How to Improve Patient Experiences and Reduce Healthcare Costs

Communication gaps can lead to negative outcomes for patients. When healthcare organizations consider the patient journey as a whole, they can reduce healthcare costs for both their clinics and patients. Fast, effective, and reliable communication often leads to a more seamless and positive care experience for both clinical staff and their patients.

A Patient Experience Story

A 57-year-old single patient named Nancy sees a new physician with complaints of painful breathing. The doctor finds adult-onset asthma to be the cause of her symptoms, prescribes an inhaler, and refers her to a free-standing imaging center for a chest X-ray.

As the day moves to night, Nancy feels her condition is worsening. She continues to have trouble breathing, and an unproductive cough develops. She calls her physician’s office after hours, but the office voicemail provides no guidance other than recommending the hospital emergency department (ED). Nancy is frantic and calls her daughter, who suggests she call 911. An ambulance arrives and rushes her to the nearest ED.

Nancy is triaged in the overcrowded ED and is put in a hallway. Her ED care team has no access to her primary care physician’s notes or the free-standing imaging report. The doctor orders a repeat X-ray and gives her another nebulizer treatment. Imaging is backed up, but after a delay, Nancy has the scan and returns to the hallway. As they wait for the results, Nancy’s condition deteriorates, and she begins spitting up blood.

The ED nurse makes multiple requests for the imaging results, and while they are waiting, the ED care team is pulled away to handle other priority patients. Meanwhile, Nancy’s daughter has been calling the ED to find out her mother’s condition, wondering whether it’s necessary to come in or not. Does her daughter make the two-hour drive to the hospital?

When the report finally arrives, the care team is not notified and only sees the results when they next open Nancy’s chart. Finally, the care team reviews the imaging results that reveal diffuse pulmonary nodules. The ED physician flags the asthma diagnosis as suspect and admits the patient for observation and additional blood tests. Nancy is now stuck in the hallway, waiting for an open bed. She is concerned, confused, and not sure what to do next.

Communication Breakdowns Increase Costs and Negatively Impact Patients

Care coordination gaps and delays similar to those experienced by Nancy are common. But the risk is higher when clinics fax reports, use pagers, or don’t have reliable processes for out-of-network communications.1

In the above case, lengthy and unpredictable communication cycles made it difficult for the ED care team and patient to make timely decisions, impacting both quality of care and patient safety. They led Nancy to call 911, followed by a potentially preventable ambulance ride, ED visit, and inpatient admission that all placed more demands on scarce—and costly—resources. With little to go on, the hospital team ordered duplicate tests, exposing Nancy to unnecessary excess radiation and duplicate treatment. Through the many delays, her condition worsened. The entire process was an unfortunate experience for the patient and her family—they’re anxious, tired, and frustrated.

Equipping patients and care teams with the right information at the right time—whether it’s about their diagnosis, the logistics of their treatment, resources available to them, or something else entirely—can improve the care experience and outcomes by removing as much confusion and ambiguity as possible.

Providers across the board struggle with the communication gaps that hindered Nancy’s care in the above story. With better communication solutions, these gaps can be mitigated, and the problems that providers and patients face can be avoided. The chart below highlights some of the gaps providers, patients, and patient families commonly face and how better solutions can alleviate their impact:

Clinical Communication Gap

The Right Tools Elevate The Patient Experience

PerfectServe’s clinical communication and patient engagement solutions are built to equip all members of the care team—including the patient and their family members or loved ones—with the right information at the right time to make the best care decisions. When you remove communication delays and other obstacles to allow for effective, efficient care delivery, you create a better experience for patients and providers alike.

With the introductory story mentioned above, how do you think the situation could be improved? Have you ever been in a similar situation? We always appreciate the chance to learn from firsthand experiences.

Schedule a demo to share your story and learn how PerfectServe might be the right fit for your organization’s needs.

 

1 Effects of Poor Communication in Healthcare. HIPAA Journal. https://www.hipaajournal.com/effects-of-poor-communication-in-healthcare/

How Team Based Care Works with Primary Care Patients

Team Based Care with a Patient and Multiple Specialists

Does your medical communication involve your patient’s other healthcare experts to provide team-based care? For various reasons, patients often seek treatment from different healthcare specialists, and you may not be aware of all of them.

For example, if a patient had oral surgery and was prescribed a strong painkiller that made them feel sick, they would most likely go to their primary care physician for answers. Certain painkillers and medications may have side effects that impact one’s mental health and can leave a patient feeling depressed. If that were the case, they may want to talk to a psychiatrist. 

This is why physician-led team-based care is an important strategy. It enables health care practitioners to create the most effective and efficient solutions for the patient. Let’s look at how team-based care approaches are used, while exploring ideas for your medical organization.

What is Team Based Care?

‘Team-based care’ is a method of connecting multiple healthcare providers in order to meet a patient’s needs by utilizing collaborative communication. Nurses and advanced practitioners lay the foundation for this value-based care by providing necessary communication between different practices and hospitals. 

A patient’s primary care provider can communicate with their cardiologist if they’re experiencing chest pain and need to be admitted to the hospital, but it’s  usually nurses who tend to be on the front line of this medical communication. They bridge the gap between specialists. Medical assistants often step in and fill this gap for physicians too, giving time back to doctors so they can focus on patient care needs while unloading some of their more administrative tasks.

