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

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

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

Optimized Scheduling Drives Hospitalist Satisfaction

31% of hospitalists are not satisfied with their schedules.

Today’s Hospitalist 2019 Career & Compensation Survey reveals that hospitalists are unsatisfied with their schedules, citing a lack of flexibility, inability to take vacation, and inequitable distributions of shifts like weekend and call.1 Other top complaints included burnout, administrative tasks, and an overwhelming patient census.

One root cause of these issues? Ineffective provider scheduling.

Learn how optimized scheduling can increase hospitalist satisfaction at your organization by incorporating provider preferences, simplifying scheduling workflows, and aligning provider supply with patient demand. Click the image below to download the infographic.

To learn more about how PerfectServe can support better hospitalist scheduling at your organization, click below to contact one of our Scheduling Specialists.

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Resources:
1. Today’s Hospitalist 2019 Career & Compensation Survey: todayshospitalist.com/salary-survey-results/

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How Virtual Waiting Rooms Protect Patients, Staff, and Productivity

How Virtual Waiting Rooms Protect Patients, Staff, and Productivity

A traditional waiting room can be a melting pot for germs and bacteria. Learn how a virtual waiting room protects patients and staff by reducing their risk of exposure to infection. Possible side effects: more pleasant patient-provider encounters, increased patient and provider satisfaction, better adherence to social distancing best practices, and improved overall outcomes.

May 2020, 90% of patients globally reported that the quality of care was as good or better with the recent surge in virtual care than care quality before COVID-19.1

What is a “virtual waiting room”?

If you’ve been out to eat at a restaurant in the past few years, you may have noticed a change in the experience of waiting for a table. Rather than asking you to stay within earshot while you wait, today’s hostess will likely request your cell phone number and offer to text you when your table is ready.

The text-to-table process makes the entire experience feel more personal, comfortable, and customer-centric. That’s because waiting is less unpleasant when you are free to do what you want—where you want—until the moment your turn arrives. Now, the same experience has become essential in healthcare to minimize patient discomfort and protect public safety with social distancing.

A virtual waiting room (aka mobile waiting room, zero-contact waiting room, or curbside check-in) is a service that allows patients to check in using their mobile phone and notifies them through a direct text message when it is their turn to be seen by the doctor.

An ideal virtual waiting room serves two essential purposes:

  1. Giving in-person patients the freedom to wait for their turn privately in their car or wherever they choose, rather than being confined to a stuffy, crowded waiting room and risking exposure to new germs and potential illness.
  2. Facilitating a smooth check-in process for telehealth visits.

Both purposes improve the patient experience and encourage healthy practices.

Why are virtual waiting rooms essential for in-person patient visits?

31% of patients say they are uncomfortable visiting a doctor’s office and 42% are uncomfortable visiting a hospital.2

Traditional waiting rooms that require patients to touch shared surfaces and breathe shared air are both uncomfortable and unsafe in the current environment. Virtual waiting rooms serve the important health purpose of enabling social distancing, and they also enhance the patient experience.

Unlike a traditional waiting room, a virtual waiting room reduces the risk of patients (and staff) associating your organization with frustrating factors beyond your control, which may include pesky sounds, smells, other people, and even boredom. As demand rises for a safer, more comfortable healthcare experience, virtual waiting rooms are the key to getting patients in the door while increasing their odds of leaving satisfied.

How can virtual waiting rooms apply to video visits?

Ideally, the same virtual solution used to help manage in-person patient visits can be adapted to also queue up video visits, allowing providers and patients to indicate when they are ready.

What’s the best way to implement a virtual waiting room?

In short, work with what you’ve got. If you have a patient engagement solution that can also facilitate a virtual waiting room and video visits, talk to your vendor about the next steps for launching a virtual waiting room.

