文稿教案中央監(jiān)護(hù)apac2010international psn session

1、General Floor Monitoring Sales TrainingJanuary 2010Helping clinicians improve outcomes on teral care floorthrough early detection and response to avoidable adverse events協(xié)助普通醫(yī)生更早發(fā)現(xiàn)并對(duì)病情作出反應(yīng)© 2010 Masimo CorporationReal World Event 真實(shí)的案例悲劇發(fā)生后，新加坡國(guó)立大學(xué)醫(yī)院將所有移植術(shù)后轉(zhuǎn)往進(jìn)行血。壓、心率以及血氧飽和度小時(shí)的觀察，而不是直接送往普通©

2、 2010 Masimo CorporationMasimo PatientSafetyNet>監(jiān)護(hù)系統(tǒng)讓普通的病人更加安全。When you leave the room,well still be thereThe Masimo Patient SafetNet System> Connect patients with caregiversquickly, easily and accurately更快、更早以及更準(zhǔn)確更可靠的床旁監(jiān)護(hù)可操作性更強(qiáng)的系統(tǒng)僅在需要時(shí)啟動(dòng)的快速反應(yīng)更及時(shí)更合適的診療介入© 2010 Masimo CorporationUnique Val

3、ue Proposition獨(dú)特的優(yōu)勢(shì)“可幫助普通顯著降低或消除與呼吸相關(guān)的病情，并提升醫(yī)院效益。Masimo安全網(wǎng)是唯一能令人矚目地改狀況，減少I(mǎi)CU轉(zhuǎn)運(yùn)（返運(yùn)），強(qiáng)化快速反應(yīng)并減少成本善，提高ICU效率的強(qiáng)大解決方案?！?#169; 2010 Masimo CorporationCurrent situation in most hospitals大部分醫(yī)院的現(xiàn) 狀Post surgical patients receiving pain medications are at risk術(shù)后尚處于止痛階段的處在風(fēng)險(xiǎn)中¡ 數(shù)據(jù)顯示， 搶救失敗與呼吸衰竭導(dǎo)致的占了CMS報(bào)告的，并帶來(lái)億

4、的損失。¡ ICU轉(zhuǎn)運(yùn)（返運(yùn)）消耗了ICU的大量以及。© 2010 Masimo CorporationCurrent situation in most hospitalsFor the first time, a comprehensive turnkey system is available that meets ALL of the recommended practices WITH objective peer reviewed evidence and positivefinancial return首次出現(xiàn)經(jīng)同比證實(shí)的并帶來(lái)立即使用的，能滿足所有實(shí)際需求的

5、系統(tǒng)。效益，可Guidelines for the Perioperative手術(shù)Initiative: Safety During Patient- Controlled Analgesia安全的疼痛管理中管理指引Management of Patients with OSA期內(nèi)Establish Rapid Response Teams建立快速反應(yīng)小組© 2010 Masimo CorporationImprove Recognition and Response to Change in Patients ConditionCurrent situation in most h

6、ospitals Rapid Response Systems require early detection to be effective快速反應(yīng)系統(tǒng)要求高效的監(jiān)測(cè) Existing continuous monitoring systems have failed現(xiàn)有的連續(xù)監(jiān)測(cè)系統(tǒng)無(wú)法達(dá)到要求 Improving patient safety has become a major hospitalinitiative提升的安全成為醫(yī)院日趨重要的課題© 2010 Masimo CorporationWhy have existing general floor systems f

7、ailed?現(xiàn)有 普通的監(jiān)護(hù)系統(tǒng)失敗在哪里？1.Too many alarms due to patient movement or low perfusion因體動(dòng)和低灌注產(chǎn)生太多警報(bào)Too costly造價(jià)昂貴Too complex過(guò)于復(fù)雜2.3.4.Low patient and nurse compliance太低All of the above和護(hù)士的依從度5.© 2010 Masimo CorporationIndependent Collateral Material研究Anesthesiology麻醉學(xué) February 2010¡ Editorial by

8、 Dr. Abenstein, Mayo Clinic¡ Feature Article Dartmouth Study¡ Full page Masimo PSN Add (back cover)¡ Press Release, American Society of Anesthesia (pending)¡ Press Release, Dartmouth (pending)>>ECRI Institute急救研究學(xué)March 2010: Health Devices¡ Dartmouth “Best Technology A

9、ward”¡ Press Release, ECRI Institute (pending)ECRI Institute is already referencing the Dartmouth study to clients>© 2010 Masimo CorporationMasimo is the only solutionMasimo Radical and Rad87 are the best in class choice>Masimo Rainbow SET measure-through-motion substantially reduces