Team Based Primary Care Approaches

The Old Care Model

Clinical patient treatment has traditionally followed a transactional, one-and-done, provide-a-diagnosis-and-get-reimbursed approach. With this model, physicians may be incentivized to have a particular service or procedure rendered within a narrow scope. They may not receive reimbursement for time spent coaching, listening to, and educating the patient through more intangible means. With this pressure, the physician may overlook other health issues the patient could be experiencing.

To be clear, patient health has always been a top priority in the medical field. However, the old model mostly makes room for “traditional” healthcare practices like meeting the patient, rendering a diagnosis, and giving treatment. In the new team-based care model, doctors focus on coming together to take a more holistic approach versus a single, isolated diagnosis and treatment for their patients. However, under this model, several challenging factors can arise, such as reluctance to communicate due to the inconvenience and potential time constraints among multiple providers.

“The five most common challenges that face healthcare teams relate to accountability, conflict management, decision-making, reflecting on progress, and coaching. These challenges were similar across both clinical and administrative team types.”1

Patients who don’t proactively share the full scope of treatment they’re receiving can cause challenges for clinicians and medical practice leaders. Patients may not share with their primary care doctor that they are also seeing a psychiatrist, neurologist, or other specialist. When each physician flies solo without collaborative communication, they’re not able to make the most informed care decisions based on the patient’s complete treatment regimen.

The New Team Based Care Model

The new team-based care approach requires a holistic change in workflow management that improves the value patients extract from the care they receive. With the patient’s permission, it can provide an environment where multiple practitioners and specialists share information, responsibilities, and delegate tasks. Having a medical assistant, nurse, physician, or specialist assess and gather patient information ahead of time and during patient intake can help improve a patient’s experience.2 

Consider updated digital workflow tools to improve the patient experience. Gone are the days of passing around clipboards and sticky notes for room rotations and patient updates. As one example, sending follow-up messages, educational materials, and other information via modern technology systems that use text messaging can accelerate speed to care and improve patient engagement.

Team-Based Care Communication Tools with PerfectServe

Physician Led Team Based Care: What Works?

When healthcare executives involve physicians, physician assistants, and nurse practitioners in the decision-making process, patient satisfaction increases. The main priority should be the patient’s satisfaction and comfort. How is this accomplished?

It’s only natural for some providers to feel like their own practice and field is “the best.” However, when it comes to the patient, their health and wellbeing are the main priority. If the opportunity presents itself, it’s vital for all providers involved in the patient’s care to communicate with one another, because one medication or method for diagnosis may affect another symptom the patient is experiencing.

Ineffective Team Based Care

As one example of an ineffective approach to patient care, what this “couples therapy” video about cardiology and nephrology. It’s a comedic take on approaching team-based care.

 

In this skit, the specialists let the real issue escape them because they’re more concerned with who’s right. 

Although team-based care provides patients with multiple professional opinions and solutions, it can still be confusing. When healthcare professionals from different fields come together to focus on one issue, there is a shared level of responsibility they must accept. Having this responsibility can sometimes lead to irrelevant disagreements, which takes attention away from their main focus—the patient’s needs.

What Performing Team-Based Care Providers Are Doing

Organizations like Health Advocate take a look at all factors that may affect their patients. Instead of focusing on the diagnosis alone, they take the time to show empathy. It’s not just about finding a quick and easy solution—it’s about asking questions that dive deeper into the patient’s issues which could include other factors like finances, mental health, and overall stress.

“Our Health Advocacy service serves as the integrator for all healthcare and benefits needs. Our Personal Health Advocates will direct people to other experts on our team or coordinate with your benefit vendors to create a seamless transition.”3

Solutions like HealthMap focus on bringing multiple providers together to help those with Chronic Kidney Disease. They may incorporate dieticians and skilled practitioners to align with the nephrologist. Since each patient is unique with comorbidities, their care must be customized to fit their specific needs.

“We partner with patients’ providers, such as primary care physicians, nephrologists, cardiologists, and endocrinologists, to support and manage the ‘whole’ patient in our Kidney Population Management program.”4

Other healthcare teams might take a few minutes each day to align medical staff around that day’s priorities and incoming patients. Here is one example of a medical group aligning priorities and communicating effectively:

Medical Team Providing Team-Based Care in a Medical Staff Meeting

Team-Based Care Strategies for Your Organization

Is it time to rethink your patient care model? If ensuring optimum collaboration across all specialists in a patient’s orbit isn’t on your radar, it should be.. A few benefits of rethinking and optimizing your patient care strategies:

  • An organized process leads to true valued-based care. 
  • Having balanced, professional opinions benefits the patient.
  • Patient education initiatives get them more involved in their own care.
  • Regular, updated communication between provider and patient builds mutual trust.
  • Better processes and technology lead to decreased workloads for medical staff.

