Improve Patient Experience Before, During, and After Care

Improve Patient ExperienceWhen it comes to communicating with patients, nothing beats the immediate connection of text messages. While email and phone calls are increasingly ignored, 90% of text messages are read within three minutes.1

Let’s explore some opportunities to engage with patients via text message throughout their healthcare journey to reduce the cost of outreach and improve the patient experience.

Changing Patient Expectations

The healthcare industry has shifted focus from volume to value, working on the “Triple Aim” of enhancing patient experience (including health and satisfaction), improving the health of populations, and reducing costs.2 Patient satisfaction has become linked to reimbursement at a time when patient expectations for the healthcare experience continue to evolve.

Patients, financially responsible for a sizeable share of their care, are now approaching healthcare encounters with consumer expectations. They expect convenience, personalization, and access to care anytime from anywhere.

Healthcare organizations need new ways to keep patients engaged in their care and to continually assess patient satisfaction. Unfortunately, improving health system performance toward Triple Aim results has led to worrying rates of clinical burnout.

With technology often cited as one of the leading causes of burnout, organizations are now focusing on the “Quadruple Aim,” which includes provider experience and satisfaction.3 The Quadruple Aim recognizes the importance of usability, effective care processes, and improved clinical workflows to achieve Triple Aim results.

Below are some strategies designed with the Quadruple Aim in mind, reducing administrative burden with patient, population, and diagnostic-specific automations to engage with patients before, during, and after care.

Before Care

How a patient experiences their healthcare encounter begins before the patient even steps through your door. From your website and scheduling process to visit preparation and patient intake, patients are looking for a modern, seamless, and informative experience.

Healthcare organizations looking to transform the patient experience should begin by engaging with patients before their scheduled appointments:

  • Care Preparation Instructions – Use procedure-specific pathways to send reminders to start pre-operative instructions.
  • Appointment Reminders – Text patients reminders of dates, times, and locations of upcoming visits, along with detailed wayfinding instructions.
  • Social Determinants of Health (SDOH) Support – Leverage SDOH data to assist patients through barriers, such as sharing coupons for transportation to reduce no-shows. Hennepin Health recently partnered with Lyft to target patients with a history of clinic no-shows, offering them access to a corporate Lyft account to get to their appointments. At the end of a 12-month trial period, no-show rates decreased an aggregate 27%, clinic revenue increased by $270,000, and ROI was 297%.4
  • Patient Intake – Send patients a link to electronic forms to streamline check-in.
  • Real-Time Scheduling Updates – Send status updates to patients to help re-align arrival times when there are scheduling delays.

During Care

The factors that influence a patient’s experience can vary widely based on their reason and length of stay. However, we can follow the broad strokes of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey to better identify a patient’s perspective on their care experience.

The 18 substantive questions included in the survey focus primarily on communication with doctors, nurses, and staff during care and at the critical point of discharge. Other questions focus mainly on environmental factors such as cleanliness and sound level.5

From enabling fast, efficient communication between clinicians, patients, and family members to facilitating a more comfortable, safe, and convenient care environment, mobile messaging can greatly improve the patient experience during care.

Video Visits

Texting with patients is a quick and easy gateway into scheduled and/or on-demand video visits. PerfectServe’s solution, for example, enables patients to transition from text message to browser-based video visit with the simple touch of a link—no need to download an app or set up a password.

Virtual Waiting Room

A virtual waiting room uses text messages to maintain a safe and comfortable connection with patients during in-person visits by streamlining check-in to help minimize germ exposure and discomfort.

Patient Family Updates

Family members play a crucial role in supporting patients and encouraging them to follow care plans before, during, and after their stay at the hospital. Healthcare organizations are now prioritizing patient families as part of the patient experience. Family members feel more comfortable leaving the waiting room knowing they will receive updates on patient status and return time.

With PerfectServe, care team members can update approved patient family members via secure video, voice, and/or text message. Even a family member who calls into the main hospital call center can quickly get a message to the correct on-call nurse, who can easily respond with one click, masking their personal caller ID.

Read our white paper for more examples of how the right solution can simplify, automate, and strengthen patient and family member encounters.

Integrate Nurse Call, Alert, and Alarm Notifications

Centralize communication across multiple systems onto a single platform to simplify clinical workflow while eliminating extraneous noise. With a solution like PerfectServe’s Clinical Communication & Collaboration (CC&C), nurses can receive alerts on their mobile devices and choose to accept, escalate for assistance, or call back to speak directly with patients.

If a patient pushes the call button for a nonurgent or nonclinical request (such as a water request), the notification can automatically route to a Patient Care Technician, reducing nurse interruptions during care. Patients benefit from reduced noise and faster response times—critical factors in HCAHPS scores.

After Care

Preventable hospital readmissions continue to be top-of-mind, thanks largely to Medicare’s Hospital Readmissions Reduction Program (HRRP) and readmission penalties. HRRP is the “value-based purchasing program that encourages hospitals to improve communication and care coordination to better engage patients and caregivers in discharge plans and, in turn, reduce avoidable readmissions.”6

According to a study published in BMJ Quality & Safety, patients reporting high satisfaction and good provider communication were less likely to be readmitted.7 Decreasing preventable readmissions requires that patients understand and adhere to their care plan, that pain is managed, and that follow-up care is scheduled and attended in less than two weeks.8

Post-Discharge Assessments

Leading hospitals are applying a text-first strategy to monitor treatment, assess pain, and send care plan reminders (such prescription refill reminders). Care teams can use text messages to deliver questions to patients one at a time or all at once with a simple link to a secure web survey.

Frequently checking in both increases patient satisfaction and allows clinicians to escalate concerning responses to secure chat or phone call if needed. PerfectServe’s solution, for example, lets users share a secure chat link that allows patients to discuss more detailed and personal health information.

Park Nicollet Methodist Hospital worked with PerfectServe to launch a text-first follow-up program that included a series of customized questions to assess a patient’s risk for readmission. 70% of questions sent via text message received a response from patients. PerfectServe’s dashboard allowed Park Nicollet to collect and analyze every patient response and nonresponse, segmenting the patient population into risk categories and automatically flagging patients that need immediate follow-up.