10、 false alarms彩虹SET體動(dòng)中測(cè)量數(shù)據(jù)的技術(shù)顯著減少錯(cuò)誤警報(bào)New Rainbow parameters provide continuous measurements of oxygenation (SpO2), Ventilation (RRa), Circulation (PR) and internal bleeding (SpHb)全新的彩虹參數(shù)提供對(duì)血氧飽和度、呼吸頻率，循環(huán)以及內(nèi)的連續(xù)監(jiān)測(cè)>安全網(wǎng)（PSN）是唯一被證明有效的普通決方案¡ Robust but low cost性價(jià)比高¡ Easy to use易于使用¡ Advanc

11、ed alarm management先進(jìn)的警報(bào)管理Proven through per review監(jiān)護(hù)解>© 2010 Masimo CorporationSo.所以How do we turn this phenomenal opportuinto an exciting?business andal growth opportu我們?nèi)绾螌⑷绱说臋C(jī)會(huì)轉(zhuǎn)化成您生意成長(zhǎng)的機(jī)遇呢？© 2010 Masimo CorporationGFM Sales Process “Map”Identifying a clear Creating a dialogue產(chǎn)生話題 Bui

12、lding trust and rapport建立信任 Creating a sense ofopportu發(fā)現(xiàn)機(jī)會(huì)urgency營(yíng)造感Aligning stakeholders Driving closure 成交鎖定人Building a proposal建立目標(biāo)© 2010 Masimo CorporationProspect機(jī)會(huì)Target目標(biāo)Active行動(dòng)Upside優(yōu)勢(shì)Forecast前瞻Walking the halls; problem discovery; important customer success metricsClinical thought lea

13、ders identification- Why Do Something takes shapeProject defined - vision/impact reinforcedTechnology confirmed (eval) - Masimo is VOCFinal well-defined admin steps mapped outVision SweetspotRelevance keeps the project a priorityGeneral Account Selection RequirementsFunding資金Strong Masimo relationsh

14、ipStrong regional influencer區(qū)域影響力>>>© 2010 Masimo CorporationClinical Selection Criteria臨床選擇準(zhǔn)則Customer recognizes a problem or has a monitoring>initiative客戶認(rèn)識(shí)到VC3關(guān)鍵的支持者Cross functional support通過(guò)功能的支持More than 5 monitored beds超過(guò)張床位Willingness to serve as a reference installation有臨床參考

15、性質(zhì)的安裝意愿或>>>>© 2010 Masimo CorporationTechnical Selection Criteria技術(shù)選擇準(zhǔn)則Strong in-house technical resource強(qiáng)的院內(nèi)技術(shù)>>Existing network (hardwired or wireless)現(xiàn)有或有線）（無(wú)線>>>>connection for remote support對(duì)的支持IT data center to house server數(shù)據(jù)中心接入院內(nèi)服務(wù)器Space for a Clinician Ass

16、ignment StationPaging transmitter infrastructure support (if necessary)傳呼支持© 2010 Masimo CorporationMasimo Regional Requirements區(qū)域需求Masimo bedside instruments床旁Local Masimo representative¡ In-service training for customer對(duì)客戶的培訓(xùn)¡ Assistance with PSN installation對(duì)安裝的協(xié)助¡ Provide pos

17、t-installation support安裝后支持>>© 2010 Masimo CorporationIdeal Customer Profiling Hierarchy理想的客戶描 述層層深入>>Existing customers (at any time in an agreement!)現(xiàn)有客戶Nellcor customers with expiring contracts within 2 years兩年后合同將到期的Nellcor客戶Customer inquiryCurrent Customers現(xiàn)有客戶¡ Mature Rap

18、id Response System¡ OxiNet replacementSensor Amendment Customers需更換探頭的客戶¡ Accelerate renewals¡ Expressed needestablished Project TeamNew Conversion新系統(tǒng)轉(zhuǎn)換¡ Existing OxiNet or Bernoulli System>>>>© 2010 Masimo CorporationThe foundational activity:Prospecting and Tar

19、getingProspectingResearch / InvestigationCustomer profileKey initiatives Urgency迫切性Principle players重要參與人Clinical need and priority臨床需求及優(yōu)先 Internal processes內(nèi)部程序© 2010 Masimo CorporationPreparation Checklist (pre-call planning)>>>Research your hospital醫(yī)院Review the ideal profile of a VC