Read how other medical practices are teaming up to deliver exceptional patient care outcomes.[/vc_column_text]

[/vc_column][/vc_row]

1Overcoming Challenges to Teamwork in Healthcare: A Team Effectiveness Framework and Evidence-Based Guidance, Frontiers in Communication, March 17, 2021. https://www.frontiersin.org/articles/10.3389/fcomm.2021.606445/

2Kevin Hopkins, MD, on challenges to team-based care: COVID-19 & beyond, American Medical Association, April 7, 2021. https://www.ama-assn.org/practice-management/scope-practice/kevin-hopkins-md-challenges-team-based-care-covid-19-beyond

3Health Advocacy is the heart of what we do, Health Advocate, 2022. https://www.healthadvocate.com/site/our-approach

4Healthmap Solutions, 2022. https://hub.healthmapsolutions.com/for-patients

Best Practices for Healthcare Software Deployment

The HDM KLASroom Series is a virtual eLearning series from Health Data Management and KLAS Research. The series aims to share insights that can advance the healthcare industry and educate healthcare leaders and their teams about the industry’s latest technological processes and trends. In the first HDM KLASroom episode, PerfectServe’s Kelly Conklin and Gabrielle Eagles—Chief Clinical Officer and Sr. Director of Marketing, respectively—spoke with Sue Armentrout, who serves as VP of Nursing Informatics and Evidence-Based Practice at Bon Secours Mercy Health, about best practices in software development and deployment that can help to improve the clinician experience. You can watch the episode below or keep reading to get an overview with main takeaways.

When it comes to best practices for software development and deployment in healthcare, improving the clinician experience should always be a central consideration. Whether you’re a manager, a member of the care team, or both, you know these practices matter long before implementation has occurred. This was true for Bon Secours Mercy Health, a large health system based in the Midwest with 50 hospitals worldwide under its umbrella. Bon Secours Mercy Health first implemented PerfectServe’s clinical communication platform in 2018, and the two organizations have been close partners ever since. In this episode, Armentrout spoke with the PerfectServe team about the support the company provides and shared some best practices about implementing and continuously improving communication tools. According to Sue, establishing effective workflows and positive practices at the start will set a system up to achieve successful outcomes. What are those best practices, then? Let’s take a look.

Pick the Right Vendor

A successful software deployment starts with the right software—and therefore, the right vendor. The right vendor solves or nearly eliminates the issues the organization is facing, which in turn decreases frustration across the care team. In the context of clinical communication, frustration is most often caused by inefficient software design, click fatigue, lack of interoperability, siloed deployments, and a lack of insights from end users, all of which contribute to a negative experience and burnout for clinicians. The right vendor should address these core issues by working to remove communication barriers based on the client’s guidance, but the vendor’s team should also offer novel solutions and new workflow suggestions to widen the lens of what powerful communication can accomplish. Bon Secours Mercy Health chose PerfectServe to remove communication barriers, consolidate its software footprint, and improve clinical communication and collaboration between providers.

Bon Secours Mercy Health

“A good vendor will involve users in both the development and deployment process,” said Eagles. “They will be a true partner and work well with others. They will offer policy and governance best practices, and they will have an eye on the future so they can scale and continuously improve along with you.”

Create a Continuous Improvement Cycle

Creating a continuous cycle of improvement relies heavily on the first best practice mentioned above: picking the right vendor. The right vendor should be a partner who supports longevity, has experience in the field, and is willing to innovate to keep up with the pace of change. As technology changes, so does innovation. Health systems have to juggle new guidelines, changing patient expectations, evolving priorities, and many other variables, and a good technology partner will be there every step of the way. Armentrout noted that it’s important to work with a partner who has “eyes for growth,” meaning the partner will have experience working with customers and end users to identify pain points, is comfortable exchanging ideas, plays nice with other vendors, and has throughput initiatives. With these traits, your partner will always be willing to tackle new issues that arise, creating a cycle of continuous improvement and growth.

A continuous improvement cycle is also deeply reliant on identifying pain points through deliberate listening. Bon Secours Mercy Health experienced nurse and provider dissatisfaction with desktop-based communication workflows and is now working with PerfectServe to do away with a setup that, according to end users, can sometimes inhibit a clinician’s ability to provide patient care. In particular, nurses felt tied to their computer and laptop screens and expressed how this limited their ability to flexibly communicate and provide bedside care. After identifying this pain point, Bon Secours Mercy Health worked closely with PerfectServe to roll out a Care Mobility program that puts smartphones in the hands of nurses. This mobile-first approach gives nurses the full power of PerfectServe at their fingertips no matter where they’re located, and the rollout is the product of a system and partner working together to continuously solve problems and improve the clinician experience.

mobile first approach

Armentrout said a good partner is one who is “willing to walk that innovation with us and continue to change as technology changes and as the organization changes.”

Know the Power of Consultative Deployments

PerfectServe has worked with clinicians, care teams, and healthcare systems for over two decades. During this time, we’ve learned what needs to be in the library of best practices for successful software implementations, and one of the most powerful tools from which a health system can benefit is a true consultative deployment. This was the case for Bon Secours Mercy Health, as consultative deployments allow for a firsthand and up-close look at pain points experienced by care team members. While implementing and deploying the Care Mobility program, providers, management, PerfectServe team members, and stakeholders participated in active bedside simulations. This allowed all parties to consult on what solutions were working, what issues or communication functions were causing delays, and where other features or functionality could be added or simplified. This collaborative effort makes deployment smoother and surfaces real-time issues that need to be addressed.

Bon Secours Mercy Health had a strategic plan built out for their Care Mobility program, and with a consultative deployment, PerfectServe was able to assign a team to the project to learn the ways of the system. Armentrout noted that pushback from both parties during a consultative deployment is also a part of best practices, as pushback strengthens the necessary program components and highlights what functionalities are most critical for success. These practices all work in tandem to facilitate a solution deployment that will ultimately make the experience better for clinicians, as pain points will already have been diagnosed, discussed, and rectified.

