3 Ways to Save Nurses’ Time With Better Communication

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Nurses play a central role in providing patient-centered, cost-effective care. They are responsible for care coordination and communication with each patient’s family members, as well as a growing care team of physicians and specialists, ancillary staff, and care coordinators. In addition to nurses’ growing list of daily nonclinical tasks, inefficient care coordination workflows prevent them from working to the top of their licensure.

A 2018 time and motion study revealed that in four hours, nurses spent around 32 minutes communicating with patients and family and 51 minutes communicating and coordinating care with members of the care team1—fully 34.6% of nurses’ time each day. Technology aimed at improving nurse workflows has often contributed to their frustration by adding siloed, task-specific “solutions” to their workload.

Let’s talk about the alternative. Keep reading to learn three ways clinical communication and collaboration (CC&C) technology can help healthcare organizations empower their nurses to work at the top of their license to drive patient-centered care for optimal outcomes.

Reduce Communication Cycle Times

Communication workflows are often cumbersome, requiring nurses to reference several systems and/or paper on-call schedules to page, call, and relay information through office staff … and then wait for the intended recipient to call back. This error-prone process causes care delays and requires a full restart when a provider is unavailable for any reason.

An improved communication strategy built around an integrated solution like PerfectServe can reduce average response times from 45 minutes to 20 minutes or less.2 Here are some key capabilities that can make it easy for nurses to find the right physician at the right time:

  • One unified directory to find and contact clinicians by name, role, and/or on-call status (e.g. “cardiologist on call”), or to send messages to the whole patient care team at the touch of a button.
  • Built in physician contact preferences to ensure communication is delivered via the preferred/frequently checked method.
  • Read receipts and smart escalation to ensure messages are read, acknowledged, and acted upon in a timely manner.
  • Message history and EHR integration for quick context.

Faster communication leads to safer, quicker, and higher quality care.

Integrate Alerts and Critical Result Notifications

Alarms, alerts, and other notifications continue to be named among the top 10 health technology hazards for 2020,impacting patient satisfaction and contributing to alarm fatigue.

In a 2015 study, nurses reported that only 52% of bed calls required nursing care, while others could be answered by support staff.4 Constant interruptions reduce care efficiency and require nurses to make multiple unnecessary trips to patient rooms. While nurses are inundated with too many alerts, they are not adequately alerted of critical results and orders, requiring them to repeatedly check the EHR for updates.

Centralizing alerts and communication across multiple systems, including the EHR and nurse call system, can eliminate noise, add context to alert notifications, and call attention to critical alerts by allowing:

  • Delivery of alerts to mobile devices, where nurses can accept, escalate, or call back to speak with the patient.
  • Push notification of critical results (lab or radiology) or physician orders to speed up time to care.
  • Routing of nonclinical alerts to patient care techs or nursing assistants.
  • Workflow rules to help ensure that only critical alarms disrupt normal workflows and are differentiated with a distinct alert tone.
  • Clinical surveillance to send push alerts for sepsis, respiratory deterioration, organ failure, etc.
  • Routing of “leads off” alarms to only alert the nurse assigned to that specific patient, set to escalate to the charge nurse if the assigned nurse does not respond within a predetermined time frame, eliminating an audible, ward-wide alert.

Simplify Patient Engagement

Nurses are tasked with keeping family members up to date on patient status, sharing care instructions, arranging discharge, and following up with patients and their families after discharge. As nurses invest increasing amounts of time in patient and family engagement activities, they become more confined to the nurses’ station and less available at the patient bedside.

Post-discharge patient engagement often relies heavily on phone communication, with declining impact due to phone tag and low voicemail retrieval rates. On the other hand, secure texting with patients and families allows health systems to automate more effective outreach in order to:

  • Share care instructions, arrange discharge, and answer questions.
  • Route inbound messages to the call center, rather than the nurse, for triage.
  • Automate patient outreach, such as surveys, post-discharge instructions (tailored to the patient profile), and referrals.
  • Support two-way communication and allow individuals to respond to patients as needed, leveraging the expertise of nurse assistants, call agents, and more.

Start Saving Nurses’ Time

PerfectServe’s CC&C solution with patient engagement capabilities helps streamline nurse workflows, reduce care delays, improve patient safety, and boost patient satisfaction. To learn more, contact us or click below.

PerfectServe’s Solution for Nurses

 

References

  1. Nurses’ Time Allocation and Multitasking of Nursing Activities: A Time Motion Study, AMIA Annual Symposium Proceedings, 2018: 1137-1146, Yen, P. et al., 2018: ncbi.nlm.nih.gov/pmc/articles/PMC6371290/#r34-2975707
  2. Secure Clinical Communications Makes Real Patient Impact, Health IT Outcomes, Griffith, A., 2015: healthitoutcomes.com/doc/secure-clinical-communications-makes-real-patient-impact-0001
  3. 2020 Top 10 Health Technology Hazards Executive Brief, 2020: org/landing-2020-top-ten-health-technology-hazards
  4. Interruptions of nurses’ activities and patient safety: an integrative literature review, Revista Latino-Americana de Enfermagem, Monteiro Cintia et al., 2015: ncbi.nlm.nih.gov/pmc/articles/PMC4376046

Preventing Patient Leakage With In-Network Referrals

In the shift to a value-based care model, healthcare organizations must deliver cost-effective, quality outcomes across the spectrum of care to individual patients and patient populations. To succeed under value-based care and programs such as the Affordable Care Act (ACA) and the Medicare Access and CHIP Reauthorization Act (MACRA), health systems have begun to consolidate. Consolidation allows healthcare networks to leverage technology innovation, share risk, improve care coordination, and offer greater patient access to clinical services.