Park Nicollet’s results showed that patients who received and responded to text messages were 32% less likely to readmit than those solely contacted by phone (results are risk adjusted to account for the relative complexity of each patient’s conditions).

Patient Satisfaction Surveys

While CMS’ HCAHPS survey has incentivized improvements in patient experience, the response rate from patients has been on the decline.9 Declining response rates could be tied to patients’ perception of the survey’s effectiveness. HCAHPS surveys are administered 2 to 42 days after discharge and often cannot yield the timely data hospitals need to quickly address patient issues.

Given the high impact HCAHPS results have on a hospital’s financial performance, it’s important to seize opportunities to survey patients before the CMS in order to preemptively mitigate issues and improve patient satisfaction. For patient satisfaction surveys to be actionable, they need to be easy and customizable, targeting specific patient populations and encouraging meaningful dialogue.

Deploying surveys via text message is a cost-effective approach to obtaining timely patient insights. With solutions like PerfectServe’s Patient & Family Communication (PFC), surveys can be automatically triggered after healthcare encounters while the experience is fresh on the patient’s mind. Patients who indicate dissatisfaction become a service recovery opportunity. Contacting them to show concern and learn more can inform systemic improvement and change the patient’s impression of the organization.

Deliver an Exceptional Experience

PerfectServe allows hospitals to reach patients and their family members in real time before, during, and after care to better support, assess, and improve the patient experience. Book a demo with a clinical communication specialist to see how we can help you deliver an exceptional patient experience.

Book a Demo

 

Resources:
1. SMS vs Email and Apps: Customer engagement infograph, VoiceSage, Jun. 14, 2018: voicesage.com/blog/sms-compared-to-email-infograph
2. IHI Triple Aim Initiative, Institute for Healthcare Improvement (IHI): ihi.org/Engage/Initiatives/TripleAim
3. From Triple to Quadruple Aim: Care of the Patient Requires Care of the Provider, The Annals of Family Medicine, T. Bodenheimer, C. Sinsky, Nov. 2014: annfammed.org/content/12/6/573.full
4. Do Rideshare Tools Reduce Transport Barriers, Patient No-Shows?, Xtelligent Healthcare Media, Patient Engagement HIT, S. Heath, Jul. 24, 2018: patientengagementhit.com/news/do-rideshare-tools-reduce-transport-barriers-patient-no-shows
5. The HCAHPS Survey – Frequently Asked Questions, Centers for Medicare & Medicaid Services (CMS): cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HospitalQualityInits/Downloads/HospitalHCAHPSFactSheet201007.pdf
6. Hospital Readmissions Reduction Program (HRRP), Centers for Medicare & Medicaid Services (CMS): cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/Readmissions-Reduction-Program
7. The association between patient experience factors and likelihood of 30-day readmission: a prospective cohort study, BMJ Quality & Safety, J. Carter et al., 2018: qualitysafety.bmj.com/content/27/9/683
8. Timeliness of Outpatient Follow-up: An Evidence-Based Approach for Planning After Hospital Discharge, The Annals of Family Medicine, C. Jackson, PhD, et al., Mar. 2015: ncbi.nlm.nih.gov/pmc/articles/PMC4369604
9. HCAHPS Survey Non-Response Bias Impacts Scores, Practice Improvement, Xtelligent Healthcare Media, Patient Engagement HIT, S. Heath, May 1, 2019: patientengagementhit.com/news/hcahps-survey-non-response-bias-impacts-scores-practice-improvement

4 Smartphones for Nurse Mobility

 

Smartphones have the potential to transform workflows for nurses and other hospital caregivers. Rather than carrying around multiple devices, smartphones give clinicians mobile access to the EMR, integration with nurse call and telemetry, and secure medical communication and collaboration.

PerfectServe has partnered with many clients in their transition toward mobility with smartphones to enhance clinical collaboration. We want to use this experience to help other health systems in the journey. 

The first question we hear about mobilizing care team communication is usually, “Which device should we buy?” and the answer is always, “It depends.”   

No one device has emerged as the clear best choice across the board, but we are happy to share some top contenders and key considerations for health systems evaluating mobile devices.

Zebra Technologies TC52-HC1 

Zebra has been in the healthcare space for years, with their MC40 mobile computers and broad range of solutions like printers, scanners, and kiosks. A few years ago, they introduced the TC51-HC and quickly followed it up with the evolved TC52-HC.

The TC52-HC is a healthcare-focused unit that offers strong hardware performance and support for modern versions of Android. The device is protected by a rugged exterior that’s built to survive day to day in a nursing unit.  

As an enterprise device, the TC52-HC is available with built-in telephony, barcode scanning, robust battery capabilities, and many more features that come in handy in a healthcare setting. Like the other purpose-built Android devices on our list, the TC52-HC is a hardened device that can withstand repeated drops, exposure to liquids, and frequent exposure to healthcare disinfectants.

Improving upon the TC51-HC, the TC52-HC offers an additional microphone, advanced noise cancellation, and a louder speaker to hear and be heard in noisy environments. Its battery is the largest of our recommended devices, and Zebra includes software tools that ensure the battery will last through an entire 12-hour shift.

Why buy it: Long-Term Quality  

Zebra and its partner network are well established in healthcare, offering plenty of resources to help your project succeed. Zebra made sure the TC52-HC is backwards compatible with TC51-HC accessories and future-proofed the device through Android 10 and later.  

Honorable Mention: TC21-HC

Zebra also recently introduced a new TC21-HC device, targeted at ancillary healthcare workers like environmental services, transport, and food service staff. The TC21-HC offers most of the same features as the TC52-HC in a slightly smaller, more cost-effective package.

 

Apple iPhone SE2

This device needs no introduction.  

As a consumer-grade device, the iPhone delivers leading-edge hardware and software wrapped in a small, sleek package.  

Compared to most enterprise-specific devices, an iPhone SE is a low-cost option. However, as a consumer phone, the Apple device will not offer the ruggedness, battery capabilities, native IP telephony, and other enterprise-grade features. Third-party protective sleds and charging solutions are available to make the device hospital ready.

The low cost, form factor, and familiarity of the iPhone make it a good option in the current device market.

Why buy it: iOS

If your organization prefers the Apple mobile operating system, your device choice is clear. 