Critical functions

“[Bon Secours Mercy Health] has structured ourselves to be more of a shared service that is interested in standardizing across the ministry,” Armentrout said. “If we have to work with separate teams on every implementation, it’s reliving and then reinforcing, and we’re bound to get off track. Having that one team that is, oftentimes, coming to tell us, ‘this is where somebody else wants to get off track,’ then we can follow up with that. It’s been great working with a single team like PerfectServe.”

Decrease Variance in Software Use with Governance

Another best practice in successful software deployment is the use of governance and strategic policies. Armentrout and Conklin agreed that governance and other policies should be discussed regularly in work groups and oversight committees to advance initiatives. At Bon Secours Mercy Health, governance is an important part of establishing standards for different jobs within the health system. Having key stakeholders in the room where decisions are made drastically improves the flow and implementation cadence of software deployments, which ultimately moves the system toward the goal of better clinician experiences.

Governance is essential to addressing key issues and expectations during software development and deployment. The PerfectServe and Bon Secours Mercy Health teams were able to use governance strategies to address policies related to the Care Mobility program, including expected time frames for communication functionalities, compliance measures for communication response times, and more. Governance strategies should also take note of insight from the end user, who will help to drive innovation if they’re invited to participate in policy creation.

Governance strategies

“What we find to be most successful in all of our implementations—and then supporting our customers afterward—is having a multidisciplinary approach,” said Conklin. “This happens when everybody who is going to be impacted has a seat at the table to make those decisions on what gets implemented, how it gets implemented, who is going to be mandated to use the platform, how those communications are going to flow, and how things are going to work, day-to-day, within the organization.”

Identify Opportunities to Consolidate the Tech Stack

Reducing the number of applications a provider needs to log in and out of is another way to improve the clinician experience. Many healthcare organizations have an overwhelming number of technology applications to manage, forcing members of the care team to use a variety of systems to communicate and otherwise do their jobs. A project team from the right vendor will put themselves into clinicians’ shoes to understand where communication is lacking and how inefficiencies related to siloed, ineffective technology are contributing to burnout.

Project Team

During a software deployment, look for ways to reduce an organization’s tech stack by asking the following questions:

  • How can this system integrate with key solutions already in use?
  • How will this solution be used differently than existing solutions?
  • Does this solution reduce our portfolio of applications and resources?
  • What functionalities can be added, removed, or combined to reduce clinician frustration?
  • How will this leverage the communication process inside of the EHR? Does it leverage this primary platform?

These questions almost invariably lead to answers that can shape what to integrate with, or replace, to improve operational efficiencies and reduce burnout, increase collaboration, and improve communication.

“The ability to get the right alert or communication to the nurse or patient care tech helps us reduce some redundant systems in the background,” Armentrout said. “That will have a huge impact for many within our organization.”

Remember the Keys to Success

Remembering these best practices for your next technology deployment is essential to enhancing the clinician experience. Here are some key takeaways:

  1. Partnership matters! Find the right partner for your system by choosing a flexible, innovative, and experienced vendor.
  2. Establish clear policies and instill ongoing governance to enforce.
  3. Prioritize—and be an active participant in—consultative deployments.
  4. Work with your vendor to establish a cycle of continuous improvement.
  5. Burnout is real! Bring provider needs and pain points to the forefront, and find ways to address these issues with your vendor partner.
  6. Listen to end users—they drive innovation.
  7. Having key stakeholders in the room when decisions are made is essential for policy and software decisions.

“When you’re selecting a vendor, look for someone who is in it for the long haul, has a keen eye on the future, involves end users, plays well with other vendors, and has a strategy to scale and for continual improvement,” said Eagles. “We know communication workflows can be really complex, and our goal as a vendor is to manage that complexity for you so that clinicians can focus on patient care.”

Want to learn more? Check out the 8-step process hospitals and health systems are using to upgrade their clinical communication strategy.

Support Nurses Ability to Easily Communicate with Providers and Patients

Siloed communication infrastructure adds to nurse’s workload when they desperately need ways to reduce their administrative responsibilities. Empower nurses to communicate with each other, providers, and patients without logging in and out of several solutions to do so.

Reaching Providers and Patients’ Family Members Consumes Time

Nurses are responsible for multiple administrative duties on top of providing an upstanding standard of care for their patients that requires an abundant amount of collaboration and support.

Some nurses spend 33% of their shift interacting with technology and only 16% of their time on direct patient care.

Updating family members, getting a hold of the correct physician in a timely manner, communicating with respiratory, physical therapy, radiology in addition to coordinating with the nursing staff on their unit are just a few of the communications that happen throughout the nurses shift.

The time consumption initiating communications with different departments and providers could be precious time taken away from a patient’s care. A bandage may be left for the next shift to change, medications get administered later than ordered, patients miss a day of physical therapy because the nurse was unable to pull away from other tasks to help PT. Ultimately, the administrative burden nurses are under unfortunately can result in poor patient outcomes.

Tackling Nurse Communication Silos

Text, badge, EMR, email, phone – too much technology reduces efficiencies. When nurses need to login to the EMR for a critical lab result, phone a patient’s family member, use their badge to communicate with other nurses and then text the on-call provider regarding their patient, too much time is spent logging in and out of various solutions. Efficiencies can be gained just from reducing the number of technologies nurses need to use and reference.

