文稿教案中央监护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协助普通医生更早发现并对病情作出反应© 2010 Masimo CorporationReal World Event 真实的案例悲剧发生后，新加坡国立大学医院将所有移植术后转往进行血。压、心率以及血氧饱和度小时的观察，而不是直接送往普通©

2、 2010 Masimo CorporationMasimo PatientSafetyNet>监护系统让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、更早以及更准确更可靠的床旁监护可操作性更强的系统仅在需要时启动的快速反应更及时更合适的诊疗介入© 2010 Masimo CorporationUnique Val

3、ue Proposition独特的优势“可帮助普通显著降低或消除与呼吸相关的病情，并提升医院效益。Masimo安全网是唯一能令人瞩目地改状况，减少ICU转运（返运），强化快速反应并减少成本善，提高ICU效率的强大解决方案。”© 2010 Masimo CorporationCurrent situation in most hospitals大部分医院的现 状Post surgical patients receiving pain medications are at risk术后尚处于止痛阶段的处在风险中¡ 数据显示， 抢救失败与呼吸衰竭导致的占了CMS报告的，并带来亿

4、的损失。¡ ICU转运（返运）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首次出现经同比证实的并带来立即使用的，能满足所有实际需求的

5、系统。效益，可Guidelines for the Perioperative手术Initiative: Safety During Patient- Controlled Analgesia安全的疼痛管理中管理指引Management of Patients with OSA期内Establish Rapid Response Teams建立快速反应小组© 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快速反应系统要求高效的监测 Existing continuous monitoring systems have failed现有的连续监测系统无法达到要求 Improving patient safety has become a major hospitalinitiative提升的安全成为医院日趋重要的课题© 2010 Masimo CorporationWhy have existing general floor systems f

7、ailed?现有 普通的监护系统失败在哪里？1.Too many alarms due to patient movement or low perfusion因体动和低灌注产生太多警报Too costly造价昂贵Too complex过于复杂2.3.4.Low patient and nurse compliance太低All of the above和护士的依从度5.© 2010 Masimo CorporationIndependent Collateral Material研究Anesthesiology麻醉学 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急救研究学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体动中测量数据的技术显著减少错误警报New Rainbow parameters provide continuous measurements of oxygenation (SpO2), Ventilation (RRa), Circulation (PR) and internal bleeding (SpHb)全新的彩虹参数提供对血氧饱和度、呼吸频率，循环以及内的连续监测>安全网（PSN）是唯一被证明有效的普通决方案¡ Robust but low cost性价比高¡ Easy to use易于使用¡ Advanc

11、ed alarm management先进的警报管理Proven through per review监护解>© 2010 Masimo CorporationSo.所以How do we turn this phenomenal opportuinto an exciting?business andal growth opportu我们如何将如此的机会转化成您生意成长的机遇呢？© 2010 Masimo CorporationGFM Sales Process “Map”Identifying a clear Creating a dialogue产生话题 Bui

12、lding trust and rapport建立信任 Creating a sense ofopportu发现机会urgency营造感Aligning stakeholders Driving closure 成交锁定人Building a proposal建立目标© 2010 Masimo CorporationProspect机会Target目标Active行动Upside优势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资金Strong Masimo relationsh

14、ipStrong regional influencer区域影响力>>>© 2010 Masimo CorporationClinical Selection Criteria临床选择准则Customer recognizes a problem or has a monitoring>initiative客户认识到VC3关键的支持者Cross functional support通过功能的支持More than 5 monitored beds超过张床位Willingness to serve as a reference installation有临床参考

15、性质的安装意愿或>>>>© 2010 Masimo CorporationTechnical Selection Criteria技术选择准则Strong in-house technical resource强的院内技术>>Existing network (hardwired or wireless)现有或有线）（无线>>>>connection for remote support对的支持IT data center to house server数据中心接入院内服务器Space for a Clinician Ass

16、ignment StationPaging transmitter infrastructure support (if necessary)传呼支持© 2010 Masimo CorporationMasimo Regional Requirements区域需求Masimo bedside instruments床旁Local Masimo representative¡ In-service training for customer对客户的培训¡ Assistance with PSN installation对安装的协助¡ Provide pos

17、t-installation support安装后支持>>© 2010 Masimo CorporationIdeal Customer Profiling Hierarchy理想的客户描 述层层深入>>Existing customers (at any time in an agreement!)现有客户Nellcor customers with expiring contracts within 2 years两年后合同将到期的Nellcor客户Customer inquiryCurrent Customers现有客户¡ Mature Rap

18、id Response System¡ OxiNet replacementSensor Amendment Customers需更换探头的客户¡ Accelerate renewals¡ Expressed needestablished Project TeamNew Conversion新系统转换¡ Existing OxiNet or Bernoulli System>>>>© 2010 Masimo CorporationThe foundational activity:Prospecting and Tar