With the rise of large healthcare systems made up of hospitals, primary care facilities, outpatient facilities, and ancillary services comes the opportunity to create a greater care team of providers from multiple facilities to support patient and population health efforts. Large healthcare systems are working to improve care coordination, reduce duplicate testing in the referral process, and create a system to support improved patient outcomes.

Patient leakage—when a patient seeks or obtains services outside the hospital network—makes it difficult to track and support patient outcomes. The onus is on healthcare leaders to reduce patient leakage to support value-based care.

The Cost of Patient Leakage

Every year, more than a third of patients in the US are referred to a specialist. Healthcare executives report the following:

  • 43% say they are losing 10% or more of annual revenue to patient leakage.
  • 19% say they are losing up to 20% of revenues.
  • 20% say they don’t understand where or why patient leakage occurs.
  • 23% of organizations neither track nor quantify patient leakage.1

Not only does patient leakage lead to lost revenue and increased coordination costs for the health system, it can also have negative impacts on the patient. With fragmented coordination outside of network, some specialists may not have full access to the patient’s medical records and history to support the referral.

One study found that approximately 70% of primary care providers (PCPs) reported sending patient history and reason for referral, but less than 35% of specialists report receiving that information.2 Inefficiencies in the referral process can result in denied referrals, delays in patient diagnosis or care, duplicate testing, and reduced continuity of care.3

20% of malpractice claims for missed or delayed diagnoses involved communication deficits in handoffs.3

Patient leakage occurs for a variety of reasons, but it happens most frequently when physicians refer out-of-network. While relationships may be one cause of these referrals, one study found that 80% of out-of-network referrals in a 700-physician medical group were attributed to a lack of understanding of the Accountable Care Organization (ACO) network.4 Making it easier to find in-network care providers helps health systems provide coordinated patient care.

Patient Satisfaction Contributes to Patient Leakage

On one side, healthcare organizations can reduce business losses from out-of-network referrals and improve care outcomes by making it easier to find and hand off care to in-network care providers. The second side of patient leakage is when patients choose to leave the healthcare network, which could be due to a lack of information about in-network options or issues with patient satisfaction.

With patients now assuming greater financial responsibility for their care, and the consumerization of medicine in general, patients may walk away with a referral but then choose a competing facility. It sometimes happens because the patient is dissatisfied with their current care or simply because, through research or reviews, they choose a competing facility with little awareness of the impact the choice will have on the coordination of their care plan.

Optimize Communication to Reduce Patient Leakage

To reduce patient leakage, healthcare organizations need to support in-network referrals and help ensure the right information is communicated to the right care provider at the right time. A clinical communication and collaboration (CC&C) solution can help with:

  • Unified Directory – Easily look up any member of the care team by name or by role. Referring physicians can look up a “cardiologist” to see a list of in-network cardiologists, with the opportunity to further refine the list by hospital or healthcare facility to best support patients.
  • Safe Patient Handoff – Referring PCPs or hospital physicians can perform a safe handoff to seamlessly share patient history and clinical notes with the specialist.
  • Coordinated Care – Support ongoing communication among the care team to foster team-based decision making and close the loop on the care plan.
  • Patient Referral Follow-Up – After discharge or referral, an automated message can be sent to patients to connect them with an in-network provider (if not already specified) to schedule an appointment and help increase the completion rate of referrals.
  • Patient Satisfaction Surveys – Surveys after each healthcare encounter can help organizations spot and potentially recover from dissatisfaction that can impact patient loyalty.

By focusing on reducing patient leakage, healthcare networks can help realize their value-based goals. To learn how to help support coordinated care and reduce leakage, contact us for a demo.

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Resources:

1 Patient Leakage: A new survey highlights high costs, limited control, Fibroblast, Oct. 2018: com/wp-content/uploads/2018/10/Patient-Leakage-A-new-survey-highlights-high-costs-limited-control-October-2018-1.pdf

2 Referral and Consultation Communciation Between Primary Care and Specialist Physicians, Finding Common Ground, JAMA Network, O’Malley, Reschovsky, Jan. 10, 2011: com/journals/jamainternalmedicine/fullarticle/226367

3 Dropping the Baton: Specialty Referrals in the United States, The Milbank Quarterly, Mehrotra et al., 2011: nlm.nih.gov/pmc/articles/PMC3160594/

4 Four Ways Healthcare Executives Can Reduce Patient Leakage, Managed Healthcare Executive, Vold, Dec. 8, 2018: com/business-strategy/four-ways-healthcare-executives-can-reduce-patient-leakage