Spectralink Versity3 

Spectralink has years of experience providing voice handsets that run on hospital wireless networks. After entering the smartphone market in 2014 with the Pivot, Spectralink rolled out the Versity to customers in late 2018.

Looking at the spec sheet, the Versity checks all the boxes for ruggedness, battery, telephony, etc. Its hardware and Android 8 operating system raised the bar in the enterprise device market.  

Spectralink emphasizes voice quality with the Versity, leveraging years of wireless handset experience and advanced audio processing software. The device is available with a scanner or without for a sleeker, lower-cost option.

Why buy it: Form Factor  

The Versity is slim and light, as close as you will find to a consumer phone in a rugged package. 

Ascom Myco4 

Another company with deep healthcare experience, Ascom offers the Myco 3 smartphone alongside its wireless telephone and nurse call products. Although the Myco 2 received mixed reviews, the new Ascom Myco 3 (launched in 2019) shows great potential as a nursing device. The five-inch screen, battery, ruggedness, and operating system are all in line with the Zebra and Spectralink devices.

Ascom has followed a more traditional smartphone form factor with the Myco 3, but they have added some creative functional touches. The device includes a removable clip to attach to a waistband or pocket. When worn clipped to scrubs, the top edge features multi-color LEDs that supported apps can use to signal informative notifications. The dedicated barcode scanner is on the rear, rather than the top, so users can see the screen easily while they point the scanner.

The Myco 3 is the newest device on this list. We had great results testing the device in our certification lab, and now we look forward to real-world feedback from our customers.

Why buy it: The Ascom Touch  

Health systems already using Ascom nurse call and wireless phones should certainly consider the Myco 3 mobile device, along with any other team that could benefit from its unique ergonomic design.

Conclusion

This is an exciting time as manufacturers continue to bring improved smartphones to the market. PerfectServe is here to share our experience and help you achieve your goals for clinical communication.  

If you want more information about nurse mobility, click below to book a call with a clinical communication specialist.  

Request a Call

 

Building More Efficient Schedules for Academic Hospitals

Schedules in Academic Hospitals

Balance Teaching, Research, and Patient Care

Academic medical centers and teaching hospitals play an important role in the overall health system, but the expanded scope of teaching, research, and patient care means academic hospitals routinely face higher patient care costs than nonteaching hospitals.

Average Inpatient Hospital Cost Per Case1

Hospital Costs Per CaseIn such a competitive financial environment, academic healthcare organizations need a more efficient way to manage resources to ensure they can perform their critical social mission. Because labor costs are at an all-time high—likely accounting for up to 60% of hospital operating budgets2—clinical staffing is one of the most critical areas to monitor when it comes to resource management and utilization. Unfortunately, it’s no easy task.

Provider scheduling has proven to be more difficult in an academic setting.

Provider schedules must be able to balance individual departments’ scheduling requirements, organizational standards, provider preferences, and patient demand. Academic healthcare organizations require schedules that can serve as an anchor to operations, factoring in:

  • The unique needs of individual departments.
  • The overall organization’s objectives and goals.
  • Providers’ scheduling preferences.
  • Patient demand for certain care services.
  • Clinical, teaching, and research responsibilities.
  • Training requirements for residents across specialties.

The responsibility of orchestrating academic schedules falls to schedulers, who spend an average of 291 hours annually turning the above laundry list of requirements into provider schedules—often manually, or with little to no automation. Schedulers work hard building on-call lists, calendars, and schedules that meet their organization’s needs, but it’s not always a feasible task. As the hospitalist team at UNC Health, an academic medical center, grew, their scheduler felt that manually scheduling the department’s providers had become nearly impossible.

“The difficulty was we grew very rapidly. It got to where I was spending so many hours creating the schedule, and it had just gotten so complex that it almost became impossible to create. We have to take into consideration providers’ preferences, the many different services that we have. We also have particular services that only some of our providers can cover, such as the procedure service. There are so many different factors that come into play that have to be considered.”

– Administrative Coordinator, Hospitalist Division, UNC Health

Fortunately, UNC Health managed to streamline the scheduling process with Optimized Provider Scheduling powered by Lightning Bolt. Click below to see a video about UNC’s story.

Creating Complex Schedules While Saving Time

An advanced scheduling solution can be instrumental in saving schedulers time as well as creating more effective and efficient schedules. By building out rules that dictate a department’s schedules, schedulers can auto-generate provider schedules and share them globally across their organization to increase schedule visibility and give time back to supporting clinical teams.

“It has allowed me time to do other work besides just scheduling. Scheduling is only a part of what I do.”

Administrative Coordinator, Hospitalist Division, UNC Health

Uncertain how to find a scheduling platform that meets your organization’s needs? Download our new guide, Choosing an Enterprise Scheduling Solution, for a detailed discussion of how rules-based scheduling works and the capabilities you should expect from a scheduling solution.

Efficiently Utilizing Clinical Staff and Resources

In addition to generating significant time savings, an advanced provider scheduling system can also help healthcare organizations better manage their most important resource: clinical staff. Here are four ways an optimized scheduling solution can eliminate excess, cut costs, and increase revenue:

  1. Build schedules that take provider productivity into consideration.
  2. Align provider supply and patient demand to identify and optimize missed revenue opportunities.
  3. Access analytics across shifts, departments, and locations to guide decision making.
  4. Reduce turnover by ensuring shift equity with schedule transparency and provider autonomy over their schedules.

Check out our recent blog post to explore how an advanced optimized scheduling solution can streamline operations and drive efficiency for your organization.

 

Resources:

1. Estimating the Mission-Related Costs of Teaching Hospitals, Project HOPE, Lane Koenig, Allen Dobson, Silver Ho, Jonathan M. Siegel, David Blumenthal, and Joel S. Weissman, Health Affairs—Vol. 22, No. 6—Pages 112-122, November 2003: psnet.ahrq.gov/primer/duty-hours-and-patient-safety
2. Labor Management Trends, Healthcare Financial Management Association, Navigant, Aug. 2018: guidehouse.com/-/media/www/site/insights/healthcare/2018/navigant-hfma-2018-labor-pulse-survey.pdf

Fighting Alarm Fatigue for Nurses in 5 Steps

Healthcare, We Have a Problem:

Alarm fatigue is a serious threat to patient safety.