19、getingProspectingResearch / InvestigationCustomer profileKey initiatives Urgency迫切性Principle players重要参与人Clinical need and priority临床需求及优先 Internal processes内部程序© 2010 Masimo CorporationPreparation Checklist (pre-call planning)>>>Research your hospital医院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给出>Have the key differentiating features/benefits our GFM solutionhas compared to other competing solutions我们势Master the Dartmouth Anesthesiology publication熟读Master the GFM brochure-based present

21、ation熟练的表达Select from the list of GFM SPIN questions those most appropriate to ask熟习SPIN中常被问到的Carefully craft and master your bold connecting statement大胆陈述的突出优>>>>© 2010 Masimo CorporationResearch (pre-call) planning计划>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健康等级报告¡ Respiratory Failure呼吸衰竭¡ Orthopedics, Joint Replacements整形术，关节置换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; 具备战略影响Solid track record as a decision-maker; 历史上可鉴的决策者Access and influence with the c-suite对高管

24、有普遍影响力Solid command over the hospitals buying practices 在采购上有决策权Accessible 可以接近的al wins must be known as it relates to this specific initiative. 协助其取得个人成就Conviction in our proposed solution and will be able to remove obstacles 坚信我们并准备排除万难>>Thiswould agree to creating a project plan orwith the

25、specificroles, responsibilities, action plans and timelines required to bring closure to the initiative.愿意制订相应目标计划取得最终成果© 2010 Masimo CorporationKey Decision MakersStakeholderProfessional WinsChief Patient Safety Officer显著提升安全Dramatic patient safety metrics improvements.Chief Nursing Officer减轻L

26、ess stress on ICU resources提高护士医德Improved Nursing moralChief Financial Officer有说服力的投资Compelling ROI with proven resultsSupply Chain Manager减少探头使用降低了成本Reduced sensor cost with demonstrated clinical benefitRespiratory Care Director达到OSA指引要求Addresses OSA guidelines减少无效益征召Less non revenue calls to Gener

27、al FloorChief of Anesthesia达到指引要求Addresses ASA / APSF guidelinesRapid Response Team更高效的快速反应系统More effective Rapid Response SystemIT DirectorLeverages IT infrastructure investment or justifies upgrade Improved relationship with clinical customers投入产出有效益Biomedical Director提升安全Improves patient safety,

28、enhanced nursing relationshipTop 10 Problems PSN Solves1.2.3.Meet practice guidelines (APSF, ASA, IHI, JCAHO)达到准则要求Eliminate cardiopulmonary sentinel events消除心肺梗阻？ Substantially reduce avoidable adverse events极大消除本可避免的病情Reduce ICU transfers减少ICU转运Reduce Rapid Response Team activations提高快速反应小组效率4.5.6

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

30、gy 麻醉学 February 2010© 2010 Masimo CorporationEditorial by Dr. J.P Abenstein, Mayo“An Ounce of Prevention May Equate to a Pound of Cure”一盎司的预防相当于一盎司的治疗 “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.”对术后最好的监护是一对一的，但贵“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证明，每到小时重要生命指征的变化对无效的。的预防是“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.”文献和经验给我们列举了无数医生在绕圈子，护士到时以几个小时的案例“Unfortunately, (existing systems) for every post operative patientis economically impractical”很不幸，现有系统对术后不切实际了来说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可分析脉搏血氧的系统有助于极大减少抢救“ 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既能监护质量，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系统正常运行可靠率99.9995%Patient Compliance依从度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意义>Improved operational cost操作成本¡ More effective use of internal resources (Reduction in Rapid Response) 对内部资源的更有效利用¡ Patient transfers to ICU consumes valuable resourc

39、es and extends length of stay病人送返ICU将消耗宝贵延长滞留时间¡ Avoidable adverse event are not fully reimbursed>Improved ICU utilizationICU利用率¡ Improvement in hospital access reduces “diverts”减少转移（¡ Frees beds for additional admissions and associated revenue人，）空病床给新病>Improved General Floor ef

40、ficiency普通效率¡ Less ICU transfers reduces patient LOSSavings can self fund Patient SafetyNet through sensor agreement 通过探头协议节省的资金可抵消投入的成本>© 2010 Masimo CorporationNew Collateral ROI Tool新投入产出分析工具© 2010 Masimo CorporationFinancialBenefits Based on Improved Patient Flow带来的效益 Reduces I

41、CU transfers Increases ICU new admits Lowers LOS© 2010 Masimo Corporation Improves patient access Reduces ED divertsROI Elements投入产出分析因素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现状发现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影响旁敲侧击>What is the consequence of current situation. ICU occupancy?Commustanding?>Need-Payoff需求最终回报¡ 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Targeting计划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离床监护NoNoEtCO2ECG心电 / NIBP无创血压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传呼机扩容协议NoLimitedLimited?Recommendations for Post-OperativePatient Monitoring对术后监护的推荐>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.全麻及较少的医护使本可避免的>The Anesthesia Patient Safety Foundation更难解决Recommends 麻醉安全基金推荐> “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呼吸频率选 配Casmed CAS 750Masimo SETOridion EtCO2呼气末Optional NIBP无创血压, Temp体温, ECG心电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过渡到