Clinical Collaboration Systems for Hospitals—Complete Guide

Collaboration SystemsClinical communication and collaboration are critical to a healthcare organization’s delivery of effective patient-centered care. But for healthcare leaders looking to make a tangible impact on key performance metrics, terms like “clinical collaboration” and “care team communication” can feel a bit abstract.

Some may question:

What’s the best way to improve care team communication? Is it as simple as HIPAA-compliant text messaging? Is there more to “clinical collaboration” than juggling workarounds and niche vendors?

Whether you’d like to understand the effect that communication can have on patient care and clinician satisfaction, you’re trying to choose the best clinical communication app, or you just need to know where to focus first, this guide can help.

Index

Impact of Communication in Healthcare | Improving Communication and Patient Safety | Top Digital Solutions | Choosing the Right Solutions | Infographic: 8-Step Overhaul Checklist | Future of Technology in Healthcare

What is the impact of communication in healthcare?

80% of all medical errors involve miscommunication.1

Healthcare communication, sometimes known as clinical communication and collaboration (CC&C), is one of the most essential—and deceptively complex—aspects of patient care. The quality and speed of patient care delivery rely on the care team’s ability to communicate critical information accurately and rapidly.

Yet 14% of messages go to the wrong clinician at the wrong time.2

Poor communication is a key contributor to:

  • Medical Errors
  • Care Delays
  • Declining Patient Satisfaction
  • Increasing Provider Burnout

Patient expectations, which are critical in shaping their experience with healthcare organizations, continue to evolve in the age of value-based care. Mistakes, care delays, confusion, and frustration among care teams impact patient outcomes and are now reflected in HCAHPS scores and CMS reimbursements.

Joining patient satisfaction is the priority of provider satisfaction and its impact on burnout and turnover. Recently, pandemic-related surges in patient demand and declining resource availability have made care coordination more exhausting, making smooth collaboration more essential in combatting burnout.

Improving Clinical Communication and Patient Safety

Hospitals and health systems looking to improve clinical communication and patient safety should start by taking an honest look at the workflows and potential gaps that exist within and across your organization’s various roles and departments.

Where are your opportunities for improvement? Think about answers to the following questions.

Accelerating Speed to Care

  • Does communication at your organization always reach the right provider in a timely manner?
  • Could your teams accelerate speed to care by reducing the number of steps in the existing communication workflows?

Eliminating extra steps reduced UT Medical Center’s time to initiate clinical communication by 76.3%.

Reducing Provider Interruptions

  • Do physicians get nonurgent interruptions during patient encounters, surgery, or other critical moments while administering care?
  • Do your providers have the ability to “unplug” and recharge during their time off to help prevent burnout, or do they get interrupted with misdirected communication?

Burned out physicians are 2x as likely to be involved in patient safety accidents.

Enhancing Patient and Family Communication

  • Do you provide appointment reminders or virtual check-in to support patient safety and satisfaction?
  • Can nurses easily and securely communicate with patients and update their family members?

Texting patients helped Park Nicollet reduce patient readmissions by 32% and cut nurse phone calls by 25%.

If you answered “No” to any of the questions above, you have identified an opportunity for improvement. Fortunately, healthcare technology has come a long way in a short period of time, and it is easier than ever to replace siloed tools and systems with integrated clinical collaboration solutions.

What are the top digital solutions for clinical communication?

The simplest answer is: It depends. There are various clinical collaboration tools that exist to serve specific purposes. Since each health system, hospital, and even department has unique needs, the best choice is to work with a solution that offers broad integration capabilities. Select a vendor that operates as a care delivery partner and has the agility to evolve with your organization’s needs over time.

Identifying the right clinical collaboration system for your organization will require collaboration among your internal leadership if you hope to minimize your vendor footprint, avoid creating more silos, and maximize ROI.

How to Choose the Right Clinical Communication Software

Sometimes for hospitals and health systems, the hardest part about improving clinical communication and patient safety is figuring out where to start. To help, we created a checklist infographic summarizing the eight steps to a strategic clinical communication upgrade outlined by Julie Mills, DNP, MBA, RNC-OB, C-EFM, Sr. Director of Clinical Solutions at PerfectServe.3

8 Steps to a Clinical Communication Upgrade

  1. Create a multidisciplinary decision-making team.
  2. Calculate the financial impact.
  3. Start your list of requirements with HIPAA compliance.
  4. Recodify time-tested policies.
  5. Pilot while priming physician buy-in.
  6. Work through communication workflows.
  7. Choose your hardware.
  8. Create a closed loop for continual improvement.