The American Association of Critical-Care Nurses (AACN) defines alarm fatigue as a sensory overload that occurs when clinicians are exposed to an excessive number of alarms, which can result in desensitization to alarm sounds and an increased rate of missed alarms. False alarms are a strong contributor, making up 72-99% of all alarms and numbing care teams to signals meant to indicate patient danger.1

Essentially, devices and processes that were designed to protect and support patients in specific ways have compiled over time to create a cacophony of ever-sounding silos in healthcare. Sadly, the discord cannot be safely silenced. Fortunately, it can be well-orchestrated.

Let’s explore how integrating disparate, noisy alert and alarm systems can help fight alarm fatigue for nurses and care teams.

Where is all the noise coming from?

In short, disconnected legacy systems with outdated hardware and devices combine with overlapping, suboptimal workflows to create the noise fueling alarm fatigue. A few factors that add to the chaos and make it difficult for clinicians to determine the relevance and urgency of alarms include:

  • Nurse Call Systems: Patients sometimes use nurse call for non-clinical requests, such as a glass of water, which could be redirected to another team member.
  • Critical Lab Results: Upon notification, nurses in some settings are responsible for tracking down the appropriate physician to relay critical results, pulling the nurse away from the bedside.
  • Patient Monitoring Devices: It can be difficult to infer the risk level and urgency of various patient device alarms, and to know if other team members are responding or can respond more quickly.

Above are just a few of many systems that can trigger nondescript beeping sounds, which all begin to sound alike and blur together. The result? Just to find out where an alarm is coming from and what it indicates, a nurse has to leave the current task to investigate.

The nurse is forced to assign priority (current task versus potential patient threat) based on assumption in an environment where up to 99% of alarms are false, yet assuming an alarm is false puts a patient at risk. Constant decisions like these in a fast-paced, high-stakes environment contribute to mistakes, alarm fatigue, clinician burnout, patient risk, and many other potential consequences.

5 Steps to Fight Alarm Fatigue:

1. Integrate all alerts and alarms to reduce noise.

To start, put all alerts and alarms in one place that nurses and care teams can check on the go—an integrated app accessible from any device across all locations.

2. Increase mobility to decrease footwork.

For organizations that haven’t already deployed a mobile device strategy for nurses, smartphones will greatly enhance the effectiveness of an integrated solution. Being able to check alerts at the bedside and on the move reduces extra footwork and detours for staff.

3. Use shift schedules to inform smart routing.

The ideal solution should also integrate with shift and on-call schedules across the organization, using schedules to route alerts and alarms directly to the right clinicians. Smart routing like PerfectServe’s Dynamic Intelligent Routing reduces irrelevant noise while using built-in escalation policies to ensure urgent alerts are addressed within set timeframes.

4. Delay nonurgent notifications to reduce interruptions.

The ability to delay nonurgent alerts to be delivered at set intervals can greatly reduce distractions for clinicians during patient care. By minimizing multitasking, nurses and other care team members are able to complete tasks more efficiently and maximize their focus on patients at the bedside.

5. Distinguish alert types by tone to simplify recognition.

Alarm fatigue and decision fatigue often go hand in hand. While most care team members wouldn’t actively choose to ignore an alert, the ability to know in an instant based on sound whether or not an alarm is urgent can help them respond appropriately more quickly.

The Bottom Line:

Excess noise makes it difficult for clinicians to administer safe and timely care. (It also does a number on patient experience, but that’s a topic for another post.) Remove the guesswork for nurses around whether to tune out the noise and focus on the patient at hand or interrupt each encounter to assess the latest (likely false) alarm.

Click below to begin fighting alarm fatigue.

 

Resources:
1. Alarm Fatigue: A Patient Safety Concern, American Association of Critical-Care Nurses (AACN) Advanced Critical Care, Sue Sendelbach, RN, PhD, CCNS and Marjorie Funk, RN, PhD, Oct. 2013: acnjournals.org/aacnacconline/article-abstract/24/4/378/14745/Alarm-FatigueA-Patient-Safety-Concern

10-Point Checklist:
Deploying Shared Devices for Nurses

Checklist Deploying Nurse Devices


B
elow is a summary of an article published in Becker’s Hospital Review July 9, 2018.1

In a 2018 survey, 72% of respondents reported using a program that provides nurses with devices.

Smartphones equip nurses and other clinical staff with always-available communication and clinical applications that help speed up care delivery. Connected nurses more easily communicate and collaborate with care team members on patient-centered care.

Mobile devices for nurses must be rigorously tested and validated. Purchasing the wrong devices for thousands of team members without testing them in real life can have disastrous consequences. On the other hand, choosing the right devices can launch an integrated delivery network for care team collaboration and quality patient care.

Here is a 10-point checklist of best practices for planning and implementing a mobile device strategy for nursing teams:

1. Consider device usability.

Make sure the devices you put into your nurses’ hands are well received. Form factor, battery life, and performance all play into device acceptance. Any shortcomings can negatively impact adoption.

2. Verify compatibility between the device and your applications.

The most obvious application to consider is the mobile app for your EHR, but there are other apps you should also test. Create a role-by-role application inventory to guide your app testing.

3. Consider the durability of the device in three key areas.

    1. Drop Endurance: Only consider devices that pass repeated four-foot drops.
    2. Liquid Tolerance: Whether it be a sink, toilet, or any other liquid landing, care team devices need to survive getting wet to function reliably.
    3. Sanitization Survival: Good infection control practices require regular device disinfection. How well will the devices handle your facility’s sanitization agents?

4. Test the reliability of the device on your wireless network.

Not all devices seamlessly transition between wireless access points throughout a hospital. As more access points are added to improve coverage, the frequency of network issues may increase, which is one of the most common contributors to device failures.

5. Validate the voice quality of the device.

In most cases, the device is used primarily as a phone. Test the voice quality of the device when paired with your wireless network and PBX.

6. Ensure your device will support a secure operating system.

Note the operating system shipped with the device and future plans for the course of the device’s lifecycle. Specifically, ensure the device will always run an operating system that continues to receive security patches from the vendor. Avoid an end-of-life operating system.