20、3/Executive Sponsor背景Have teric “Top 10” problems our GFM solution can solveat your disposal普通管理中的大要能給出>Have the key differentiating features/benefits our GFM solutionhas compared to other competing solutions我們勢(shì)Master the Dartmouth Anesthesiology publication熟讀Master the GFM brochure-based present

21、ation熟練的表達(dá)Select from the list of GFM SPIN questions those most appropriate to ask熟習(xí)SPIN中常被問(wèn)到的Carefully craft and master your bold connecting statement大膽陳述的突出優(yōu)>>>>© 2010 Masimo CorporationResearch (pre-call) planning計(jì)劃>Hospital Wge (alt tab to internet)¡ Mission statement

22、61; Awards¡ Quality / Patient Safety Metrics¡ Center of Clinical Excellence claimsEstablished Rapid Response TeamChief Patient Safety Officer/Nursing Director/HOD Anaesthesia Healthgrades report健康等級(jí)報(bào)告¡ Respiratory Failure呼吸衰竭¡ Orthopedics, Joint Replacements整形術(shù)，關(guān)節(jié)置換US News and Wo

23、rld Reports on Best Hospitals Others?>>>>>© 2010 Masimo CorporationIdeal VC3 / Executive Sponsor Profile理想的代言人>>>>>>An Executive Sponsor has high strategic influence; 具備戰(zhàn)略影響Solid track record as a decision-maker; 歷史上可鑒的決策者Access and influence with the c-suite對(duì)高管

24、有普遍影響力Solid command over the hospitals buying practices 在采購(gòu)上有決策權(quán)Accessible 可以接近的al wins must be known as it relates to this specific initiative. 協(xié)助其取得個(gè)人成就Conviction in our proposed solution and will be able to remove obstacles 堅(jiān)信我們并準(zhǔn)備排除萬(wàn)難>>Thiswould agree to creating a project plan orwith the

25、specificroles, responsibilities, action plans and timelines required to bring closure to the initiative.愿意制訂相應(yīng)目標(biāo)計(jì)劃取得最終成果© 2010 Masimo CorporationKey Decision MakersStakeholderProfessional WinsChief Patient Safety Officer顯著提升安全Dramatic patient safety metrics improvements.Chief Nursing Officer減輕L

26、ess stress on ICU resources提高護(hù)士醫(yī)德Improved Nursing moralChief Financial Officer有說(shuō)服力的投資Compelling ROI with proven resultsSupply Chain Manager減少探頭使用降低了成本Reduced sensor cost with demonstrated clinical benefitRespiratory Care Director達(dá)到OSA指引要求Addresses OSA guidelines減少無(wú)效益征召Less non revenue calls to Gener

27、al FloorChief of Anesthesia達(dá)到指引要求Addresses ASA / APSF guidelinesRapid Response Team更高效的快速反應(yīng)系統(tǒng)More effective Rapid Response SystemIT DirectorLeverages IT infrastructure investment or justifies upgrade Improved relationship with clinical customers投入產(chǎn)出有效益Biomedical Director提升安全I(xiàn)mproves patient safety,

28、enhanced nursing relationshipTop 10 Problems PSN Solves1.2.3.Meet practice guidelines (APSF, ASA, IHI, JCAHO)達(dá)到準(zhǔn)則要求Eliminate cardiopulmonary sentinel events消除心肺梗阻？ Substantially reduce avoidable adverse events極大消除本可避免的病情Reduce ICU transfers減少I(mǎi)CU轉(zhuǎn)運(yùn)Reduce Rapid Response Team activations提高快速反應(yīng)小組效率4.5.6

29、.7.8.9.Improve ICU utilization (ie free up ICU beds) Improve patient flow through the hospitalImprove hospital financial margins提升效益利用率院內(nèi)情況Improve patient satisfaction滿意度10. Improve hospitals competitive status by becoming a patient safety luminary 讓醫(yī)院因安全而成名© 2010 Masimo CorporationAnesthesiolo

30、gy 麻醉學(xué) February 2010© 2010 Masimo CorporationEditorial by Dr. J.P Abenstein, Mayo“An Ounce of Prevention May Equate to a Pound of Cure”一盎司的預(yù)防相當(dāng)于一盎司的治療 “Can Early Detection and Intervention Prevent Adverse Events?”“The safest way to monitor postoperative patients would be one-on-one care, but th