If you do not have a solution for two-way texting or video visits with patients, or if you are looking for a replacement/upgrade to your current system, focus on finding a solution that can do the following:

  • Automated Appointment Reminders to Patients
  • Pre-Appointment and Pre-Arrival Instructions to Patients
  • Patient Arrival Notification via Simple Text
  • Entry Notification and Office Navigation Guidance
  • HIPAA-Compliant Video Connection
  • Scheduled and On-the-Fly Video Visits
  • Connect Without Requiring App Downloads or Passwords
  • Caller ID Protection for Providers
  • 24/7 Connection

Here’s a streamlined patient experience with an organization using all of the above capabilities:

Key Benefits of an Integrated Virtual Waiting Room

Virtual waiting rooms are extremely beneficial to patients, staff, and organizations that implement them, especially when they are integrated with other patient engagement solutions, such as video visits and HIPAA-compliant messaging.

Some of the top benefits include:

  • Patient Protection and Safety
  • Increased Patient Satisfaction
  • Reduced Frustration for Patients and Staff
  • Efficient Patient Intake
  • Reduced No-Shows

 

Get Started Now to See Benefits Sooner

Give your patients a safer, easier solution for maintaining their healthcare with a user-friendly, integrated virtual waiting room. To see how it works, click below.

Resources:

  1. Virtual care here to stay, PharmaTimes, Brad Michel, Jul. 21, 2020: pharmatimes.com/web_exclusives/Virtual_care_here_to_stay_1345204
  2. Breakdown of Changes in Consumers’ Health Care Behavior During COVID-19—INFOGRAPHIC, Alliance of Community Health Plans (ACHP), May 21, 2020: achp.org/research-breakdown-of-changes-in-consumers-health-care-behavior-during-covid-19

Engaging Millennial Parents to Increase Well-Child Visits

Scheduling well-child visits can be problematic for young parents. Many don’t know how often to bring in their children or understand the importance of regularly scheduled visits. Regular visits are particularly critical during the first three years of a child’s life to track growth and development, help prevent illness, and allow early intervention when necessary for optimal outcomes.

Text message reminders have become an expected touchpoint for dental appointments, vet visits, car maintenance, and various other services for today’s consumer. But some providers have been slow to engage parents via text to help keep their children on track with recommended care plans.

Millennials, who are accustomed to checking their text messages regularly throughout the day, respond positively to businesses that reach out to them via text. Young parents want the efficiency and convenience of smartphone messaging in most aspects of their lives, including appointment reminders.

See how Park Nicollet utilized PerfectServe’s Patient & Family Communication functionality to launch a text message appointment reminder program helping new parents more closely adhere to the recommended well-child visit schedule.

Constructing the Program

In 2016, Park Nicollet, part of HealthPartners, a nonprofit healthcare system based in Minnesota, launched a text-message-based reminder program to proactively support young parents in scheduling well-child visits from infancy to late childhood. The American Academy of Pediatrics (AAP) recommends six visits in the first 15 months (Health Plan Employers Data and Information Set [HEDIS] measure), which fits into the broad scope of 12 recommended well-child visits by age three.

To promote parents’ adherence to the advised schedule, our team set five goals aligned with best practices from AAP’s Bright Futures initiative:

  1. Keep children on time for well-child visits.
  2. Prevent missed visits and gaps in care.
  3. Improve the patient and parent experience.
  4. Support Bright Futures—recall and reminder system.
  5. Improve the HEDIS measure.

A program was launched using an algorithm based on birth dates to send text messages at appropriate intervals to parents of children aged two months to 36 months. Instead of waiting to reach out until after appointments were overdue, preemptive texts encouraged parents to schedule before the next well visit, offering a direct link for parents to easily schedule an appointment. The seamless and automatic process allowed Park Nicollet to reclaim precious staff time that was previously used to manage reminders.

Program Structure

Birth to Three Years

A SMS text message is sent to the child’s family or primary caregiver 30 days prior to the next well-child visit,
based on the child’s date of birth. Then, text reminders are only sent if an appointment is not scheduled in the appropriate timeframe.

Three to 10 Years

A text message is sent to the child’s family or primary caregiver two weeks prior to the next well-child visit, based on the date of the child’s last well-child visit. Then, a text reminder is only sent if an appointment is not scheduled in the appropriate timeframe.