7. Purchase during the first half of the device lifecycle.

Make sure the devices you deploy have enough horsepower to last at least three years. Purchasing devices early in the lifecycle will help maximize usable life. Purchasing too late in the lifecycle leads to performance complaints long before the devices are planned to retire.

8. Plan organizational change for device deployment.

Change can be hard, but a thoughtful plan makes all the difference. Carefully consider your training program, communication plan, and your “change champions” to help evangelize the update.

9. Consider the manageability of the devices.

Use a mobile device management (MDM) solution to deploy and manage your devices. If you don’t currently have one, bundle your MDM decision in with device selection. Do not try to deploy devices enterprise wide without an MDM.

10. Pilot the device in real-world situations.

Proper device evaluation goes beyond hands-on sessions in training rooms. Once you have narrowed your devices down to a short list, test them in the environments in which they will be used. Most clinical users move around a lot. Plan to have care team members in various roles use the devices in their everyday workflows to identify strengths and weaknesses.

Getting your mobile device strategy right is crucial in supporting nurse collaboration with care team members. Connect with one of our clinical communication specialists to talk current recommendations for your nurse devices and related strategies.

To explore how an integrated clinical communication and collaboration (CC&C) solution can complete and enhance your device strategy, click below for a PerfectServe demo.

Resources:
1. Getting it right: 10-point checklist for mobile devices and testing in nursing, Becker’s Hospital Review, 2018: beckershospitalreview.com/quality/getting-it-right-10-point-checklist-for-mobile-devices-and-testing-in-nursing.html

Battle Resident Burnout With Better Scheduling

Battle Resident Burnout

Grueling work hours have long been a part of medical training. But growing conversations about resident burnout and well-being, in addition to the impact of unsustainable working hours on patient care, eventually led to a serious revaluation of resident working hours. In 2003, the Accreditation Council for Graduate Medical Education (ACGME) limited working hours for residents to 80 hours per week and no more than 24 consecutive hours.1

So, how can academic healthcare organizations meet the ACGME’s regulations and reduce burnout while providing exceptional practice experiences? Addressing the hours providers work in a given week is a great place to start. Scheduling can play a huge role in promoting resident satisfaction and well-being, which support high-quality patient care.

Five Ways Better Scheduling Can Improve Resident Satisfaction

  1. Ensuring Shift Equity and Sustainable Work Hours
  2. Increasing Schedule Transparency and Visibility
  3. Simplifying Shift Swapping and Time-Off Requests
  4. Sharing the Schedule in a Timely Fashion
  5. Helping Administrators Better Support Clinical Staff

1. Ensuring Shift Equity and Sustainable Work Hours

Set scheduling rules that limit weekly work hours and ensure fair shift distribution.

In academic medicine, meeting the 80-hour work week guidelines is even more difficult than it seems. A multitude of scheduling factors—including physicians’ teaching requirements, research duties, and clinical responsibilities—must be considered. As a result, it can be difficult to manually prioritize work limits and shift equity with other scheduling rules.

An advanced scheduling solution can easily accommodate for complex scheduling variables once rules are set to limit work hours and balance providers’ varying responsibilities. What’s more, the system should also have the ability to factor in things like providers’ preferences and ensure that certain shifts, like weekends, nights, and call, are distributed as evenly among providers as possible.

It’s a tall order, right? But essential. The right provider scheduling solution will simplify the schedule complexity required to improve outcomes for academic healthcare organizations. We dive deeper into the capabilities that different types of organizations should expect in our new guide, Choosing an Enterprise Scheduling Solution.

2. Increasing Schedule Transparency and Visibility

Increase schedule visibility and transparency by centralizing real-time schedules in a single location.

Creating schedules is one thing, but making sure providers can access the latest schedule is another issue altogether. Locating an up-to-date schedule can be a huge source of frustration for providers and it can also have a big impact on patient care. An advanced digital scheduling solution makes the latest schedules from across your organization accessible to providers at any time from any device at any location.

The ability to easily view the schedule across devices not only cuts down on frustration by making it simpler to view the schedule, find and contact the on-call provider, and communicate with colleagues, but it also increases transparency into how schedules are created. For example, if a resident goes on their mobile app to request Friday off and sees that two other team members have already requested that day off, it may be less surprising if the request is denied.

The reporting capabilities available in the scheduling platform should also promote transparency by allowing schedulers to share reports around shift equity, time off requests approval, and more.

3. Simplifying Shift Swapping and Time-Off Requests

Make the processes easy for swapping shifts and requesting time off.

The lack of a simple, standardized process for shift swapping and time-off requests can make it unnecessarily challenging to find the right person to take over a shift when needed. It can also lead residents to swap shifts without letting the proper administrators know, resulting in outdated, inaccurate schedules that delay communication and patient care.

Centralizing shift swapping, time-off requests, and other scheduling requests on a single digital scheduling platform puts the schedule back in provider hands, giving them more autonomy and control over how and when they are scheduled without leaving administrators in the dark.

4. Sharing the Schedule in a Timely Fashion

Quickly auto-generate gap-free schedules so residents can access next month’s schedule today.

Creating schedules can be incredibly time consuming, especially in academic settings. Schedulers often try to balance teaching, research, and patient care with organizational, departmental, and individual provider needs. Resulting time constraints mean that providers often receive their schedules at the last minute, making work-life balance nearly impossible.

An advanced scheduling solution can simplify schedule creation with rules built to meet each team’s unique needs. Different departments within an organization can then auto-generate gap-free schedules built to their specifications, which helps administrators complete and distribute schedules more quickly. Complete schedules are instantly available for care team members and administrators across the organization to access any time.

5. Helping Administrators Better Support Clinical Staff

Free up administrators’ time so they can better support the needs of clinical staff.

Administrators spend roughly 291 hours annually managing provider schedules. For academic facilities with more complex schedules, the number is likely far more. That’s valuable time administrators could spend to better supporting clinical staff.

Jessica Angerman, the Program Coordinator for the Boston Children’s Hospital and Boston Medical Center Combined Residency Program, says Optimized Scheduling powered by Lightning Bolt has created a better culture for residents and administrators alike.

