improving patient satisfaction with technology: a series of workflows
TRANSCRIPT
IMPROVING PATIENT SATISFACTION WITH TECHNOLOGY: A SERIES OF WORKFLOWS
ABOUT SPOK: CRITICAL COMMUNICATIONS LEADER
• Decades of experience managing healthcare communications
• 98% customer satisfaction scores
• Financially viable, growing company
• Trusted by top names in healthcare
THE BEST ADULT AND CHILDREN’S HOSPITALS CHOOSE SPOK
Source: U.S. News & World Report’s “Best Hospitals” study 2014-2015
4,743 ADULT HOSPITALS SURVEYED
17 QUALIFIED for “HONOR ROLL”
ALL USE SPOK SOLUTIONS
183 CHILDREN’S HOSPITALSSURVEYED
10 QUALIFIED for “HONOR ROLL”
ALL USE SPOK SOLUTIONS Source: U.S. News & World Report’s “Best Children’s Hospitals” study 2014-2015
Beyond clinical excellence, how do you provide a positive patient experience?
Why does it matter?
PATIENT SATISFACTION
• Hospitals have been tracking it for years
– Avatar, Press Ganey, HealthStream, etc.
• Hospital Consumer Assessment of Health Providers and Systems (HCAHPS)
– Implemented 2006, reporting started 2008
– Now HCAHPS scores used in Hospital Value-Based Purchasing program
– 10 questions specifically target communications
PATIENT SATISFACTION
1) Give patients a fast, smooth admittance process
2) Communicate test results promptly
3) Respond quickly to the patient
4) Coordinate provider communication
5) Promote a quieter, more restful healing environment
6) Keep the patient’s family updated
7) Speed the discharge process
SEVEN STRATEGIES TO IMPROVE PATIENT SATISFACTION
Transport
Housekeeping
Bed Management Physicians
Nurses
1) Give patients a fast, smooth admittance process
ADMITTANCE
PATIENT ADMIT - PHYSICIAN COMMUNICATIONS
COMMUNICATION BREAKDOWN
COMMUNICATION BREAKDOWN
TRADITIONAL WORKFLOW
Physician is unavailable
Patient waits in ED
ED physician and attending physician need to discuss patient’s case
Nurse asks operator to page attending physician
Admissions staff updates ADT system
ED physician and attending physician finally
discuss case
PATIENT ADMIT - PHYSICIAN COMMUNICATIONS
Admit notification is sent to the attending
physician’s smartphoneAdmissions staff
updates ADT system
Attending physician presses number in
message to connect with ED physician
Attending physician gathers information from the ED physician and is
now ready to visit patient
WITH
Patient AdmitPatient ID: 1234567Patient Name: Michael TobinLocation: Room 532
Admitting Physician:Gloria Mendes, MD
PATIENT ADMIT - NURSE COMMUNICATIONS
System logs message receipt and acceptance
Nurse acknowledges message
Patient is admitted and nurse is notified on
smartphone
Nurse completes assessment
WITH
Patient AdmitPatient ID: 1234567Patient Name: Michael TobinLocation: Room 532
Admitting Physician:Gloria Mendes, MD
Radiology Results
2) Communicate test results promptly
Lab Results
Critical
Non-critical
INFORMATION SHARING
WHY ARE TEST RESULTS DELAYED?
• Notifications are largely a manual processes
– Phone tag – voice mails, faxes, etc.
– Manually track notifications
– Manual data entry
TRADITIONAL WORKFLOW
After some phone tag, Radiologist speaks with the ordering physician
about the patient
Results are critical
Radiology tech attempts to contact ordering
physician
Physician recommends patient has chest x-ray
Treatment begins
COMMUNICATION BREAKDOWN
CRITICAL TEST RESULTS
WITH
Results are sent immediately to the
physician’s device and includes audit trail
Results are critical
The patient’s physician must be notified
Physician recommends patient has chest x-ray
Attending physician takes immediate action
Results are entered into Spok
CRITICAL TEST RESULTS
• Improved patient care and sped treatment and discharge with faster communication of test results and incidental findings
•Reduced time physicians wasted calling around for test results or clarifications
•Developed a communications audit trail ready for Joint Commission visits
Tuomey Regional Medical CenterSumter, SC
“During the three months immediately following implementation, we saw an 11% improvement in patient discharge times.”
- José BennettPACS Administrator
SPEEDING CRITICAL TEST RESULTS
3) Respond quickly to the patient
Glass of water
Pain medication
Go for a walk
IV Is beeping
Short of breath
PATIENT REQUESTS
COMMUNICATION BREAKDOWN
COMMUNICATION BREAKDOWN
TRADITIONAL WORKFLOW
When able, the nurse goes to patient’s room
Staff begins to trackdown the nurse
Patient presses nurse call button
Request goes to nursing station
Nurse follows up with appropriate action
NURSE CALL REQUEST
Nurse messages attending physician for instructions
Nurse calls patient to determine need (pain)
Patient presses nurse call button.
Notification is automatically sent to
nurse’s smartphone with patient’s room number.
Patient receives medication quickly
WITH
NURSE CALL REQUEST
Nurse Call Request:7523
Thx!