31、e cost would be prohibitive.”對(duì)術(shù)后最好的監(jiān)護(hù)是一對(duì)一的，但貴“Vital signs every 2h, 4h, or each shift is an ineffective way to prevent adverse outcome, as repeated sentinel events demonstrate.”哨兵事件的一再重演證明，每到小時(shí)重要生命指征的變化對(duì)無(wú)效的。的預(yù)防是“The literature and each of our own experiences have examples of physicians on rounds, or

32、 nurses checking in on patients who have been dead for hours.”文獻(xiàn)和經(jīng)驗(yàn)給我們列舉了無(wú)數(shù)醫(yī)生在繞圈子，護(hù)士到時(shí)以幾個(gè)小時(shí)的案例“Unfortunately, (existing systems) for every post operative patientis economically impractical”很不幸，現(xiàn)有系統(tǒng)對(duì)術(shù)后不切實(shí)際了來(lái)說(shuō)Anesthesiology, V112, No 2, February 2010John P. Abenstein MD, Bradly J Narr MD; Mayo Clinic&

33、#169; 2010 Masimo Corporation“An Ounce of Prevention May Equate to a Pound of Cure” “Can Early Detection and Intervention Prevent Adverse Events”“Taenzershow that a system that analyses pulse oximetry andtriggers communications is associated with significant reduction of rescue events and ICU admiss

34、ions可分析脈搏血氧的系統(tǒng)有助于極大減少搶救“ We believe Taenzer has shown us a glimpse of the future.Not onlywill such systems allow us to improve the quality of care, but will also be a key to lowering costs.PSN既能監(jiān)護(hù)質(zhì)量，又能降低成本Anesthesiology, V112, No 2, February 2010John P. Abenstein MD, Bradly J Narr MD; Mayo Clinic

35、69; 2010 Masimo CorporationImpact of Pulse Oximetry Surveillance on Rescue Events and Intensive Care Unit TransfersTen month PSN evaluation by Dartmouth- Hitchcock Medical Center, covering 36 bed unit, 2,841 patients and 9,978 monitored days and over 1 billion data points© 2010 Masimo Corporati

36、onSystem Uptime Reliability系統(tǒng)正常運(yùn)行可靠率99.9995%Patient Compliance依從度98.2%Average Alarms per patient per day每天每病人4Impact of Pulse Oximetry Surveillance on Rescue Events and Intensive Care Unit Transfers"We believe that Taenzerhave shown us a glimpse ofthe future. Not only will such systems allow us

37、 to improve the quality of care of our patients, but will also be a key to lowering costs.“ Dr. Abenstein, Mayo ClinicClinical Outcomes* Insufficient data points to establish statistical significance135 ICU days saved annually© 2010 Masimo CorporationBefore PSNAfter PSN%ChangeMortality4250%*Res

38、cue Events per 1000 patient discharges3.41.265%ICU Transfers per 1000 patient discharges5.62.948%Financial Implications意義>Improved operational cost操作成本¡ More effective use of internal resources (Reduction in Rapid Response) 對(duì)內(nèi)部資源的更有效利用¡ Patient transfers to ICU consumes valuable resourc

39、es and extends length of stay病人送返ICU將消耗寶貴延長(zhǎng)滯留時(shí)間¡ Avoidable adverse event are not fully reimbursed>Improved ICU utilizationICU利用率¡ Improvement in hospital access reduces “diverts”減少轉(zhuǎn)移（¡ Frees beds for additional admissions and associated revenue人，）空病床給新病>Improved General Floor ef

40、ficiency普通效率¡ Less ICU transfers reduces patient LOSSavings can self fund Patient SafetyNet through sensor agreement 通過(guò)探頭協(xié)議節(jié)省的資金可抵消投入的成本>© 2010 Masimo CorporationNew Collateral ROI Tool新投入產(chǎn)出分析工具© 2010 Masimo CorporationFinancialBenefits Based on Improved Patient Flow帶來(lái)的效益 Reduces I

41、CU transfers Increases ICU new admits Lowers LOS© 2010 Masimo Corporation Improves patient access Reduces ED divertsROI Elements投入產(chǎn)出分析因素Avoidable Costs¡ Reduced Rapid Response Calls¡ Fewer ICU transfersRevenue improvement¡ Improved ICU utilization¡ Fewer transfers = more ava

42、ilable ICU beds+ Operational costs sensors, cables service Capital equipment depreciation+Benefit =minus© 2010 Masimo CorporationSPIN Questions:>Situation現(xiàn)狀發(fā)現(xiàn)What is their current circumstances regarding patient safety on the general care floor?Problem>引出¡ How effective have current

