Elimination of delays in consultant care
Munroe Regional Medical Center (MRMC) had a long history of prioritizing performance improvement initiatives. Leaders at the 421-bed, not-for-pro t, community hospital were well-versed in Six Sigma and other performance improvement strategies. The organization had already streamlined many care processes and had eliminated waste throughout the system. However, MRMC leaders recognized the need for a standardized process to ensure timely clinical communications, especially given the high volume of communications events at the organization: the 450 physicians and 2,500 clinical staff members completed more than 150,000 calls per year. MRMC had been using a home-grown system for contacting physicians, relying on telephone calls to physician offices or answering services, which often proved unreliable and inefficient. Leaders realized the organization needed a systematic, reliable process for contacting physicians. Senior Vice President of Medical Affairs and Chief Quality Officer Lon H. McPherson, MD, had previous experience with PerfectServe in another healthcare organization. McPherson was familiar with the benefits of PerfectServe and was able to champion the project using his past experience with implementation.
While the implementation of PerfectServe helped MRMC improve all forms of clinical communications, this case study focuses on the ways in which PerfectServe specifically helped the organization monitor and refine its physician consultation process.
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Automating stroke response for efficiency and effectiveness
When a patient exhibits symptoms of a potential stroke, time is the most important consideration in the battle between life and death. As they continually strive to deliver the best patient care, healthcare systems work to reduce the time involved in every segment of the process: door to tPA; door to CT; rst neurology exam; and more. The strongest programs are able to meet the criteria to become credentialed as Primary Certi ed Stroke Centers. One such program is Genesys Regional Medical Center in Michigan.
According to Rebecca Banat, RN, Director, Neuroscience, Stroke Center,
Neuro Tele-Med & Oncology Services at Genesys Regional Medical Center, “We have been accredited as a certi ed stroke center three times, but we knew we still had opportunities for improvement.” Some of the issues they faced were:
- A pager system that was unreliable, with delayed delivery of messages
- Inconsistent messaging content, which led to confusion among responding clinicians
- A work-around that used overhead paging, disrupting the hospital’s intent to provide a quiet healing environment
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Eliminating overhead physician pages results in higher productivity and happier staff
Reducing noise in a hospital can have a positive effect on staff productivity and on patient satisfaction, a key component of HCAHPS scores. All kinds of noise can come from the normal, daily activity in a hospital. Overhead paging, alarms, phones ringing, doors opening and closing, conversations in the hallway — all contribute to noise.
Advocate Good Samaritan Hospital in Downers Grove, Illinois, was looking
for a new technology-based communications solution that would provide a quiet, restful and healing environment for its patients. At the 333-bed hospital, with more than 1,000 physicians representing 63 specialties, the volume of overhead pages for physicians was very high. In one month alone, the hospital tracked 609 overhead physician pages.
Mancill Stewart, communication lead at Good Samaritan, says, “We were doing about 30-40 overheads a week… Anytime a doctor would walk away from a unit, they would call us to overhead page them.”
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Chicago-based ACO and managed care organization Advocate Medical Group (AMG) strengthens continuity of care for patients
Advocate Medical Group (AMG), a Chicago-based medical group with more than 200 different practice sites, has a Managed Care Population Program (MCPP) as part of their Accountable Care Organization.
The MCPP handles risk-based financial contracts for the managed care population, and assumes the full financial risk of patient care. The program’s utilization is managed by Lata Patel and Virginia Stasaitis.
Patel and Stasaitis work closely with the physicians in both Advocate Medical Group and Advocate Physician Partners to provide cost effective, quality care to reduce overall medical costs, and maintain continuity of care for patients who are high utilizers of services across various practices.
To ensure that costs are monitored closely and that patients continue to receive the levels of care their Advocate physicians provide, the Managed Care Population Program regularly communicates with other hospitals and healthcare facilities in the area, as well as Advocate physicians, to maintain members’ healthcare needs within the insurance plan’s network.
According to Stasaitis, accountable care organizations, and those working toward value-based care, need to have a mechanism in place to keep managed care population patients in network; not only to reduce medical costs, but to provide more comprehensive continuity of care, which is important for achieving improved outcomes.
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Streamlined follow-up appointment scheduling aims to reduce readmissions
Reducing readmissions is top of mind for healthcare leaders across the country. With regulations changing, the financial impact of readmissions within a 30-day window pack a greater punch than ever.
In an effort to reduce readmissions — and post-procedural complications that could lead to invasive open-heart surgery — the Society for Cardiovascular Angiography and Interventions issued a statement in 2016 that scheduling follow-up appointments before cath lab patients are discharged is a process best practice that should be implemented.
In this success story, we examine how UT Medical Center’s Cath Lab and Cardiovascular Recovery Unit successfully reduced readmissions by implementing PerfectServe into their process.
New technology simplifies complex resident communication workflows
Dr. Randall (Randy) King, CMIO and chief of staff at Mercy St. Vincent Medical Center, says, “We were probably a pretty standard large community hospital with a bunch of residents who communicated with our physicians, primarily through our operators, a paper call schedule, phone numbers and pagers.”
While the hospital’s communication processes seemed to be standard, internal discussions revealed that text messaging had emerged as a newer, faster, easier way for residents and attendings to connect with each other.