“Our leadership team of program directors and associate program directors really like to foster a good culture between the admin team and leadership and the residents. Lightning Bolt has definitely helped us reach the residents in a more personal way. A lot of the times our administrative team doesn’t get to meet with them one-on-one because they’re so busy. It’s really given us that opportunity to understand where they are day-to-day and what their work includes, and they understand more of what our work includes.”

Jessica Angerman, Program Coordinator, Combined Residency Program, Boston Children’s Hospital and Boston Medical Center

Watch the full interview with Jessica to learn more.

Increase Resident and Care Team Satisfaction With Better Scheduling

To learn more about how we can support better scheduling at your organization, click below to contact a scheduling specialist.

 

Resources:
1. Duty Hours and Patient Safety, Agency for Healthcare Research and Quality, Patient Safety Network, Sept. 7, 2019: psnet.ahrq.gov/primer/duty-hours-and-patient-safety

Real-Time Data Entry for Better Patient Care

Real-Time Data Entry Header

It has always been recommended that charting take place as near to the care event as practical, with the key word being “practical.” In reality, clinicians and nurses often stay after shifts to do their charting because entry is not seamless during patient care.

The more time that passes between the health event and the data entry, the less detailed the data input becomes and the greater its risk of containing errors. Delayed data entry impacts patient outcomes and creates unnecessary administrative overhead.

Benefits of Real-Time Data Entry

“Real-time electronic data is a potential treasure trove of insights, which can be analysed to improve patient care and use nurses’ time more effectively.”
– Helen Glenister, Chief Operating Officer (COO) of The Learning Clinic1

Real-time data entry has been shown to improve patient care (particularly the identification of patients who may be deteriorating), free up more direct-care time for nurses and clinicians, and help hospitals better deploy staff and resources.

According to a study published in Nursing Times, the availability of up-to-date data can help nurses and clinicians spot patterns in data that indicate a patient is deteriorating or may have an infection.1 While some data points may automatically feed into the EHR, vital observational data from nurses and doctors are not automatically entered.

Timely electronic recording of all clinical data—including observations, assessments, and actions—gives the overall picture of a patient and provides a clear data trail in the event of a complaint or incident investigation. Real-time documentation and order entry during rounding also helps speed up care and minimize future interruptions.2

The benefits of real-time data entry are well known, but challenging to achieve in some hospitals.

Challenges to Real-Time Data Entry

Siloed technology systems, device mobility limitations, and logistical issues in some EHRs can be the biggest barriers to real-time charting.

“One nurse believes that since going live, EHRs have added 3 hours to a
12-hour shift.” – Laura A. Stokowski, RN, MS3

In order to chart data that is accurate, actionable, and timely, the care team must be supported with an integrated solution that allows for simplified real-time charting in the EHR/EMR.

How to Achieve Real-Time EHR Data Entry

Healthcare IT integration can be very complex, but the right technology can integrate disparate IT, clinical, telecom, and EMR/EHR systems to allow information to flow freely. The result is a cohesive, integrated communication ecosystem that ensures the right information is available at the right time to support quality patient-centered care.

An ideal solution will support real-time charting with:

  • Intelligent field mapping to reduce duplicate data entry.
  • Voice-to-text capability to speed up and simplify data entry.
  • An easy and elegant interface with all information available on a single platform; no switching between apps.
  • Easy transfer of clinical notes for rapid documentation.
  • Immediate delivery of critical lab and test results to the right clinician with date, time, recipient, delivery status, and read status auto-recorded to the EMR in accordance with Joint Commission requirements.

Next Steps for Getting Started

Explore how your team can combine real-time EHR data entry with seamless care coordination in one integrated solution by speaking with a clinical communication specialist.

 

Resources:
1. How real-time data can improve patient care, Nursing Times, Sep. 21, 2015: nursingtimes.net/clinical-archive/patient-safety/how-real-time-data-can-improve-patient-care-21-09-2015/
2. How Hospitalists Can Improve Efficiency on Inpatient Wards, The Hospitalist, Rajesh Chandra, MD, FHM, et. al., May 2014: the-hospitalist.org/hospitalist/article/126231/how-hospitalists-can-improve-efficiency-inpatient-wards
3. Electronic Nursing Documentation: Charting New Territory, Medscape, Sep. 12, 2013: medscape.com/viewarticle/810573

Rapid Critical Result Reporting With Clinical Communication Technology

Delays in communicating life-threatening lab or radiology results can lead to unnecessary patient transfers to higher levels of care and longer lengths of stay. In contrast, rapid and accurate communication of critical lab and radiology test results leads to timely clinical interventions, improved treatment outcomes, and prevention of comorbidities.

The Joint Commission’s National Patient Safety Goal 02.03.01 requires that organizations report critical results of tests and diagnostic procedures on a timely basis,1 yet some teams struggle to measure compliance and meet their goals. Even with the increasing number of high-tech tools available to hospitals, it’s not always easy for inpatient and outpatient laboratories to optimize critical value reporting due to several challenges.

For example, delays related to intermediaries and unavailability can affect reporting times. One of the most challenging aspects in an outpatient setting is the volume of unanswered pages and forgotten callbacks from providers, despite the fact that nearly 90% walk around with smartphones in their pockets.2 Compliance issues also tend to result from faulty processes in which the provider that ordered the test is no longer on call—a complication which, in an inpatient setting, requires the nurse to track down the correct covering provider.

To ensure that messages are received by providers that can immediately act upon the information, intelligent systems must be employed. Integration with modern clinical communication and collaboration (CC&C) technology helps organizations ensure that test results are immediately delivered to the appropriate bedside nurse, ordering physician, and/or covering on-call provider. A comprehensive solution will also escalate results within specific timeframes if necessary and document all communication for auditing purposes.

Ensuring Timeliness and Accuracy in the Notification Process

The challenge some organizations face with the timely delivery of test results is ensuring that the correct person is notified. First, the right recipient can be difficult to determine when dealing with an expansive care team and complicated on-call provider coverage. Then, delivery of results can be a challenge due to varying levels of EHR access and adoption, sometimes in addition to technical message transmission issues.