Ms Avery 523 requesting more pain control
I’ll enter an order
Two-way communication between nurse and patient, with escalation rules and an audit trail
Lake Norman Regional Medical CenterMooresville, NC
"We wanted to improve nurse responsiveness. It was one category on patient surveys that repeatedly showed an opportunity for increased satisfaction - but we didn’t want to add complexity to a nurse’s day.”
- Brian Bissonnette Director of Information Systems at Lake Norman
PATIENT REQUESTS
4) Coordinate Provider Communication
“U.S. hospitals waste more than $12 billion annually from communication inefficiencies among care providers.”
- Agarwal, R., Sands, D.Z., Schneider, J.D. (2010)
Quantifying the economic impact of communication inefficiencies in U.S. hospitals. Journal of Healthcare Management, 55(4), 265-82
PROVIDERS
Code Calls
Physician-to-physician
Nursing staff
COORDINATING PROVIDER COMMUNICATIONS
BEFORE SPOK
Manual Paging
Manual Phone Tree
Wasted Time
Unconfirmed Responses
BEFORE Spok e.NOTIFY = 129 MINUTESTIME TO COMPLETE THE PROCESS:
START
RESPONSE TEAM• Cath lab staff • House supervisor• ICU shift
coordinator/nurses
• Attending cardiologist• Cardiovascular
coordinator• ER director• Cardiovascular director
• ER shift coordinator• X-ray/imaging
technicians• Lab technicians
Heart Attack Balloon Successful
Over communicate to ensure proper response
Inefficient phone trees among 30
people
THE CODE STEMI ALERT: WITH SPOK
Heart Attack Balloon SuccessfulStaff Respond w/Availability
Use e.Notify to Deploy Code
e.Notify Manages Response & Escalation
RESPONSE TEAM• Cath lab staff • House supervisor• ICU shift
coordinator/nurses• Attending cardiologist• Cardiovascular
coordinator
• ER director• Cardiovascular
director• ER shift coordinator• X-ray/imaging
technicians• Lab technicians
e.Notify• Logic for on-call calendar• Auto escalations based on
responses or non responses from staff
• Eliminates manual calling trees and messy escalations
BEFORE Spok e.NOTIFY = 129 MINUTESTIME TO COMPLETE THE PROCESS:
START
WITH Spok e.NOTIFY: 68 MINUTES
•Streamlining their average door-to-balloon time for heart attack patients
•Reduced average door-to-balloon time from 129 minutes to 68 minutes
IU Health Goshen HospitalGoshen, Indiana
“For code STEMIs, there were a multitude of calls being made that didn’t need to be. It all just happens now.”
- Andrea Daniels, RN, BSN Director of Cardiovascular Services
SPEEDING CRITICAL TEST RESULTS
5) Promote a quieter, more restful healing environment
Silence squeaky wheels
Promote inside voices
Reduce overhead pages
Less hallway conversation
QUIET TIME
COMMUNICATION BREAKDOWN
COMMUNICATION BREAKDOWN
TRADITIONAL WORKFLOW
Nurse calls for other staff nearby to assist
Nurse hears the alarm and runs to patient room—
realizes it’s a V-fib alarm
Patient monitor alarm goes off
Care team runs to patient room to begins defibrillation
PATIENT ALARM - V-FIB ALARM
Nurse and team arrive in patient room quickly and
begin defibrillation
Nurse receives urgent priority
V-fib alarm on smartphone and calls for staff
assistance on the way to the patient room
Patient monitor V-fib alarm
goes off
WITH
PATIENT ALARM - V-FIB ALARM
Urgent:V-Fib alertRoom 203
Routes all nurse call requests and patient monitoring equipment alarms and alerts to the right individual’s mobile device
Maple Grove HospitalMaple Grove, MN
"One of the significant effects of this approach, and one of the most frequent patient comments we receive, is how noticeably quiet the hospital is.”
- Craig Wolgemuth Senior IT Project Manager at Maple Grove Hospital
QUIET TIME
6) Keep the patient’s family updated
PATIENT’S FAMILY
PATIENT’S FAMILY
“She’s out of the OR and into a room…”
Family members given iPad in waiting room, loaded with messaging app.
Can browse the web, check email, and be notified of status changes for their loved ones.
7) Speed the discharge process
Nursing
Transport
Housekeeping
Infection Control
Pharmacy
DISCHARGE
Tuomey Regional Medical CenterSumter, SC
“During the three months immediately following implementation, we saw an 11% improvement in patient discharge times.”
- José BennettPACS Administrator
SPEEDING PATIENT DISCHARGE
COMMUNICATION BREAKDOWN
TRADITIONAL WORKFLOW
Nurse has to track down the specialist indicated by the attending for approval
Attending physician writes note stating “OK to discharge pending approval from…”
Patient is ready to be discharged
Patient waits until approval is received, and is eventually discharged
SPEEDING PATIENT DISCHARGE
Nurse messages attending physician for instructions
Attending looks up and messages specialist to get
discharge approvalPatient is ready to be
discharged
WITH
SPEEDING PATIENT DISCHARGE
Thx!
OK to discharge Jane Smith in 421?
Fine by me
SUMMARY
Coordinate staff required for patient admissions and discharge with automated messaging
Route nurse call requests, patient monitoring equipment alarms, and alerts to the right individual’s mobile device
Automatically notify ordering providers when test results are ready
Reduce noise with secure texting and mobile clinical alerts
LET’S GET IN TOUCH!
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CASE STUDIES VIDEOS
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