Want more detailed information about completing each step to shape your clinical communication strategy? Download our clinical communication checklist.

What is the future of technology in healthcare?

Technology will continue to provide new and better ways to support healthcare processes, streamline clinical communication, and enhance patient safety. That’s why it is important to be selective when considering new vendors and systems. The right choices can unify and simplify care team collaboration, but the wrong choices could add silos, waste resources, and impede patient-centered care.

Prioritize integration and look for solutions that unify as many workflows as possible—clinical communication, provider scheduling, patient communication, patient family updates—into one user-friendly platform accessible from anywhere on any device.

Sources

  1. Joint Commission Center for Transforming Healthcare Releases Targeted Solutions Tool for Hand-Off Communication, Aug. 2012: jointcommission.org
  2. Paging Dr. Right, ACP Hospitalist, Stacey Butterfield, May 2012: acphospitalist.org/archives/2012/05/success.htm
  3. Checklist for a successful clinical communication overhaul, Nursing Management, Mills, Julie MBA, RNC-OB, C-EFM, Vol. 52, Issue 1, p. 10-13, Jan. 2021: journals.lww.com/nursingmanagement/Fulltext/2021/01000/Checklist_for_a_successful_clinical_communication.4.aspx#

Partnering With Our Customers to Accelerate Speed to Care

Covid Year in Review

The past 12 months have been difficult in more ways than we can count. But, while we lament the struggles and mourn the hundreds of thousands of lives lost in the United States, we can also take stock of the victories, accomplishments, innovations, and breakthroughs achieved in the age of COVID-19. We can even appreciate some of the ways healthcare has changed for the better.

To quote our Chief Clinical Officer Kelly Conklin, who spent 20 years as a trauma and ER nurse, “These ‘unprecedented times,’ challenging and sad though they’ve been, are the impetus for a lot of promising change in the world of healthcare, and I’m optimistic that the ‘new normal’ is going to be a friendlier, more convenient, and more modern experience.”

COVID-19 Demanded a Flexible Response

At PerfectServe, our COVID experience has been focused on supporting the hundreds of healthcare organizations that use our technology every day. Infectious disease doesn’t ask permission to spread, so deploying PerfectServe’s technology quickly and effectively has been key to our efforts. We started with an offer of free software and services for customers. As time went on, use cases became more varied.

Initial Wave in March 2020

  • Supported curbside testing coordination.
  • Built a new platform to enable hospitals on lockdown to communicate with patients’ family members from the core PerfectServe system.
  • Facilitated news, announcements, and other mass communication for employee and clinician alignment on treatments, procedures, and protocols. (Core communication traffic increased by 400%.)

Mid-Pandemic

  • Reduced infection risk for clinicians by allowing them to use their mobile devices to round on less acute COVID patients.
  • Enabled quick and app-less telehealth visits as clinics remained closed.
  • Offered a Rapid Surge Scheduling solution to help organizations easily build and update provider schedules as available staff, patient load, and even hospital facilities changed rapidly.

Reopening

  • Enabled a virtual waiting room capability to help clinics adhere to safety protocols as certain facilities reopened

Vaccine Rollout

  • Facilitated the communication of vaccine procedures and distribution of information within clinical care teams.
  • Currently leveraging Lightning Bolt’s Access Optimization capability to build optimized provider schedules based on time taken to vaccinate patients—using average vaccination throughput as a driver for provider schedule creation.

The growing list of new use cases reflects how PerfectServe has embraced the agility required to be an effective technology partner for healthcare organizations. To echo Sachin Jain’s recent column for Forbes, Change does not have to be slow, plodding, and hyper-rational. At the height of the COVID-19 crisis, healthcare organizations showed remarkable agility because the situation demanded it.”

We know how important communication and coordination are for care delivery, and we’ve delivered solutions that meet the needs of a once-in-a-century moment.

  • Pull together a team to launch a new patient communication platform in a few weeks?
    We can do that.
  • Rethink our implementation protocols to execute a virtual multi-site go-live for a large health system?
    We can do that too.
  • Launch an easy-to-use, fast-to-deploy video visit platform that enables providers to reach more of their patient population while in-person visits are discouraged?
    We’re on it—and we’ll do it quickly.

