FIVE WAYS TO SAVE YOUR HOSPITAL MONEY WITH BETTER COMMUNICATIONS

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The rising cost of delivering care and shrinking operating margins means that cost reduction is a constant initiative at hospitals and health systems across the United Kingdom. Organisations are looking at everything from tighter supply controls to energy efficiency initiatives. Another avenue that hospitals are evaluating more closely is communications. Inefficient communication is expensive because it wastes doctor's time, delays patient treatment and discharge, and can contribute to costly medical errors. In this eBrief we look at five ways hospitals can save money with better communications.

INTRODUCTION

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1 Studies examining how doctors spend their time during the day reveal that a quarter of each shift is devoted to communications, nearly half of which is to collaborate with other caregivers.1,2 Minutes spent trying to figure out who is on call and the best method to contact that person means valuable attention is taken away from other, more important activities. By reducing the amount of time staff spend searching for colleagues’ numbers, hospitals can decrease this administrative task and give doctors more time to treat and interact with patients.

One way to accomplish this type of time savings is to arm staff with better communication tools. Smartphones have been a big step forward for mobile workflows, but the devices alone are simply a platform. The ability to access colleague contact information, up-to-date on-call schedules, and secure messaging channels is key to making these devices efficient. Being able to include actionable information in secure, text-based communications with the correct on-duty doctor is a valuable time saver. This supports fast, meaningful interactions and reduces voicemail tag and even phone conversations.

Faster communications will help save clinical time as well as speed up admissions, treatment, and discharge through better-coordinated information exchange among clinicians, portering, and housekeeping staff.

SAVE TIME1

CASE STUDYLearn how Froedtert Hospital and the Medical College of Wisconsin created better provider communication processes, increased satisfaction, and improved care.

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CASE STUDYRead how North Mississippi Medical Center sped communications and pleased staff by supporting the ability to access the web directory and on-call schedules from mobile devices, as well as send

messages securely to smartphones.

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“Having the same information shared among the web directory, on-call scheduling, and operator console solutions has been seamless…and communications are more efficient.”

Mac Stanford Biomedical/Communication Services North Mississippi Medical Center

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2Breakdowns in the communication of important information to the right people during the discharge process can lead to significant delays, which in turn increase patient average length of stay.

In a study by Agarwal et al. that sought to quantify the economic impact of inefficient communications, the authors estimated that 53 percent of the wasted cost comes from increased length of stay. The study calculated this to be approximately $2.45 million per year for a 500-bed hospital.3 Faster communications among care team members, such as secure smartphone messaging between doctors and nursing staff, is one way to recapture some of this wasted time and cost by speeding the discharge process. Faster discharge times also have the potential to increase patient satisfaction by providing a positive final impression for the patient.

In addition to shortening the discharge process itself, there are other opportunities during the patient journey to reduce length of stay. Communications play an important role for test results reporting, especially in the accident and emergency department. At many hospitals the current reporting process for both radiology and lab results is a manual one involving phone tag, paper documentation, and EMR (electronic medical record) documentation. The ordering doctor might also spend unnecessary time frequently checking the EMR to see if results have been posted. The wasted time in this workflow can range from minutes to hours, and can be especially costly for critical results because of treatment delays that may lead to patient harm and increased length of stay. In the case of negative or normal results that indicate a patient can be discharged, extra time in the reporting workflow simply keeps a patient longer than necessary, increasing length of stay and potentially reducing patient satisfaction.

One way to improve the test results reporting process is with a critical test results management solution that can deliver results directly from the laboratory information system (LIS) and the picture archiving and communication system (PACS) to an ordering doctor's mobile device. By integrating these systems with the EMR and automatically populating a patient record with test results, hospitals can reduce or eliminate administrative time spent tracking dictations, maintaining a document log, and making phone calls. Further, by automatically triggering messages that notify the ordering doctor that results are available, organisations can improve discharge times for negative results and improve patient outcomes for critical findings.

