by unit-level, intervention coordinator, and rapid-response teams. Ultimately an effective approach to EHR-based patient safety and quality is validated by actionable AE Outcomes used to drive measurable, material, and maturing results.
Supporting high frequency improvement — measured in hours or days (high frequency) versus weeks or months (rapid cycle) — is also a core function of Risk Trigger® as part of the VPS solution. Because this timely EHR-based method to identify patterns of harm more quickly than alternative and conventional methods, this valuable information can be fed into high frequency quality improvement to improve outcomes more efficiently and more effectively — not only patient safety and quality but in organizational functions enterprise-wide.