A couple of customers shared some thoughts about the support PerfectServe provided as their organizations ramped up COVID-19 response efforts:

“When COVID hit, we had to look for alternative virtual solutions in an attempt to connect with all of our patients. PerfectServe was able to quickly help us stand up their video platform to assist in certain situations. They were able to understand and meet our patients’ needs.”

– Andrew Bradford, Director of Virtual Health, St. Elizabeth Physicians

“As far as COVID support from PerfectServe, implementing the Lightning Bolt Rapid Surge Scheduling solution was a very simple process. I was able to add and change assignments as needed, which I have always been able to do, but the most helpful was when we had to add more support personnel on the fly. Having that flexible scheduling capability was critical during such an uncertain time, and the whole PerfectServe team was a huge help.”

– Sandee Leslie, Practice Program Coordinator, St. Luke’s Health System (Nampa and Meridian Medical Centers)

Amplifying Diverse Voices

2020 challenged companies to think differently in many ways. We’ve been reminded time and time again that recognizing and amplifying diverse voices makes a business stronger, wiser, and more inclusive. PerfectServe’s Diversity & Inclusion (DE&I) Advisory Council led the charge to adopt a revamped diversity charter for the company, and a simple but powerful new motto permeates all DE&I efforts:

“Different is Perfect.”

PerfectServe works with hospitals and practices in every corner of the country, and we want our team members to reflect the diversity of thought, background, and experience that we see in our customers—and our customers’ patients—every single day. This work never ends, and our CEO, Guillaume Castel, constantly emphasizes the egalitarian nature of healthcare:

“No matter who you are, where you come from, what you believe, or what you look like, we all need care at some point in our lives.”

– Guillaume Castel, Chief Executive Officer, PerfectServe

Healthcare affects everyone, and that means everyone should have a seat at the table.

To recap, a lot has been learned in the last year:

  • We listened closely to customers so we could address their most pressing needs with our solutions—and we created new solutions along the way.
  • We tweaked, reworked, and updated processes to get work done more efficiently than ever in a virtual environment.
  • We found new ways to reinforce a company culture that starts with inclusivity and committed to growing on that momentum.
  • We saw real life in stark relief as Zoom calls were graced with—not interrupted by—pets, family members, friends, and everything in between.

More than 100 million COVID vaccine doses have now been administered in the United States, and as a glimmer of normalcy looms on the horizon, rest assured that PerfectServe will emerge from the pandemic with clarity of purpose and a steadfast commitment to customers: With our technology and the talented employees who make our company tick, we will continue to accelerate speed to care by making collaboration more intuitive, scheduling more optimized, and communication more effective.

Would you like to learn more about how we can help your organization thrive with better communication, scheduling, and/or collaboration?

Radiology Productivity: Beyond the RVU

Radiology Productivity

The workload of US radiologists has increased over the past two decades.1 Unfortunately, the number of new radiologists entering the field hasn’t grown to match demand. The shortage of radiologists and increasing demand for imaging services make measuring radiologist productivity more important than ever. Explore why current productivity standards for radiology departments and groups might be missing the mark and how a digital scheduling solution can double as a radiology productivity software.

Radiology Productivity Metrics: Is the RVU enough?

Many radiology practices and departments measure productivity using Relative Value Units (RVUs), but the RVU system has known limitations.2 Compared to other services, interventional procedures are somewhat undervalued while MRI services are given a higher value.

In addition to the issues inherent in the RVU scale, other factors including scheduling can impact a group’s ability to accurately measure productivity. For example, a physician working during a weekend shift may generate fewer RVUs than generated on a regular day shift. Unless your team equally distributes holidays, weekends, and other shifts, RVUs can’t reliably measure radiologist productivity.

RVUs also fail to provide insight into all the work providers are doing. Time spent on continuing education, professional development, teaching, and research are all valuable to your organization, but are not reflected in RVUs. Radiologists are increasingly required to spend more time on administrative tasks—which means they read fewer films and spend less time on patient care. Long story short: RVU metrics can not tell us how much work physicians are doing.

A Better Way to Track Radiology Productivity Benchmarks

If your organization is manually scheduling providers, you know that human error can impede your ability to see the number and types of shifts your providers are working. With a digital scheduling platform, your organization can automate the scheduling process and gain an accurate picture of your providers’ workloads. Digital scheduling gives you access to a lot of data that can streamline operational efficiency to effectively serve as radiology productivity software for your group.