The result – both improved nurse satisfaction and improved outcomes for patients. We want to reduce frustrations nurses encounter day to day, and streamline communication for all care team members.

With family members the inefficiencies are similar, find the correct number, call, no answer, leave a voicemail. Or find and call the alternate phone number and speak with a family member who has 20 minutes of questions, while the nurse is on the phone, the physician has returned the page and the nurse missed their call due to the fact that the nurse was on the line with the family member.

Clinical Communication Governance

Leading organizations have clear policies around communication response times, such as a routine message must be responded to in 60 minutes but an urgent message within 30 and STAT within 15. This becomes increasingly difficult without the right, and siloed, communication tools.

Text First Approach

82% of text messages will be read within five minutes of being sent—with an average response time of just 90 seconds.

A text first approach for all clinicians provides a single app to be used for nurse, provider, patient and auxiliary staff to ensure tight coordination of patient care. Look for a solution that also embeds into the EMR to improve clinical workflows. Nurses should be able to see a patient record from their mobile, the communication stream between care team members, critical lab results and any other pertinent details that will keep them abreast of their patient from any location—decoupling them from the nurse station.

Connect with our team to learn more.

5 Ways Clinical Communication Technology Reduces Clinician Workload

A clinical collaboration platform can make it easier and quicker for physicians to coordinate care inside and outside the organization, giving physicians more time to focus on patients.  With increased demands for documentation, streamlined communication can help reduce click fatigue and better support physician work-life balance. Click on the image below to get the infographic!

Ready to see what PerfectServe can do for you?

How to Improve Nursing Communication and Collaboration

Nurses are trusted experts who provide incredible patient care. The profession is a calling, a passion, and it is incredibly important that we have the nursing workforce that prioritizes caring for themselves to be fully present for the patients who need them.” – Ryannon Frederick, Chief Nursing Officer, Mayo Clinic, (Becker’s Hospital Review).1

Outdated systems, silos, and disconnected communication among nurses and physicians cause added strain to an already in-demand nursing workforce.2 Nurses can work 9-5 at an acute care facility or they can be seen pushing through 10 to 12-hour rotations. In every situation, nurse communication is a crucial part of their shift, as they are required to share accurate patient information between care providers, in addition to the other responsibilities required of a front-line caregiver for patients and their families. 

If they had a list of additional job descriptions and responsibilities, it would include:

  • Prescription Interventionist
  • Medical Administrator/Transcriptionist
  • Emergency Responder
  • Counselor/Therapist
  • Care Coordinator
  • Educator 
  • Server
  • Mechanic
  • IT Troubleshooter
  • You name it, they probably do it.

Let’s now look at how nurses communicate and balance responsibilities in different contexts.

Nurse Collaboration at Hospitals and Clinics: The Current Situation

Nurses at Hospitals

Imagine you’re in the ED. You have to react moment by moment in the queue as patients pour in, decompensating right in front you. How do you respond? Which patients need care faster? These nurse triage decisions can feel overwhelming.

Now imagine you’re a nurse on the labor and delivery floor. Last-minute emergency C-sections, women rapidly moving through the stages of labor, and patient screams echoing through the hallways. An infant may get rushed and transferred to the NICU for additional neonatal nursing care. It may be an intense, yet rewarding experience when the babies arrive.

Nurses face many different scenarios ranging from geriatric to post surgery care, all while maintaining required documentation demands and changing shift schedules. Nurses have to collaborate quickly and there is a need for communication to be efficient, timely, and reliable. If nurses need to make frequent calls to another care provider, patients may not receive adequate treatment on time.

Nurses at Private Practice Clinics

Imagine this situation at a medical specialist office. They have 2 main clinic locations, and different patient demographics visit each site. Nurses are required at both locations, yet office A is open until 7 PM while office B closes at 5 PM.

It’s 5:10 PM. One patient who regularly visits office B accidentally calls office A from their Google search, thinking they can walk-in to the clinic. The call messaging routes them incorrectly to office A. The covering on-call nurse says it’s okay for them to check in to the office for their chronic condition. However, the on-call nurse doesn’t see in their health record which location this patient usually visits, and there is a lack of notes on file. The nurse waits for a long time, and the patient doesn’t arrive. Frustrated about a lack of provider collaboration and communication, the patient leaves a 1-star review online for the clinic.

The next day, the physician and nurse on-call at site B call site A, disappointed their clinic location received a low patient satisfaction rating. They get the practice owner and manager involved. Now they have a warning discussion with the nurse on-call, when it was truly a breakdown in communication systems for their healthcare clinic.

The physician and nurse collaboration framework in this faux scenario led to poor patient outcomes. In one real-life study, nurses may not always have input or say on how a medical practice is managed. “The participants stated that if nurses were more involved in the development of nursing policies, this would have a positive influence on patient care.”3

Poor communication between clinicians and patients can result in misunderstandings about medications and the miscommunication of follow up instructions, which can result in poor outcomes and readmissions, and could result in a patient coming to harm.4

Whether nurses work for a hospital or private medical practice, better scheduling collaboration and nurse communication software is needed. If nurses are able to find the best communication options for their day-to-day interactions, it would significantly reduce barriers to effective healthcare treatments.

