Addressing clinical communications security with PerfectServe

Healthcare leaders are increasingly concerned about the security of clinical communications in their organizations. The enhanced HIPAA enforcement environment, a number of well-publicized breaches and settlements and a simultaneous increase in the use of asynchronous electronic communication in the clinical environment — specifically text messaging — have made the issue top-of-mind for many leaders. They are concerned about the potential dangers of the transmission of protected health information (PHI) without adequate safeguards; the risk of privacy and security breaches that may result in adverse legal and financial consequences; and the loss of patient trust and reputation in the marketplace.

The recent uptick in the use of text messaging for clinical communications has resulted in a greater focus on the security of text messages sent via mobile devices. While secure text messaging is an important aspect of clinical communications security, simply addressing the security of text messaging leaves organizations vulnerable to breaches in other modes of communication, such as voice messages and texts sent from mobile carrier websites, Web-based paging applications, call centers, answering services and hospital switchboards.

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Rapid team notification accelerates treatment at St. John Hospital

Stroke occurs frequently in the United States, with almost 800,000 people suffering a new or repeat stroke each year.1 It is a common cause of death in this country and a major cause of disability.

Timely treatment of acute ischemic stroke has been shown to significantly reduce disability and mortality.

In-hospital mortality was significantly lower among acute stroke patients who were treated with intravenous tissue plasminogen activator (tPA) within 60 minutes of ED arrival, compared with those who were treated after more than 60 minutes.

A recent study found no benefit to tPA when administered 4.5 hours or more after symptom onset; beyond this time point, the risks associated with the therapy may outweigh the potential benefits.

Current treatment recommendations emphasize the need for rapid evaluation and treatment of patients presenting with symptoms of acute stroke.
Joint American Heart Association/American Stroke Association guidelines call for interpretation of the CT scan within 45 minutes of ED arrival and treatment initiation within 60 minutes.

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Automating ED call schedules at St. Elizabeth Healthcare

Nowhere is the on-call schedule more challenging than in an Emergency Department. By definition, every case is an emergency. By necessity, the ED must be able to quickly reach the on-call physician in every service line. And within hours of any given day, the ED’s list of on-call doctors is likely to be out of date.

Now imagine five EDs, together treating more than 100,000 patients a year and needing to reach on-call doctors in more than 30 departments, each with
its own constantly changing call schedule.

That was the situation faced by St. Elizabeth Healthcare in Northern Kentucky. One of the oldest and largest medical providers in the Greater Cincinnati
region, St. Elizabeth Healthcare encompasses seven hospitals, 1,200 physicians with admitting privileges, nearly 100 primary care and specialty
office locations, three freestanding imaging centers, two ambulatory surgery centers—and five very busy Emergency Departments.

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Optimizing communication at San Jacinto Methodist Hospital

Chief executive officer Donna Gares and the leadership team at San Jacinto Methodist Hospital (SJMH) in Baytown, Texas, knew that something had to be done to make contacting physicians easier and more efficient. A member of the Houston-based Methodist Hospital System, the 275-bed community hospital was experiencing a challenge common to many hospitals and health systems.

As leaders looked to improve the continuity of care and clinical integration, they came face-to-face with a longtime complaint of clinical staff: communicating with physicians efficiently. On the verge of installing an updated information system, they believed the timing was right to address the issue.

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Using PerfectServe to enable secure, rapid clinical communications

A member of MemorialCare, Orange Coast Memorial Medical Center is a not-for-profit, 218-bed hospital located in Fountain Valley, CA. The organization serves the community with more than 12,000 hospital admissions and 23,000 visits annually. Both the hospital and the health system have a long history of focusing on quality and safety and were early adopters of an electronic medical record (EMR) system to improve clinical communications.

Although Orange Coast Memorial Medical Center had implemented lean management techniques for several years, leaders saw additional areas in which to remove excess waste, including the clinical communication process. As part of an ongoing commitment to performance improvement and reliability, leaders focused on improving clinical communication in two key realms: between nurses and physicians and between emergency department (ED) staff and physicians. The organization’s specific goals were to reduce variation in time to call back, reduce time wastage for “phone tag,” increase nurses’ time in direct care and improve nurse satisfaction.

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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 physician pages results in higher productivity, 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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Advocate Medical Group strengthens continuity of care

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.

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