Auto-Generate Radiology Schedules That Ensure Even Shift Distribution

Creating shift schedules that ensure full sub-specialty coverage, meet patient demand for different diagnostic imaging types, and distribute shifts evenly among providers is complex if tackled manually. But it is the first step to gaining better insight into the productivity of your providers. Without even shift distribution, you can’t be certain the data accurately reflects productivity.

“We can really coordinate what’s happening within our facilities, where our resources are going.”

– Jim Clabo, Director Systems and Scheduling Administration, Northwest Permanente

An advanced rules-based scheduling solution can automatically distribute your shifts evenly. You simply create highly customizable rules designed to schedule providers across subspecialties and locations in a way that is fair and equitable, and then, auto-generate the schedule.

Tag Shifts by Type of Work or Diagnostic Imaging Type

Once you’ve created the schedule, you can tag various shift assignments by type of work. For example, tag shifts for specialty imaging like neurology, breast imaging, pediatrics, and ultrasound. Plus, tag shifts for non-clinical time, including administrative work, continuing education, teaching, and research.

Tagged shifts reflect the type of work providers are doing, so you can generate granular reports about their type of work, when they are scheduled, and where each shift takes place.

Streamline Value Management and Resource Utilization

Your organization can take value management a step further to gain insight into resource utilization. Many clients use our scheduling solution to track exam room and OR utilization. The same can be done for imaging equipment. Assign radiologists and radiology technologists to specific equipment to identify inefficiencies and opportunities to increase revenue.

By scheduling providers with certain equipment and rooms, you can see which equipment may be underutilized and when. Capitalize on those opportunities by scheduling additional providers at specific times. Alternatively, you can see when equipment is in high demand and schedule faster readers during peak times to increase capacity.

Increase Radiology Productivity With a Radiology Scheduling Software

An advanced scheduling solution can help your organization streamline processes and gain better insights into your operations. Save time by streamlining complicated scheduling processes and access advanced workforce analytics that reveal actual value versus perceived value. Maximize productivity and value management with a clear picture of when your resources are and are not being utilized.

Hear from our customers at Northwest Permanente, who currently use Optimized Provider Scheduling powered by Lightning Bolt to streamline value management across the organization. The Permanente Medicine team uses our solution to schedule providers directly into exam rooms and operating rooms.

See How It Works

 

Resources:
1. Radiologists’ Variation of Time to Read Across Different Procedure Types, Society of Imaging Informatics in Medicine, Daniel Forsberg, Beverly Rospiko, and Jeffrey L. Sunshine, Journal of Digital Imaging– Vol. 30 (1), 86-94, 2017: https://doi.org/10.1007/s10278-016-9911-z
2. Leveraging the electronic health record to evaluate the validity of the current RVU system for radiologists, Elsevier Inc., Ronnie Sebro, Clinical Imaging, 2021: doi.org/10.1016/j.clinimag.2021.02.007

Coordinating COVID-19 Vaccination:
3 Essential Elements

Covid Vaccination Coordination

COVID-19 has transformed healthcare indefinitely and forced agility from care teams at every turn. Vaccination efforts are no exception. Healthcare organizations across America are in the midst of a massive, frazzled effort to coordinate hundreds of millions of COVID-19 vaccinations.

As demand peaks for information around vaccine eligibility, availability, and distribution, healthcare organizations should be proactively educating patients and providers to help combat misinformation and build confidence in the vaccination process. Effective communication is critical between healthcare organizations, staff, and patients to support compliance with public health guidance.

Unfortunately, some organizations simply haven’t had the resources to plan ahead for the number of logistical variables impacting vaccine communication and coordination. We want to help by summarizing the challenges and solutions of three essential elements of vaccination coordination:

  1. Patient Communication
  2. Provider Communication
  3. Resource Allocation

1. Patient Communication

Challenges: Trust, Compliance, and Safety; Combatting Misinformation

To build trust and increase compliance among patients, organizations must communicate and provide real educational material to counteract misinformation such as social media myths.1 Managing expectations and helping patients assess their relative risks in context are challenges that only get harder as myths and disinformation spread online.

