Boosting the care experience: The Philips patient-centered monitoring workflow in action

Consider the scene at many hospitals: Moving a patient typically means relying on a cumbersome, designated transport monitor or temporarily forgoing monitoring altogether. All told, the range of patient monitors – some fixed to bedsides, others single-purpose – means frequent equipment switches. Instead of focusing on patient care and safe handoffs, teams must scramble to find available monitors and supplies, remove and reattach cables, and manually reenter patient data.

These hurdles don’t reconcile with the ongoing pressure to manage staff workloads, provide consistent, reliable care, support patient safety and flow, and capture full documentation. Nor do they meet expectations to provide the best possible care experience, as re-cabling often leaves patients feeling exposed – potentially intensifying an already vulnerable time.

In response, the patient-centered monitoring workflow with the Philips X3 helps health systems do right by their patients and their teams, while also supporting operations. It seeks to unify fragmented workflows, close monitoring gaps, and reduce equipment needs and transitions. The full, optimized workflow starts by assigning a Philips IntelliVue X3 at the point of entry – usually the emergency department or procedure and treatment unit – and typically keeping it with the patient until discharge. (At times, clinicians may still choose to switch patients to traditional telemetry monitors for additional mobility.)

Learn more about the full workflow through the lens of a 70-year-old patient, “Evelyn,” who receives care at a health system with a standardized and optimized Philips monitoring solution:

After falling while gardening and hitting her chest, Evelyn gets driven to the ED by her daughter. As with many American hospitals, the ED is crowded, so care has spilled into the hallway. The triage nurse helps Evelyn onto a stretcher there, and another team member quickly connects her to an X3 to start monitoring her heart rate and rhythm, SpO2, and blood pressure. (The hospital can use the X3 anywhere its 802.11 network covers, to meet both daily demands and health emergency surges.) The X3 now stays with Evelyn, as does a standard set of supplies (some reusable) for three measurements: SpO2, NIBP and 10-lead ECG.

Evelyn is assigned the X3 using built-in ADT capabilities, with her waveforms, numerics and alarms then flowing into the Philips PIC iX central informatics platform. Since PIC iX ties together the health system’s patient monitoring, Evelyn’s information quickly becomes available wherever it’s needed, through a shared interface – on the X3, Philips central stations, computer web browsers and the Philips Care Assist mobile app. (The charge nurse can use the additional viewing options to keep an eye on the situation, even though Evelyn is not in a traditional bed or near a nurse’s station.) While only data snapshots go to the EMR, Evelyn’s full record is saved for seven days in PIC iX and then for a year in Clinical Insights Manager, the Philips analytics platform.

Since Evelyn has reported modest chest pain, the nurse wants a more thorough ECG evaluation. With 12-lead ECG capability built into the X3**, the nurse doesn’t need to wait for a specialized cart and technician. (While 12-lead carts and vital signs monitors are still needed in certain situations – ED triage, for example – the X3 workflow means health systems can potentially lower their count of those devices, saving space and maintenance efforts.) The 12-lead ECG shows some minor abnormalities but nothing conclusive.

After a chest X-ray and ultrasound, Evelyn gets diagnosed with a pericardial effusion and flagged for a pericardial window. Given the urgency for surgery, staff get ready to move her out of the ED. However, in less time-sensitive circumstances – and with room availability – they could first take her to a Philips bedside monitor within the ED. All Philips IntelliVue MX monitors require a plugged-in “brain” such as the X3 to function; the X3 can dock into all MX monitors or connect to a Philips XDS display. Docking can provide:

The continuous workflow means nurses don’t have to fuss with swapping cables and other supplies as they quickly prepare Evelyn for transport. And the transport team doesn’t have to find new equipment – the X3’s portability and functionality make single-purpose transport monitors obsolete. Instead, the two teams can focus on effective handover and direct patient care, spending time to comfort Eveyln. As the transport team wheels Evelyn toward pre-op, the X3 continues capturing key parameters and sending an uninterrupted data flow to the PIC iX platform. As an additional benefit of PIC iX integration, monitor techs at the health system’s shared Philips Central Monitoring Unit (CMU) help the transport team watch Evelyn.

Once Evelyn arrives in the operating room, the care team quickly docks her X3 into a Philips stationary monitor, in this case an MX850. The same set of sensors and cables remain, and Evelyn’s trend data, demographic information and measurement settings quickly appear on the new monitor. It’s a sharp contrast to past workflows, when equipment changes left care teams trying to secure handoffs while manually entering information and scrambling to find and change supplies. (Such transitions often exposed patients and added to equipment wear and tear). In those moments, monitoring remained paused, leaving an incomplete patient picture and deteriorations potentially unnoticed.

Evelyn’s operation goes well and she’s ready to go to the PACU. Her X3 is disconnected from the MX850 and stays with her, to continuously capture post-op vitals during transport. In particular, the cross-acuity functionality of her X3 means that end-tidal CO2 monitoring can begin right away. (The health system has chosen optional, built-in C02 monitoring; otherwise, the Philips extension, powered by the X3, can add functionality for advanced parameters such as CO2.)

Despite coming in with some comorbidities, Evelyn is doing well, with monitoring confirming she is stable enough to avoid the ICU. By remaining on the X3, she does not experience the backups that previously kept patients in the PACU awaiting monitors in other recovery areas. Instead, her care team takes her straight to step-down, where the X3 provides the only monitoring needed. Once there, nurses use the Care Assist app to safeguard Evelyn while retaining flexibility to fulfill other duties. From anywhere in the hospital, they can acknowledge or escalate alarms after receiving substantive context. They can also view streaming waveforms and start a blood pressure or SpO2 reading.

Evelyn is now ready to go home to continue her recovery. Once she is discharged, her X3 and reusable supplies are cleaned and ready for the next patient. A collaborative process called “fair exchange” ensures that X3s and related supplies end up where they’re needed, so points of entry don’t run short of equipment. Centralized purchasing and maintenance of X3s promote the idea of shared assets, rather than unit-based ownership.