How to Improve Nurse Collaboration for Better Support

Some nurses said they felt like labourers…if you’re not valued at work, you don’t have the desire to stay in the public system.5

Nurses Need Opportunities to Receive Care in Order to Give Care

Nurses are in short reserve, but the demand for nurses continues to grow. What can hospitals and group practices do to alleviate their stress? Organizations may increase pay incentives, but is that enough? It’s not just about the money.

Nurses need a platform to communicate not only the needs of their patients, but for their colleagues as well. Promoting team-based care, sharing of new evidence-based care guidelines, and management of staffing shortages are strategies that leaders can rely on for effective communication platforms. This reduces the burdens experienced by nurses.

When Nurses Collaborate, Patients Feel It

With all the roles nurses fill, it’s important for them to communicate in a timely manner. Nurses may leave due to burnout and better pay opportunities,6 and this could result in more miscommunication mistakes among staff. This leads to poor patient outcomes and expensive provider costs. However, there is good news…

When nurses have time to collaborate patient care through text, cell, EHR, or face-to-face, the results improve for patients and providers. Hospital executives and nurse leaders who take time to care for their teams and find appropriate medical communication solutions will create bright spots for the future of nursing.

Need a better way for nurses and clinical teams to communicate?

See how PerfectServe’s medical communication software can eliminate wasted time and help nurses be more efficient.[/vc_column_text]

1Jensik, L. (2021, October 29). Will nurses come back? 3 healthcare leaders weigh in.Becker’s Hospital Review. https://www.beckershospitalreview.com/hospital-management-administration/will-nurses-come-back-3-healthcare-leaders-weigh-in.html
2NursingTimes. https://www.nursingtimes.net/news
3Kieft, R.A., de Brouwer, B.B., Francke, A.L. et al. How nurses and their work environment affect patient experiences of the quality of care: a qualitative study. BMC Health Serv Res 14, 249 (2014). https://doi.org/10.1186/1472-6963-14-249
4Effects of Poor Communication in Healthcare. HIPAA Journal, https://www.hipaajournal.com/effects-of-poor-communication-in-healthcare 
5Wilton, K. (2021, September 16). ‘Not about the money’: Nursing report addresses exodus from Quebec’s public sector. Montreal Gazette. https://montrealgazette.com/news/local-news/not-about-the-money-nursing-report-addresses-exodus-from-quebecs-public-sector 
6Virkstis, K. (2021, August 12). Why so many nurses are leaving amid delta—and how you can keep them. Advisory Board. https://www.advisory.com/Daily-Briefing/2021/08/12/nurse-shortage#our-take-weve-reached-the-tipping-pointhow-do-organizations-move-forward-see-our-3-keys

Real-Time Data Entry for Better Patient Care

Medical training encourages charting to 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 medical data entry into the EHR is not seamless during patient care. Patient demands, alerts, and urgent interruptions may pull medical practitioners from filling out the medical chart online.

The more time that passes between the health event and the data entry, the less detailed the data input, resulting in errors. Charting errors in nursing and physician care impacts patient outcomes and creates unnecessary administrative overhead. What can be done to improve medical charting for nurses and doctors?

Benefits of Real-Time Data Entry

“Real-time electronic data is a potential treasure trove of insights, which can be analyzed 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.2 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. Jumping from software tool to software tool, logging on to each room’s computer, and trying to type up the information at the end of each patient round can be daunting.

“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 clinical 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.
  • Mobile reminders and mobile alerts that sync with the clinical communications platform.

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

3 Ways to Save Nurses’ Time With Better Communication

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

A 2018 time and motion study revealed that in four hours, nurses spent around 32 minutes communicating with patients and family and 51 minutes communicating and coordinating care with members of the care team1—fully 34.6% of nurses’ time each day. Technology aimed at improving nurse workflows has often contributed to their frustration by adding siloed, task-specific “solutions” to their workload. On top of this, nurse turnover rates increased from 13.5% to 16.7% during 2019.2 From 2020-2021, nurses felt burnt out and overworked due to increased patient demand, poor communication, and hospital staffing shortages.

Let’s talk about an alternative approach to help these medical heroes on the frontlines. Read below for three ways clinical communication and collaboration (CC&C) technology can help healthcare organizations empower their nurses to drive patient-centered care.

Reduce Communication Cycle Times

Communication workflows can be cumbersome, requiring nurses to reference several systems or paper on-call schedules. When they go to page, call, and relay information through the office staff, they have to wait for the intended recipient to call back. This error-prone process causes care delays and requires repetitive steps when a provider is unavailable.

An improved communication strategy built around an integrated healthcare solution can reduce average response times from 45 minutes to 20 minutes or less.3 Here are a few capabilities that make it easier for nurses to find the right physician at the right time:

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

Faster communication leads to a safer, quicker, and higher-quality patient experience.

“When healthcare professionals communicate effectively—conveying critical information in a timely or easily understandable manner, clearly spelling out orders or instructions, and answering questions thoroughly and thoughtfully—they deliver safer and higher-quality care.” -James Merlino, MD

Integrate Alerts and Critical Result Notifications

Alarms, alerts, and other notifications continue to be named among the top 10 health technology hazards for 2020,4 impacting patient satisfaction and contributing to alarm fatigue. This fatigue continues to be an issue for healthcare employees and nursing staff.

