Patient-Centered Approach Simplifies Complex Resident Communication Workflows

Established more than 160 years ago in Toledo, Ohio, Mercy Health St. Vincent Medical Center is the critical care regional referral and teaching center within the Mercy Health system. With 852 physicians on staff, more than 61,000 Emergency Department visits, and more than 17,000 inpatient admissions per year, a secure and streamlined clinical communications process was critical to facilitate efficient, high-quality patient care.

Challenges

Like many other healthcare facilities in the U.S., Mercy Health St. Vincent Medical Center’s most common communication channels for physicians were operators, phones, and pagers. The emergence of text messaging as a fast and easy way to communicate quickly became the “path of best efficiency,” especially with residents at St. Vincent.

Dr. Randall King, CMIO and Chief of Staff at Mercy Health St. Vincent Medical Center, said, “We were probably a pretty standard large community hospital with a bunch of residents who communicated with our physicians, primarily through our operators, a paper call schedule, phone numbers, and pagers.” While the hospital’s communication processes seemed to be standard, internal discussions revealed that text messaging had emerged as a newer, faster, easier way for residents and attendings to connect with each other.

“We couldn’t help but notice that [residents] were extremely quick to adopt text messaging,” said Dr. King. “The residents, who are usually closer to the forefront of technology than others in the organization as they’re a younger group … had taken the path of best efficiency and had been texting communications back and forth … because it works.”

However, the IT staff at St. Vincent quickly realized that this “path of best efficiency” was not secure. Because securing protected health information was a priority, the organization immediately began searching for a solution that allowed easy and secure communication between residents, attendings, nurses, and other clinicians—and would ultimately benefit their patients by enabling fast and efficient clinical decision making.

Dr. King and his team at St. Vincent learned about PerfectServe from their colleagues at sister hospital, St. Rita’s Medical Center, which had just completed implementation of the solution. After internal discussions with the CEO and regional leadership, the team decided PerfectServe’ PerfectServe ‘s Clinical Collaboration solution was also the right solution for St. Vincent.

Implementation

St. Vincent began with a pilot program. As the implementation progressed, it became apparent just “how much the PerfectServe solution illuminated some legacy processes  that were profoundly dysfunctional,” said Dr. King. 

Because paper call schedules were not being updated each time a physician’s schedule changed, nurses were often making multiple phone calls in an attempt to reach the right person. Since the manual process was convoluted, automating it with technology immediately brought the legacy issues to light and physicians clearly saw the impact of not keeping schedules up to date. 

PerfectServe’s Dynamic Intelligent Routing® capability automatically identifies and provides immediate connection to the right care team member for any given clinical situation. If physicians didn’t update their schedules in the PerfectServe mobile app, they still ended up getting calls that should have been routed to the designated covering resident or attending. 

St. Vincent introduced a process improvement step to address this challenge, and the hospital began holding physicians accountable for updating their own call schedules. To effectively manage this new process, physicians are now mandated to keep their schedules updated directly in the PerfectServe mobile app. 

Additionally, St. Vincent also now requires 700 of the employed physicians and residents to use PerfectServe as the only mode of secure communication with each other. All other physicians who are affiliated with St. Vincent are also strongly encouraged to use the solution.

Results

St. Vincent’s IT staff partnered with the PerfectServe professional services team for a smooth implementation and go-live. The St. Vincent team allocated staff members and other technical infrastructure to support physicians during the PerfectServe implementation, which helped the transition. While analog phone and pager users required a bit more hand holding, the majority of techsavvy physicians were fully functional within a month. 

Dr. King reports, “It was a very straightforward transition. Physicians downloaded the phone app and began immediately reaping the benefits. Those on the app get quicker information—like traumas coming in or transfers with special needs. Historically, residents and physicians were paging and waiting on call-backs. Now they use PerfectServe to quickly and securely trade information back and forth.” 

In fact, St. Vincent staff now exchange upwards of 15,000 secure messages via PerfectServe every month. “That’s huge when you think about it—the ability for physicians to interact at that high level for minute-by-minute patient care. It’s a dramatic improvement over the old way of communicating,” said Dr. King.

In addition to standard text messages, the staff at St. Vincent realized another significant advantage with PerfectServe—the ability to send attachments securely. They can now share X-rays, photos or images, and more easily consult with other physicians on patient care. 

“[We’ve had] remarkable utilization by many of our physicians and residents. It’s light years ahead of where we were [before PerfectServe],” noted Dr. King. 

With the implementation of a secure care team collaboration solution and internal process changes, Dr. King and others at St. Vincent have ensured that patient-centered communications happen securely and quickly. “It is encouraging to know we have a tool [physicians] can use that makes communication easier and faster for physicians, patients, and their families. I can get more done in a given day using PerfectServe than I ever could before,” reported Dr. King.

Expanding the PerfectServe Footprint

After implementation, the team at St. Vincent focused on broadening the use of PerfectServe throughout the facility by getting as many physicians as possible on the platform and keeping them trained— and compliant with—new processes and security protocols. 

After physicians were onboarded, nurses quickly recognized the enhanced functionality provided by PerfectServe—particularly the potential benefits afforded by simple and efficient nurse-to-provider communication. To make this a reality, the nursing staff at St. Vincent are now part of the same PerfectServe ecosystem and enjoy bidirectional communication with physicians.