Dr. King continues, “We couldn’t help but notice that [residents] were extremely quick to adopt text messaging. The residents, who are usually closer to the forefront of technology than others in the organization as they’re a younger group…had taken the path of best efficiency and had been texting communications back and forth…because it works.”
However, the IT staff at St. Vincent quickly realized that this “path of best efficiency” was not secure. Because securing protected health information was a priority, the organization immediately began searching for a solution that allowed easy and secure communication between residents, attendings, nurses and other clinicians— and would ultimately benefit their patients by enabling fast and efficient clinical decision making.
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Care teams benefit from real-time, integrated communication solution
An important clinical communications metric for many hospitals is the ability to reach physicians on the first call attempt. When nurses have to repeatedly call physicians to get answers, it can result in delays in patient care.
That’s why, after Spectrum Health streamlined clinical communications between physicians in 2014 through PerfectServe, it was soon able to expand access to the technology to nearly 4,000 nursing roles.
“[With PerfectServe] our nurses reach the physician on the first attempt more often,” said Julie Scholten, RN Project manager for nursing administration at Spectrum Health.
In this success story, you’ll hear from Julie and Michelle Wangler, Spectrum’s hospital supervisor, how speeding time-to-treatment created value in nursing roles and other benefits to broader care teams.
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Doctors and hospital leadership recognize elevated patient safety and physician satisfaction
When the executive team of West Michigan’s Spectrum Health System, a 12-hospital network of more than 3,000 physicians and 30,000 employees, made the decision to implement PerfectServe’s secure care team collaboration system, Dr. Matthew Denenberg, who serves as Vice President of Medical Affairs (VPMA) of the system’s Helen DeVos Children’s hospital, said it was for all the right reasons.
It wasn’t about being “cutting edge” or increasing the hospitals’ competitive share of the marketplace. The decision came from a shared understanding that it was time to move toward a direct and digital method of communication for the hospital network’s physicians because the old way simply wasn’t working anymore.
“It was unsafe,” Dr. Denenberg said. “And it wasn’t cost effective.”
In addition to his role as VPMA, Dr. Denenberg also serves as an ER physician. That puts him in the unique position of understanding firsthand the angst of hospital staff when facing archaic processes in times of real emergency.
Like many systems of its size, Spectrum maintained paper schedules for all of its physicians. Contact information regarding who to call for any given reason resided either in a book or binder on someone’s desk, or within an un-automated and unintegrated copy-and-paste calendar application.
If schedule changes needed to be made on the fly, instant updates were not an option.
This resulted in wasted time and effort on the part of hospital staff responsible for patient care, which suffered due to communication delays.
“We started seeing a rise in the number of event reports of delayed communications with physicians during time of patient need,” said Denenberg.
It became apparent that the paper-based system was no longer appropriate in today’s era of direct and digital communications.
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Intelligent clinical communications are key to transfer center’s success
When the new WellStar Transfer Center in Atlanta went live in August 2013, it was with a clear mission in mind: to enable physicians to communicate quickly, easily and directly so that patient hand-offs could be handled as seamlessly as possible.
In the transfer’s center’s first year, it received more than 2,600 patient transfers but experienced issues when looking to see when and why transfer processes broke down and how often patients were sent to other facilities.
The issues WellStar was facing were not unusual. Administrators had no way of knowing when or why transfers were breaking down or how often patients were being sent to other facilities. They had a sense that there were problems but they could not isolate or quantify them.
No clear-cut, repeatable process existed for fast-tracking connections between referring physicians and the appropriate WellStar clinicians. Communication was always on an ad hoc basis, and depended largely on a paper trail. So WellStar leadership decided to design a whole new system from the ground up.
Learn how, with PerfectServe in place, WellStar Transfer Center leaders were able to track process breakdowns and make lasting protocol improvements that resulted in 90 percent of all transfer coordination communications taking place in five minutes or less.
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Improve on-call cardiac team response time through streamlined communications
St. John Macomb-Oakland Hospital is a 535-bed facility, split between two campuses in suburban Detroit. It provides a full array of medical and surgical specialties, including Centers of Excellence in cardiovascular services, cancer care and neurosciences.
In 2007, the hospital began to improve communication process accuracy and reliability across both campuses by using PerfectServe, which automatically identifies and provides an immediate, secure connection to the right care team member for any given clinical situation at any time.
St. John Macomb-Oakland is accredited as an Advanced Primary Stroke Center. It has also earned, for its expertise in cardiothoracic surgery with percutaneous coronary intervention, the prestigious three-star rating from the Society of Thoracic Surgeons.
To further focus its efforts on reducing the amount of time between a heart attack patient’s arrival at the hospital and the time they receive treatment, St. John Macomb-Oakland began to look more closely at the cath lab team and protocols for notifying on-call team members.
The national standard of door-to-balloon time states that a healthcare team must proficiently deliver percutaneous coronary intervention in 90 minutes or less—a protocol the St. John Macomb-Oakland team already performs efficiently, typically delivering treatment in 70 minutes or less. Improved door-to-balloon time is a measure of quality that requires the teamwork of several disciplines—one of which is care team communication, an area the hospital recognized could be improved with a more efficient on-call notification system.
Learn how PerfectServe enabled St. John Macomb-Oakland set in motion the consistent evolution of a process that exceeds industry standards and hospitals goals and ultimately redefines the standard of care.
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