DECREASE LENGTH OF STAY

CASE STUDYDiscover how Palmetto Health Tuomey improved ED patient discharge times with a critical test results management solution.

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“During the three months immediately following implementation, we saw an 11% improvement in patient discharge times.”

José Bennett PACS AdministratorPalmetto Health Tuomey

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3Beyond supporting better patient care and helping hospitals improve the average length of stay, a critical test results management solution can also help hospitals reduce litigation costs because it maintains a full audit trail of when notifications were sent, viewed, and acknowledged. This record of communication can help inform the hospital and the provider in the event there is a question about message timing and receipt. And because a robust system also escalates unacknowledged notifications to another provider, there is further assurance that notifications will be received in a timely manner for action, even if the ordering doctor is unavailable or is no longer on duty.

Tracking critical test result notifications and escalations is merely one avenue for reducing costs. Another is to use a clinical alerting solution. This intelligent software can act as the first stage of triage by incorporating the facility’s pre-set priority levels and using built-in logic to pass along the highest level of alerts first, helping patients with urgent medical needs receive faster attention and treatment. And critical alerting software also provides escalation pathways for unacknowledged alerts and allows hospitals to maintain a full audit trail of every notification. The systems logs when each message was received, viewed, and responded to.

REDUCE LITIGATION EXPENSES

VIDEOLearn how Banner Health improved patient care—for adults and the tiniest infants—with patient monitoring that keeps nurses informed.

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Poor communication (including quality and accuracy of information) accounts for three in ten

complaints about the NHS.4

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We’ve looked at critical test results management and clinical alerting in the context of decreasing patient length of stay and reducing litigation costs, but these solutions were designed first and foremost to give doctors better communication tools that support excellent patient care.

Using a clinical alerting solution to integrate a variety of patient care and monitoring systems with staff’s Wi-Fi phones, smartphones, pagers, and/or voice badges speeds notification and response times to important alerts from patient monitoring equipment. The challenge with patient monitoring alarms comes from the sheer volume of noise produced by these devices every day on a hospital floor. A study5 at Johns Hopkins Hospital found an average of 350 alarms per bed per day, which can cause nurses and caregivers to easily become desensitised. This is referred to as “alarm fatigue,” and the risk is that valid alarms may be missed or disabled, leading to unnecessary complications and even patient death.6

Another solution that aims to simplify communications and give patients faster care when needed is emergency notification. During a life-threatening emergency, whether that emergency is detected by a test result, a patient monitor, or a paramedic en route to the hospital, quickly coordinating a response is vital because seconds count.

There are two key components of coordinating a care team during an emergency: quickly notifying the right providers, and tracking their acknowledgments to ensure an appropriate level of response. Both of these tasks can be accomplished with a robust emergency notification solution.

Instead of spending valuable time manually working through a calling tree, or sending individual pages to each member of a response team, the entire process can be launched at once. Whether triggering an emergency call or calling on-call staff to the hospital to handle a large influx of patients, hospitals can rely on emergency notification software to alert the correct responders on their preferred devices. Text alerts are especially valuable in this situation because responders can immediately acknowledge that a message has been received and whether they are available to attend to the patient(s). One way this solution is being used by hospitals is to facilitate code STEMIs (ST-elevated myocardial infarctions) and coordinate the 30 or more staff required for successful average door-to-balloon times of 90 minutes or less.

PROMOTE BETTER PATIENT OUTCOMES4

A study5 at Johns Hopkins Hospital found an average of

350 alarms per bed per day.

INFOGRAPHICLearn more about how efficient communications can simplify clinician workflows and improve patient care.

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CONCLUSIONHospitals exist to improve the lives of their patients through the care they deliver. But they are also tasked with providing their services in the most efficient and effective ways possible. This means evaluating all of the possible ways to control and reduce costs using the latest technologies and workflow processes. Improved communications are within reach for hospitals able to take a step back and look at how all members of their staff interact to provide care—and how they could do this better at every turn. There are significant efficiencies and cost savings to be had through intuitive solutions that reduce length of stay and improve the handoff of patient information as shifts, staff, and events change.