In a 2015 study, nurses reported that only 52% of bed calls required nursing care, while others could be answered by support staff.5 Constant interruptions reduce care efficiency and require nurses to make multiple unnecessary trips to patient rooms. While nurses are inundated with alerts, they are not adequately alerted of critical results and orders that truly need their assistance. They are forced to repeatedly check the EHR for updates, wasting valuable time for patients in need.

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

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

In addition to better medical alert systems, learn how nurses can improve self-care.

Simplify Patient Engagement

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

Post-discharge patient engagement relies heavily on phone communication. This has a declining impact due to phone tags and low voicemail retrieval rates. With spammy robocalls and unsolicited messages on the rise, it’s no wonder patient follow-up becomes an arduous task.

On the other hand, secure texting with patients and families allows health systems to automate more effective outreach in the following ways:

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

Start Saving Nurses’ Time

PerfectServe’s CC&C solution with patient engagement capabilities helps streamline nurse workflows, reduce care delays, improve patient safety, and boost patient satisfaction.

PerfectServe’s Solution for Nurses

 

References:

  1. Nurses’ Time Allocation and Multitasking of Nursing Activities: A Time Motion Study, AMIA Annual Symposium Proceedings, 2018: 1137-1146, Yen, P. et al., 2018: ncbi.nlm.nih.gov/pmc/articles/PMC6371290/#r34-2975707
  2. Why so many nurses are quitting (and what to do about it), Peng, J., Rewers, L., 2021: https://www.advisory.com/Daily-Briefing/2021/10/06/nurse-turnover
  3. Secure Clinical Communications Makes Real Patient Impact, Health IT Outcomes, Griffith, A., 2015: healthitoutcomes.com/doc/secure-clinical-communications-makes-real-patient-impact-0001
  4. 2020 Top 10 Health Technology Hazards Executive Brief, 2020: org/landing-2020-top-ten-health-technology-hazards
  5. Interruptions of nurses’ activities and patient safety: an integrative literature review, Revista Latino-Americana de Enfermagem, Monteiro Cintia et al., 2015: ncbi.nlm.nih.gov/pmc/articles/PMC4376046

Elevating the Role of the Nurse to Support Value-Based Care

When nurses collaborate together, they help the patients and healthcare systems win together. As healthcare has evolved toward a value-based payment model, nurses bridge the gap between hospital leadership and the patient experience. Progressive and innovative healthcare organizations are embracing this new focus on value-based care. It has shifted toward an interdisciplinary approach which leverages population health management and social determinants of health. This increase in patient engagement improves outcomes across the spectrum of care.

“Nursing is a critical player that can directly or indirectly influence hospital performance in the 3 CMS value-based care programs…Nurses are the curial hub that links individuals with the disparate spokes of the health system.”¹

The role of the nurse elevates with value-based care. Nurses provide more patient-centered, efficient, and cost-effective care. From the pre-appointment and intake to discharge and follow-up, nurses can streamline clinical workflows. In the primary care setting, progressive providers have increased patient access by conducting nurse-only patient visits, during which registered nurses document patient histories, order lab or other diagnostic tests, and determine patient acuity. If these wellness visits are virtual, nurses can triage if the patient needs to be admitted right away or if an appointment should be scheduled with their specialist or primary care physician. 

Increased Demand for Nurse-to-Patient Care

To meet the increased demands of value-based care, nurses must work to the top of their licensure. Studies conducted several years ago indicated that, on average, nurses spend as little as 25% to 30% of their time at the bedside.2 On top of clinical workloads, nurses are responsible for care coordination and collaboration among an expanding team of medical professionals and specialists.

Care teams have expanded under value-based care incentives to include nurses, physicians, therapists, and home care workers across multiple hospitals and acute and primary settings. Through these changes, nurses struggle with inefficient workflows associated with legacy communication devices and numerous clinical and communication systems. 

What is being done to help nurses spend more quality time with patients? 

Read how Orange Coast Medical Center implemented PerfectServe’s Clinical Communication & Collaboration system to give time back to nurses for a better patient experience.

Read Our Success Story

The key to supporting the elevation of the nurse is the elimination of activities that do not directly contribute to the health and well-being of patients. The incorporation of innovative technology can assist in this effort. For example, advanced communication technology can help nurses communicate efficiently with other members of the care team including those off-site, such as home health nurses and healthcare professionals at specialized hospitals, skilled nursing facilities, and wound care clinics. 

HIPAA-compliant secure text messaging may take over many of the time-consuming communication tasks to prepare or follow-up with patients. The ideal solution helps reduce non-clinical tasks to allow nurses to focus their time on those patients who need additional care or have chronic condition management needs.

How PerfectServe’s Platform Helps Nurse Collaboration

PerfectServe’s clinical communication and care coordination platform addresses the inefficiencies of work processes and administrative tasks. This allows nurses to assume a more significant role under value-based care, including:

  • Care Team Coordination – Collaborate with providers inside and outside the network. Connect with on-call care team members as a group, or by name or role such as “On-Call Cardiologist.” This ensures a nurse can reach the right physician at the right time to accelerate outcomes, without the inefficiencies of referencing call schedules or playing phone-to-pager tag with physicians.
  • Pre-Appointment Patient Communication – Automate the communication for day-of-procedure information, appointment reminders, and wayfinding to prepare patients for upcoming appointments or procedures.
  • PostAppointment Patient Communication – Automate post-discharge communications to reiterate the care plan, send timely reminders (such as follow-up scheduling and prescription pick up), and assess patient health status and satisfaction with text-first survey questionnaires. Nurses can prioritize follow-up time to only those patients in need of clinical intervention.
  • Time-Critical Updates – Rather than force nurses to log into the EHR to check for results or orders, critical updates (orders and critical lab results) are pushed to the nurse and other care team members to speed up care coordination and delivery.
  • Real-Time Charting – A mobile, easy-to-use interface to access patient information and take notes, with text shortcuts, voice-to-text, and intelligent field mapping to reduce duplicate data entry.
  • Nurse Call, Alarms, Alerts – Nurses receive alerts on their mobile devices and web apps, where they can accept, escalate for assistance, or call back to speak with the patient.