43、initiative to improve patient safety. Is there recognition that PSI metrics could be improved?Impact影響旁敲側(cè)擊>What is the consequence of current situation. ICU occupancy?Commustanding?>Need-Payoff需求最終回報(bào)¡ How can Masimo help the customer improve both outcomes and financial payoff?© 2010

44、Masimo CorporationSample SPIN Questions for Patient SafetyNetDo you have an established Rapid Response Team? (S)¡ Yes, it has been in effect for over three years.Great What floors or patient types are their most concerns? (P)¡ Post op general care areas, especially patients with Obstructiv

45、e Sleep Apnea, or are on PCA pumps. Rapid Response is often called too late to make any differenceBuilding your caseWhat are the consequences of late identification of these patients? (I)¡ They end up transferred to the ICU, but often the outcomes are poor.What if I could provide you with an af

46、fordable and reliable continuous monitoring system that provides early detection and notification directly to the nurse assigned to these patients? (N)¡ Wow, this addresses a host of challenges we are facing right now. Tell me more!>>>>© 2010 Masimo CorporationThe foundational

47、activity:Prospecting and TargetingProspecting探查T(mén)argeting計(jì)劃Why do somethingResearch / InvestigationGenerate project interest Gap analysis: CurrentCustomer profile Key initiatives Urgency Principle playersClinical need and priority Internal processesState vs Desired StateDevelop Proposal Develop Stake

48、holders Financial options: Capitalvs Sensor Agreement?© 2010 Masimo CorporationFEATURESPSNWAOXINETCPCNK IIIBEDSIDEMasimo SETNoNoRainbow Co-oximetryNoNoNoNoRainbow RAMNoNoNoNoContinuous Monitoring w/ Ambulation離床監(jiān)護(hù)NoNoEtCO2ECG心電 / NIBP無(wú)創(chuàng)血壓No3-D AlarmsNoNoNoNoIntegrated WiFi connectivityNoNoNoCon

49、figurable Alarm Bedside /Central©S20t0aMatimiooConporationNoNoNo© 2010 Masimo CorporationFEATURESPSNWAOXINET IIICPCNKNETWORKIntegrates on Hospital ITInfrastructurelimitedNot RecommendedNoWireless 802.11a/b/glimited802.11b/gonlyWMTSSERVERInstruments/Server80282424/ 50040Independent Displays

50、411No LimitNetKonnectEMR interface (HL-7)YesSeparateserver require d© 2010 Masimo CorporationFEATURESPSNWAOXINET IIICPCNKCLINICIAN ASSIGNMENT STATIONNumber of Patients / Screen40 Configurable2824Dynamic24Dynamic40TouchScreen AvailableNoReal-timeWaveformsNoNoNoFull DisclosureNoNoNo?NOTIFICATIONP

51、aging SupportNoPager Escalation Protocol傳呼機(jī)擴(kuò)容協(xié)議NoLimitedLimited?Recommendations for Post-OperativePatient Monitoring對(duì)術(shù)后監(jiān)護(hù)的推薦>The combination of patient-controlled analgesia and lower staff-to-patient ratios on teral floor make it less likely that aclinician will be there to observe an avoidable a

52、dverse event.全麻及較少的醫(yī)護(hù)使本可避免的>The Anesthesia Patient Safety Foundation更難解決Recommends 麻醉安全基金推薦> “continuous monitoring of oxygenation (pulse oximetry) and ventilation in non-ventilated patients receiving PCA, neuraxial opioids, or serial doses of parenteral opiods”> “It is critical that any mo

53、nitoring system be linked to a reliable process to summon a competent health care professional to the patients bedside in a timely manner.”Weinger MB. Dangers of Postoperative Opioids: APSF Workshop and White paper address prevention of postoperative respiratory complications. APSF Newsletter, 2006;

54、21:617.© 2010 Masimo CorporationMasimo Respiration Rate PSN Options呼吸頻率選 配Casmed CAS 750Masimo SETOridion EtCO2呼氣末Optional NIBP無(wú)創(chuàng)血壓, Temp體溫, ECG心電Oridion Capnostream20Masimo SETOridion EtCO2Rainbow Acoustic Monitoring§ Analyzes respiratory sound patterns§ Less complex§ Greater patient comfort© 2010 Masimo CorporationPSN Brochure© 2010 Masimo CorporationMastering the PSN 5 minute Brochure presentation> Refer to the PSN brochure© 2010 Masimo CorporationTransitioning to Active Stage過(guò)渡到