Launching the Program

Launching the program with a small patient population (birth to three years) enabled Park Nicollet to see results quickly; early results showed that the text outreach was positive. Patient satisfaction increased among parents, who loved the ease and convenience of the program. Prior to the texting program, patients were seen an average of one month after their recommended well visit. Only three to six months after initiating the text reminder program, the one-month average gap was cut in half, meaning patients were seen closer to AAP recommendations.

Implementing the program on a smaller scale provided an opportunity to identify and address problems before expanding to the larger population. The biggest challenge involved parental consent and whether to design an opt-in or opt-out program. Park Nicollet defaulted to an opt-in program, requiring parents to provide consent to start receiving text reminders. Eventually, this obstacle overcome by training frontline staff to have parents sign consent forms, but the face-to-face process limited enrollment to the parents who were already making and keeping appointments.

Efficient enrollment and expansion required automation and updating of the electronic health record (EHR). Following the EHR integration, enrollment consent was captured in the EHR and parents didn’t need to be present in the office if they had consented to text messaging as their preferred appointment reminder.

With enterprise-wide expansion of PerfectServe’s Patient & Family Communication to all HealthPartners facilities in 2017, the automated process increased enrollment by over 35,000 and increased well-child visits by 10%. Based on the last reported 12-month period, enterprise-wide enrollment has over 79,000 active patients, which includes HealthPartners and Park Nicollet, and over 43,000 enrolled patients for Park Nicollet alone (see Table 1).

Table 1

Development and Expansion

With expansion of the program to Park Nicollet’s entire clinic care group in 2019, they began using text reminders for well visits for children up to age 10. Future initiatives with the program for Park Nicollet included incorporating additional languages (a sizable subset of HealthPartners patients is non-native-English speaking). In addition, increased enrollment of the millennial population presented opportunities to address various patient population needs—such as:

  • Reminders for flu vaccines and other immunizations.
  • Health metrics monitoring.
  • Checks for postpartum depression.

A Roadmap for Getting Started

Leveraging technology with a trusted and experienced partner enabled the team at Park Nicollet to create a program that worked for patients’ families. Following a digital roadmap, PerfectServe and Park Nicollet worked together to build reports derived from actionable, engaging, timely, and relevant data. Based on these insights, here are five recommendations for implementing a successful texting program:

  1. Partner with a solution that has proven expertise with EMR systems and experience providing reliable, secure communication to patients and their family.
  2. Engage a project champion to guide project design, implementation, effectiveness, expansion, and quality assurance.
  3. Assemble a multidisciplinary team—mobile communication technology partner, EMR vendor, physicians, quality improvement specialists, health information management (HIM), compliance and legal experts, growth strategists, and frontline managers—and solicit input from all stakeholders.
  4. Launch a scaled down program with a small population to identify and address problems before expanding to a larger patient population.
  5. Initiate the process with a mindset of patience. Avoid trying to implement the program hastily and without forethought. This endeavor demands careful preparation to ensure success.

PerfectServe’s Patient & Family Communication solution gives providers a simple and elegant way to engage directly with patients. From sharing directions to your office before an appointment to checking in with patients post-discharge, text messaging is a quick, effective, and easily automated way to stay connected with any patient population—most of all millennials.

Learn more about how PerfectServe supports patient-provider communication by contacting one of our Clinical Communication Specialists below.

Comprehensive Clinical Communication to Support Mother-Baby Care Delivery

Nearly four million babies are born per year in the United States.1 Obstetricians, pediatricians, nurses, case managers, discharge coordinators, and various other providers and care teams work to ensure that mothers and babies have optimal solutions for pregnancy, labor, delivery, and child healthcare.

From preconception to parenthood, PerfectServe’s comprehensive communication solutions can help your practice provide top-notch care at every touchpoint of mother and baby’s healthcare journey. Click the image below to download the infographic.

1Births and Natality, Centers for Disease Control and Prevention: cdc.gov/nchs/fastats/births.htm

To learn more about how PerfectServe can support your organization in mother-baby care delivery, contact one of our Clinical Communication Specialists.