By expanding the role and leadership of registered nurses and implementing improved processes facilitated by innovative technology, healthcare organizations can transform healthcare delivery, achieving improved efficiency and better outcomes at lower costs.

Learn More

1https://www.nurseleader.com/article/S1541-4612(20)30210-X/fulltext
2https://www.healthleadersmedia.com/nursing/outsourcing-discharge-follow-calls-keep-nurses-bedside

The role of secure communications in your clinical integration strategy

If you could take one solution with you on your journey to clinical integration, what would it be?

Clinical integration is the unification of healthcare data, services and coordination across acute, outpatient and post-acute care. It portrays an environment where waste and inefficiency are all but eliminated from healthcare communications, costs decrease and care improves. It’s the future of medicine.

You wouldn’t be far off course if your first thought was to rely heavily on the EHR to support your clinical integration strategy. While the EHR is a valuable tool for sharing patient information within hospital systems and broader care networks, it lacks a fundamental quality that bridges the gaps between Meaningful Use and true clinical integration.

Fully realized clinical integration can only occur when the barriers of communication have been broken down, and interdisciplinary clinicians can accurately and reliably coordinate care in real time across organizational and geographical boundaries. As with most things related to healthcare communication and the sharing of information across disparate networks, securing those communications has been and will continue to be a primary focus for healthcare IT leaders. In an environment where healthcare organizations are driving toward an end-goal of clinical integration, enabling secure communications alone just isn’t enough.

To achieve clinical integration, clinicians need a solution that enables immediate, accurate, reliable and secure communications.

Immediacy in healthcare communication

Real-time communication is a crucial element of delivering high-value care. In the most critical emergencies, every second counts. The time that clinicians waste identifying the right on-call care team member to contact, and then trying to reach that person, can quite literally be the difference between life and death. Even in non-emergent situations, early detection and treatment are well-known effective preventers of worsening conditions.

Yet it’s all too common for inefficient and broken communication workflows to create time-consuming hurdles for clinicians to clear—sometimes even to just begin the conversation.

Clinically integrated settings approach clinician-to-clinician communication with a sense of real-time urgency. That’s not to say that every message should be sent with an emergency status, just that the process of identifying the provider you need to connect to and the delivery of that message should be seamless and immediate.

Reaching the right care team member on the first attempt should be an important metric for all hospital systems. To keep performance numbers high in this area, you must ensure clinicians always know exactly whom to contact for any given medical issue.

However, most clinicians today initiate time-sensitive contact to the broader care team by thumbing through a lengthy paper-based on-call schedule, making a call, and then waiting to receive a response.

Real-time clinical communication and collaboration tools immediately deliver secure communications, and even allow the clinician initiating the communication to see in real time when messages are delivered and read.

Contact accuracy

Reaching providers on the first attempt is important, but it’s just as important to reach the right provider—the one who can act on the medical issue at that moment—via his or her preferred method of contact.

It’s not uncommon for providers to have a different preferred contact medium for every variance of their schedule. And it’s not uncommon for those schedules to change at a moment’s notice. Yet many hospitals, in both small and large systems, only print the schedule and patient assignment lists once per day.

Clinicians in this setting have no way of knowing if they are accurately reaching out to the right providers via the right contact method. Manually producing a list of whom to contact and how is a process riddled with opportunity for inefficiency and inaccuracy.

Dynamic Intelligent Routing™ eliminates those opportunities for communication breakdown. A distinct capability of PerfectServe, Dynamic Intelligent Routing analyzes workflows, call schedules and contact preferences, enabling clinicians to reach the right person at the right time with just the tap of a button.

Reliable communication workflows

If your clinicians depend on inaccurate call schedules or outdated, cumbersome processes to drive clinical communications, your communication workflow isn’t reliable.

When clinicians can immediately contact the care team member they need via that provider’s preferred contact method, communication workflows become reliable and trustworthy, which leads to high adoption and improved patient care, no matter the care setting.

From improved care coordination to reduced costs

Inefficient communication workflows not only interfere with the realization of clinical integration, but also they inflate healthcare costs. For example, if a radiologist identifies a critical result in an outpatient test, the radiologist needs to contact the patient’s PCP so action can be taken right away. If the communication is not immediate, accurate or reliable, the process breaks down and the delay could result in medical complications for the patient that end up costing more to treat.

Moving a patient safely through the admissions, treatment, discharge and post-acute care processes requires a tremendous amount of coordination, good communication and a sound clinical integration strategy. The tools you use to support that communication and collaboration will play an important role in your success.

See how an innovative partner rated Best in KLAS for Clinical Communications after four consecutive years leading the category can help ensure you’ve got the right solutions working for you.