Finally, confirmation that the test results were received and action is being taken is needed to close the communication loop, but various factors can lead to a lack of response from the recipient, such as:

  • An error in reaching a provider who is available to immediately act on the information (e.g. the correct on-call provider, covering physician, assigned nurse, or care team member).
  • Sending a message via EHR to an affiliated provider who does not access the EHR outside the facility (and therefore does not see the message).
  • A delay in message delivery because the recipient is beyond the reach of the hospital’s Wi-Fi and/or cellular coverage.
  • Alarm fatigue and/or confusion caused by a multitude of alert sounds that bombard clinical staff throughout their day.

The right CC&C technology can be very effective for automating protocols like those related to critical result notification to bypass various obstacles.

3 Keys to Success With Your Critical Result Communication Program

1. Guarantee that the correct care team receives the alert.

Your CC&C solution should offer the ability to customize which care team members are notified of which clinical findings. For example, a critical potassium alert might always go to the nurse and the provider, while a critical BUN only alerts the nurse. To inform message routing and ensure the correct team members receive the alert, the solution must rely on comprehensive electronic on-call schedules that incorporate service line, group, and personal coverage details. If multiple scheduling tools are used across the organization, they all must be integrated to inform accurate message delivery.
Additionally, your CC&C technology should integrate with all care team systems that house patient assignments including the EHR, nurse call, ancillary department applications, etc. to ensure that the appropriate patient care team members are alerted to new clinical findings.

2. Ensure that physicians, nurses, and care team members can easily acknowledge, accept, and decline/escalate results.

The improved process will garner greater adoption if all recipients can easily respond to alerts by tapping a button (e.g. “Acknowledge,” “Accept,” or “Decline”/“Escalate”) or selecting a response from a dropdown menu (e.g. “I’m entering an order in the EHR now.”).
The workflow can be further streamlined if the CC&C solution facilitates quick access to the EHR through a link within the result message. Tight application integration enables staff to seamlessly move between applications and functions to access patient context.

3. Build escalation protocols to transmit the critical result to the next-level provider if a response is not received within a certain timeframe.

If a physician, nurse, or care team member is either unavailable (e.g. in a sterile procedure) or inaccessible (e.g. offline; out of Wi-Fi range or cell coverage), the ideal solution will automatically escalate the message to ensure a timely response.

Consistency, a Sign of Success

As your new critical result reporting process reduces workload for staff by automatically delivering results to the correct recipient, an advanced CC&C solution also removes variability caused by the human element. A fully integrated solution will eliminate staff inconsistencies related to reaction times, follow-up with non-responsive individuals, and documentation of event notifications.

Evaluating the Timeliness of Reporting

The Joint Commission’s National Patient Safety Goal for communication of critical results and diagnostic procedures specifies the need to evaluate the timeliness of reporting. In the quest for continuous quality improvement, your CC&C solution should provide real-time dashboards that display acknowledgement status for all critical results and rich reports with auditing capabilities for all critical value communications.

Time stamps and event logs allow organizations to set goals, measure performance against established criteria, identify patterns (e.g. day of week, time of day), and most importantly, support accountability across providers and clinical staff.

“We measured our response time to critical lab alerts across 1,100 results and achieved a 42% improvement in acknowledgment times. The fastest alert read was two seconds, the fastest acknowledgment was 7 seconds, and the median acknowledgment time was one minute, 23 seconds. We’re extremely pleased with the role CC&C has played in our ability to monitor and manage critical result notifications.”

– Robyn Townsend, Assistant Director, Clinical Applications, Hospital for Special Surgery

If you’d like to explore how PerfectServe can help improve your laboratory and diagnostic reporting processes, click below to request a call with a clinical communication specialist.

Resources:

  1. National Patient Safety Goals Effective January 2017: Laboratory Accreditation Program, The Joint Commission, 2017: jointcommission.org/assets/1/6/NPSG_Chapter_LAB_Jan2017.pdf
  2. The Dilemma Surrounding Critical Value Reporting: What Does it Take to Improve Communication? Malone, B., Clinical Laboratory News,2012: AACC.org/publications/cln/articles/2012/december/critical-value-reporting.aspx

Improve Healthcare Operations With Clinical Workforce Analytics

Scheduling-AnalyticsWith rising labor costs,1 growing expenses, falling EBITDA, and decreasing operating margins,2 healthcare organizations need new strategies for controlling costs and improving operational efficiency. While analytics are often used to inform strategic decision making such as supply chain management, some healthcare organizations are missing the opportunity to use analytics to maximize their most important resource: their clinical workforce.

Let’s explore how an advanced provider scheduling solution can deliver analytics that play an essential role in improving healthcare operations.

Four Ways Workforce Analytics Improve Operations

  1. Reduce waste by adjusting staff levels to meet trends in patient demand.
  2. Ensure patient access and minimize leakage by maximizing clinical capacity across locations.
  3. Improve provider retention by increasing work-life balance and schedule autonomy.
  4. Optimize clinical staffing models to enhance productivity.

1. Reduce Wasted Resources

Advanced scheduling analytics allow your organization to identify trends in patient demand and service utilization across locations and departments to adjust staffing levels over time. You can analyze demand for specific services, determine the number of clinicians needed to deliver those services for a given timeframe, and reduce staff and labor costs when patient demand tends to be lower. Here is an example:

The Chief of Surgery wants to better understand seasonal trends in patient demand for elective surgeries. He runs a report and finds that case numbers are much lower during January and February. With granular insights into provider supply and patient demand, he is able to project exactly how many surgeons are needed during each shift. He asks the department scheduler to reduce staffing levels for January and February.

2. Ensure Patient Access

After using analytics to identify trends in patient demand, you can respond to rising demand by proactively increasing staff levels to improve patient access and increase revenue. For example:

The Emergency Department’s Medical Director runs a report and finds that during the summer months, the need for pediatric emergency care greatly increases. Currently, the team only staffs a single pediatric emergency physician. The Medical Director contacts the department scheduler and requests for a pediatric advanced practice provider to be added to the schedule for June through August.

In the example above, the ED has both increased patient access to pediatric emergency care and increased clinical capacity—helping the department generate more revenue based on a particularly common type of service for the specific timeframe.

3. Improve Provider Retention

A key approach to cost reduction is to improve provider retention. Replacing a single physician can cost anywhere from $500,000 up to $1 million, according to the American Medical Association (AMA).3 That means focusing on provider satisfaction and retention could save your organization hundreds of thousands of dollars.

