Case Study Focus
How Munroe Regional Medical Center engaged physicians to transform its clinical communication processes in a single day.
A Missing Link: Direct Clinician-to-Clinician Communications
The communications transformation at Munroe began with an old-fashioned idea: Physicians can take better care of patients when it’s easier for them to communicate with each other and the nurses that need to contact them.
“The pace of practicing medicine has gotten so fast that doctors have fewer and fewer opportunities for direct communications,” said Dr. Lon McPherson, Munroe’s senior vice president of medical affairs and chief quality officer. “We wanted to facilitate one-to-one conversations that used to be such an important part of patient care.”
“It was almost impossible for our nursing staff to keep track of physicians’ schedules and where and how they wanted to be contacted. They didn’t have any tools to manage this process other than their lists and notes,” said Diane Coleman, Munroe’s performance improvement manager.
A Comprehensive Strategy for Physician Engagement
Munroe needed a communication system that could effectively manage the highly variable information regarding physician-contact processes, and it needed active cooperation from the medical staff to deploy an effective solution.
PerfectServe was selected because it had the technology to address Munroe’s technical requirements. Plus, it offered an implementation methodology that was proven to engage and mobilize physicians.
Munroe launched a multi-faceted campaign to effectively communicate individual benefits to each physician. The campaign was directed to all medical staff members with an emphasis on the subset responsible for 90 percent of case volume.
“The main challenge was educating physicians about what PerfectServe could do and how this would help them in their everyday lives,” said Coleman. “We only had about 90 days to accomplish this before the implementation went live.”
The tactical benefits to the doctors were different from the strategic benefits to the hospital. To physicians, the new system is designed to give them control over the communications the hospital directs at them, which helps them save time and improve their personal efficiency.
The campaign included numerous tactics to emphasize these benefits, collect each physician’s workflow rules, and configure the physicians and their mid-level providers on the system.
Key elements of the physician engagement process included:
- An introductory letter and registration kit sent to all credentialed staff from the chief of staff and the chief medical officer.
- Presentations at the Medical Executive Committee and quarterly medical staff meetings.
- Establishing a firm “go-live” date when all physicians and hospital staff would transition to the new system.
- Follow up phone calls to physicians and their practice managers to collect workflow rules for each physician.
- A full week when PerfectServe consultants met with physicians on site, both in the physician’s lounge and in their practices.
- Pre and post “go live” training sessions for practice managers.
- Posters and fliers distributed at strategic locations throughout the hospital.
- A link on Munroe’s online physician portal for easy Web registration.
- Personalized support and encouragement from the chief of staff and chief medical officer with individual physicians as needed.
“Another effective tactic to get physicians on board was PerfectServe consultants going to the doctors’ offices and demonstrating its benefits to their managers,” said McPherson.
Results: Efficient Communications Increase Physicians and Staff Satisfaction
Munroe launched PerfectServe on May 19, 2010. On that day, all of its 522 physicians and mid-level providers were accessible through the new system.
The rapid adoption was assisted by Munroe’s openness to process change, referred to internally as “the Munroe Way.” PerfectServe’s voice portal was also a catalyst for adoption, enabling physicians and nurses to quickly connect with anyone on the medical staff by dialing a single, unchanging number and speaking a doctor’s name.
Since going live, Munroe has processed and documented approximately 14,000 clinical communications events each month.
Physicians are pleased with the new system because they can now easily contact each other directly without the communication handoffs that waste time and can cause errors. In addition, they are receiving calls and messages with greater accuracy according to their precise instructions.
“As a practicing physician, I was often frustrated when I received inappropriate calls, which doesn’t happen anymore,” said Dr. Krishna Swaminathan, president of the medical staff. “I’m impressed PerfectServe is so easy to use.”
McPherson says virtually every physician, nurse and clinical staff member has had a positive reaction to the new clinical communications changes since day one: “One of our doctors said this was the first time in 20 years he could sleep through the night because non-urgent calls were routed to his office instead of his home phone.”
“I’ve done a lot of IT implementations over the last 12 years, and no company has been easier to work with than PerfectServe,” said Joy Bauer, RN, director of information systems. “It’s phenomenal the number of calls we now handle—and handle satisfactorily—each day. The system has really reduced stress levels for our nurses.”
Automatic Documentation
Now that Coleman has data on each communication event, she is able to measure, monitor and continually improve clinical communications performance. For example, before implementation, the ED’s manual call log showed that, over a period of eight days, the department made about 40 outbound calls per day with more than 90 percent resulting in communication handoffs.
Since going live with PerfectServe, Munroe has documented nearly 70 emergency department calls daily, with only 33 percent resulting in third-party handoffs.
“There’s no guessing anymore about whether a consultant or specialist received a call from the ED because we have the documentation,” said Dr. Frank Biondolillo, chief of emergency services.