Solution: Rapidly Educate, Remind, Triage, and Follow Up

A 2020 population survey of US adults found that individuals were more likely to accept a COVID-19 vaccine if they thought their healthcare provider would recommend vaccination.2

Build trust and patient satisfaction by distributing educational material to patients on their most preferred communication device—their cell phone. The right patient engagement solution will offer HIPAA-compliant video, voice, and text messaging that empowers you to:

  • Reach out to patients about vaccine availability and location.
  • Send timely appointment updates and confirmation.
  • Provide guidance on preparation, wayfinding, and check in.
  • Track confirmations, cancellations, and who is running late.
  • Instantly broadcast changes in supply, location, or procedure to the patient population.
  • Create a triage pathway for patients who have questions, complications, or adverse effects from the vaccination.
  • Provide automated reminders to support second dosage compliance. For example:
  • Clients are using PerfectServe’s Patient and Family Communication solution to send patients reminders of their second dose date with simple scheduling instructions.

2. Provider Communication

Challenges: New and Evolving Processes; Accommodating Patient Demand and Follow-Up Needs

Surging patient demand and shifting vaccine supply make it difficult to coordinate staff and ensure the right providers can be reached at the right time. Organizations must keep providers educated, up to date, and prepared to answer patient questions. It is also up to organizations to facilitate rapid follow-up to patient questions and concerns post-vaccination.

Solution: Dynamic Communication, Smart Routing, and Instant Updates in One App

Communication should make it easy for providers to understand the process of the vaccine rollout and answer specific technical questions.3

The same communication solution that addresses your patient needs should also support seamless coordination between clinical and operational staff in an environment of surging demand and dynamic vaccine availability. Look for a solution that lets you:

  • Share educational material with staff via news bulletins.
  • Update care teams about locations, procedures, and supplies.
  • Instantly communicate changes to staffing and site plans across your organization.
  • Facilitate real-time responses from providers to address patient issues associated with vaccine complications. For example:
  • One hospital has implemented an “Adverse Vaccine Reaction Hotline” that care team members can access via PerfectServe web or phone number. Three different providers rotate through the hotline service so the case load is spread evenly.

3. Resource Allocation

Challenges: Balancing Staff Distribution With Changes in Vaccine Demand and Supply

One of the most difficult and important resources to coordinate is your staff. Balancing staff vaccination with provider shift schedules to adequately support patient vaccination will be increasingly challenging. Adjusting provider schedules manually during chaotic surges in supply and demand across locations could become a nightmare.

Solution: Optimized Provider Scheduling With Real-Time Update Distribution

“A world safe from vaccine preventable diseases requires well-functioning human resources within a supportive environment.” – World Health Organization4

Automate the schedule-building process with a solution that can adapt to shifting variables—such as temporary vaccination sites and changes in vaccine supply—and update your staff in real time. An ideal scheduling solution will:

  • Integrate with your communication solution.
  • Provide easy access via smartphone app.
  • Serve as a provider scheduling source of truth that stays up to date in real time.
  • Simplify shift swaps and time-off requests for providers to help reduce burnout
  • Accommodate unique needs with customization for your organization. For example:
  • Optimized Provider Scheduling powered by Lightning Bolt is helping organizations meet fluctuating staff needs during COVID-19 surges by automatically generating balanced schedules to include new and redeployed staff across existing and temporary locations.

Streamlining Vaccination Coordination

COVID-19 vaccination presents healthcare organizations with several challenges exacerbated by many shifting variables. Don’t leave your teams fumbling to keep up. Leading organizations are overcoming vaccine-related communication and resource challenges with comprehensive collaboration solutions that solve as many challenges as possible with one streamlined, user-friendly interface.

See how integrated solutions can support your COVID-19 vaccination coordination.

Demo PerfectServe

Resources:
1. Effects of fact-checking social media vaccine misinformation on attitudes toward vaccines, J. Zhang et al., ScienceDirect, Preventive Medicine – Volume 145, Apr. 2021: sciencedirect.com/science/article/abs/pii/S0091743520304394?dgcid=author
2. Acceptability of a COVID-19 vaccine among adults in the United States: How many people would get vaccinated? P. Reiter et al., Vaccine – Volume 38, Issue 42, Sep. 29, 2020: sciencedirect.com/science/article/pii/S0264410X20310847
3. Communicating about the COVID-19 Vaccines: Guidance and Sample Messages for Public Health Practitioners, Public Health Institute, Dec. 10, 2020: phi.org/thought-leadership/communicating-about-the-covid-19-vaccines-guidance-and-sample-messages-for-public-health-practitioners
4. Immunizations, Vaccines and Biologicals – Workforce, World Health Organization: who.int/immunization/programmes_systems/workforce/en

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

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