According to the 2020 Medscape National Physician Burnout & Suicide Report, spending too many hours at work is a key contributor to provider burnout.4 But what is the definition of “too many hours” and how can you help prevent provider schedules from reaching the threshold?

Scheduling analytics help ensure that certain shifts, like weekends and call, are evenly distributed across a team of providers. You can also share reports with your team that show even shift distribution to eliminate any possible suspicion of unfairness, which may not completely eliminate the issue of spending too many hours at work, but it helps address a source of provider dissatisfaction.

4. Optimize Staffing Models

Not all providers and care team members are alike. Some prefer to work more than others, some practice part-time, and they each vary in their preferences and productivity levels, making it challenging to optimize staffing models by specialization and availability alone. Advanced reporting provides the detail needed to enhance your organization’s staffing models for productivity.

Over time, you can note which providers are more productive during specific shift times to create rules that schedule individual providers for their most productive shifts as needed. You can also review the larger impact of certain staffing models on productivity and adjust your scheduling rules on a macro level. Without scheduling analytics, this type of insight and optimization is nearly impossible. With the evolving demands and expectations in healthcare, it is also essential.

Interested in improving operations, reducing labor costs, and increasing patient and provider satisfaction with better clinical scheduling?

Learn more about the clinical workforce analytics available in our Optimized Provider Scheduling solution and how they can enhance your organization’s operations.

Resources:

  1. Labor Management Trends, Healthcare Financial Management Association, Navigant, Aug. 2018: guidehouse.com/-/media/www/site/insights/healthcare/2018/navigant-hfma-2018-labor-pulse-survey.pdf
  2. Hospital profitability withers in November as volumes, revenues lag, Becker’s Healthcare, Morgan Haefner, Becker’s Healthcare Review, Jan. 2, 2020: beckershospitalreview.com/finance/hospital-profitability-withers-in-november-as-volume-revenues-lag.html
  3. At Stanford, physician burnout costs at least $7.75 million a year, American Medical Association, Sara Berg, American Medical Association, Nov. 17, 2017: ama-assn.org/practice-management/physician-health/stanfordphysician-burnout-costs-least-775-million-year
  4. Medscape National Physician Burnout & Suicide Report 2020: The Generational Divide, Medscape, January 15, 2020: medscape.com/slideshow/2020-lifestyle-burnout-6012460 – 5

The Power of Provider Schedule Visibility

Provider schedule visibility—or lack thereof—has broad impacts on various aspects of patient care. Two top areas that can be improved by making schedules more visible are patient safety and provider satisfaction.

Patient Safety

A review from the Joint Commission reveals that communication failures are at the root of over 70% of sentinel events.1 Often, lapses in clinical communication are caused by the inability of care team members to locate and contact the correct provider, a problem exacerbated by siloed and outdated scheduling systems. If different department call schedules are accessed in different locations across the organization and providers are expected to go through different processes for each department, dangerous delays in communication are inevitable.

A study by the Agency for Healthcare Research and Quality refers to the time care team members spend attempting—but failing—to contact the correct provider as “problematic time.” According to the study, many communication events include time spent searching for information, identifying the appropriate provider, or searching for accurate contact information.

On average, problematic time consisted of 10-40% of total communication time.1 To eliminate problematic time, schedules must make it easy to quickly locate and contact the correct provider.

“To be able to see who is the surgeon that’s going to be taking this case, who’s the radiologist on call, who’s the infectious disease provider on call—all at a glance—that just has huge value to an organization for patient safety and workflow efficiency.”

– Dr. Corey Joekel, Chief Medical Information Officer, Children’s Hospital & Medical Center Omaha, Optimized Provider Scheduling Client

Smart organizations improve speed to care and reduce medical errors with one digital scheduling solution that offers the latest schedules and provider contact information for all departments at the touch of a button. An accessible solution also integrates real-time schedules with other essential systems, like the EHR, call center software, and clinical communication and collaboration (CC&C) solutions.

Modern provider schedules that are centralized, easily visible, and always up to date make connecting with the right provider much quicker and easier, eliminating delays and streamlining patient care.

Provider Satisfaction

Inefficient and varying processes for locating the on-call provider can be a huge source of dissatisfaction for physicians, care team members, and administrators, contributing to increased turnover.1 A lack of schedule transparency is a frustrating issue that inhibits your staff’s perception of shift fairness, impedes their ability to collaborate quickly, and brings down their overall satisfaction at work. It’s easy to understand why…

A provider who cannot access a full view of the schedule is more likely to get the misconception that a coworker is getting “better” shifts than one who can easily pull up the full team schedule. Perceived unfairness leads to frustration, friction, and dissatisfaction. As provider dissatisfaction spreads, schedulers become overwhelmed with schedule complaints and shift change requests. In the absence of a scheduling solution that is easy to access, edit, and share, schedule changes increasingly pull schedulers away from other important tasks.

The vicious cycle repeats itself in teams that lack schedule visibility, leading to burnout and turnover.

With the cost to replace a physician ranging from $500,000-1 million2, healthcare organizations stand to lose thousands, even millions, of dollars annually in turnover.

Investing in better provider scheduling can save big money in the long run.

Better Scheduling Transparency Improves Healthcare

Ensuring provider shift and on-call schedules are easily accessible across your organization can dramatically increase both patient safety and provider satisfaction by improving healthcare operations.

Want proof? Optimized Provider Scheduling powered by Lightning Bolt helped UK Healthcare’s Hospitalist Department decrease the time to contact the on-call provider by 86.5%.

Contact one of our Clinical Scheduling Specialists today to learn how Optimized Provider Scheduling can drive results for your organization.

Resources:

  1. Improving Patient Safety Through Provider Communication Strategy Enhancements, Agency for Healthcare Research and Quality, Dingley C., et al., Advances in Patient Safety: New Directions and Alternative Approaches – Vol. 3, Aug. 2008: ncbi.nlm.nih.gov/books/NBK43663/
  2. Please don’t go: ways to reduce physician turnover, Medical Group Management Association (MGMA), Sep. 20, 2018: mgma.com/data/data-stories/please-don-t-go-ways-to-reduce-physician-turnover#:~:text=According%20to%20Christine%20Sinsky%2C%20MD,costs%20by%20reducing%20physician%20turnover