The efficiency of healthcare communications also contributes to patient satisfaction, which can directly and indirectly impact a hospital’s budget. Indirectly, communications shape a patient’s experience, which contributes to a facility’s perceived brand in the community. Patients now have a choice of where to go for care, and perceived brand can bring more patients to a hospital or send them to another.

There are also more direct ways communications can influence hospital costs. They can impact patient experience scores, measured through various patient surveys conducted throughout hospitals.

According to the Care Quality Commission's review of the 2014 Inpatient NHS surveys7, 48% stated it took more than three minutes to get help when they used their call button.

Patients are often dependent on nursing staff for pain medication, water, and even bathroom visits. Being able to quickly respond to calls for assistance is one way to improve patient satisfaction. Sending nurse call notifications to mobile devices gives this mobile workforce instant alerts of patient calls, as well as the details for follow-up. Some integrations support instant call-back to the patient’s room or pillow speaker to provide reassurance that the call has been received and help is on the way, as well as escalation pathways for calls that remain unacknowledged after a specified amount of time.

IMPROVE PATIENT EXPERIENCE AND SATISFACTION 5

CASE STUDYRead how Aspen Healthcare - Holly House Hospital ensures patient call requests are handled quickly by nursing staff.

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ABOUT SPOK, INC.Spok, Inc., a wholly owned subsidiary of Spok Holdings, Inc. (NASDAQ: SPOK), headquartered in Springfield,

Va., is proud to be a leader in critical communications for healthcare, government, public safety, and other

industries. We deliver smart, reliable solutions to help protect the health, well-being, and safety of people

around the globe. Organisations worldwide rely on Spok for workflow improvement, secure texting, paging

services, contact centre optimisation, and public safety response. When communications matter, Spok delivers.

References1 O'Leary KJ, Liebovitz DM, Baker DW. How hospitalists spend their time: insights on efficiency and safety. Journal of Hospital Medicine. 2006

Mar;1(2):88-93. http://www.ncbi.nlm.nih.gov/pubmed/172194782 Matthew D. Tipping MA, Victoria E. Forth MA, Kevin J. O'Leary MD, MS, David M. Malkenson BS, David B. Magill BS, Kate Englert BS and

Mark V. Williams MD, FHM. Where did the day go?—A time-motion study of hospitalists. Journal of Hospital Medicine. 2010 Jul/Aug:5(6):323-

328. http://onlinelibrary.wiley.com/doi/10.1002/jhm.790/abstract3 Agarwal R, Sands DZ, Schneider JD. Quantifying the economic impact of communication inefficiencies in U.S. hospitals. Journal of Healthcare

Management. 2010 Jul-Aug;55(4):265-81; discussion 281-2. http://www.ncbi.nlm.nih.gov/pubmed/208125274 Complaints about acute trusts 2013-14 and Q1, Q2 2014-15. Parliamentary and Health Service Ombudsman. http://www.ombudsman.org.

uk/__data/assets/pdf_file/0004/28876/Complaints_about_acute_trusts_2013-14_and_Q1,-Q2_2014-15.pdf5 AAMI Foundation/HTSI. Using data to drive alarm improvement efforts. 2012. http://www.tnpatientsafety.com/LinkClick.

aspx?fileticket=JWJtlpyK_yc%3D&tabid=2806 http://www.washingtonpost.com/sf/feature/wp/2013/07/07/too-much-noise-from-hospital-alarms-poses-risk-for-patients/7 Care Quality Commission. National Results from the 2014 Inpatient Survey. May 2015. http://www.cqc.org.uk/sites/default/

files/201500519%20NHS%20Inpatient%20Survey%202014%20National%20summary%20and%20results%20tables%20FINAL.pdf

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