Customer Stories: Improving Communication and Collaboration

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EHR

Elevating Patient Safety

Beaumont Hospital 1,000 bed teaching hospitalTroy, MI

Challenge:Hardwire patient safety by improving communication between Central Telemetry and the hospital’s thirteen floors

PatientSafety

• Unit nurses are assigned to “bed groups” in Vocera. Upon a change in the patient’s status, Central Telemetry calls the “bed” and is routed to the assigned caregiver, providing priority and urgency to telemetry alerts

• 9+ minutes from alarm notification to closure• 28% of alarms with documented

closure

• 39 seconds from alarm notification to closure • 100% of alarms with

documented closure • Increased staff efficiency

and effectiveness

Situation Approach Impact

EHR

Reducing Care Team Communication Delays

Birmingham Children’s Hospital361-bed hospital serving 270,000 young patients annually inEngland’s West Midlands County

Challenge: Improve communications between care team members in a large, multi-ward paediatric ICU (PICU)

Patient and Staff Experience

• When the hospital expanded its PICU to include a second ward separated by a corridor and a double door entryway, nurses and physicians could no longer locate each other quickly with a visual scan of the unit

• Communications between care team members were delayed by the need to physically locate colleagues

• Reduced response time for inquiries to roaming staff from 2 minutes to 9 seconds• Reduced connection time for

inbound calls to staff by two-thirds• Staff-initiated emergency events

fell from 2.17 per 100 occupied bed-days to 1.69• Reduced workplace tension and

frustration

Situation Approach Impact• Implemented the wireless, hands-

free Vocera® Communication System for bedside nurses, consultants, nurse managers, team leaders, registrars and tech team nurses – with higher priority for more mobile personnel

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EHR

Improve Operating Room Efficiency

Central Maine Medical Center190 Bed, Level II Trauma and Referral Hospital, Lewiston, ME

Challenge:Improve communication efficiency to build operating room capacity without increasing labor costs.

Operational Excellence

• EMR system highlighted delayed or inefficient process related to ineffective communication, averaging 37 minutes per surgical case• Top six charge team members

receiving over 752 pages per month w/average 3-minute page cycle

• Average length of surgical case was decreased 2.6%; 350 hours of capacity were created• Productivity improved 9%• FTEs were decreased by 11.6% –

a savings of $303K• Beeper pages to key personnel

decreased 93% per month; @ 3 min./page cycle, that cuts 35 hours per month

Situation Approach Impact• OR and Anesthesia staff identified

key communication lag-points through the EMR data and observational studies• Researched and deployed Vocera

throughout the full perioperative continuum including the ancillary services and 18 Anesthetizing sites

EHR

Improve Care Team Communications to Meet Demands of Critical Access Hospitals

Columbia County Health System25-bed hospital and 49-bed skilled nursing facilityDayton, WA

Challenge:Improve communications at a rural hospital and skilled nursing facility to enhance patient care; improve emergency care coordination; reduce noise levels, and transport-related staff injuries

Patient and Staff Experience

• ER staff couldn’t communicate easily with EMS personnel to prepare for patient arrivals

• Nurses and assistants couldn’t summon assistance for two-person patient moves

• Skilled nursing facility patients complained of night time noise

• No funding for communications technology solutions

• Improved HCAHPS scores*:• Response to nurse call buttons : 68%

to 82.6%• Quietness around patient rooms: 63%

to 69.2%

• Decreased call light response times and patient fall rates

• Reduced wait times for transfers and improved patient care

• Reduced noise levels in rest home patient areas

Situation Approach Impact• Partnered with Vocera and

received a Washington State Hospital Association grant

• Implemented the Vocera® Communication System with configuration and training support by Vocera Professional Services

• Assigned a direct call-in for external emergency services

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* Dayton General Hospital reported significant improvements in 3 communications-related metrics from July 2014 to June 2015, even though the Vocera solution was active for only two months.

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EHR

Improving Nurse Call Response Times

Community Heart and Vascular Hospital56 Bed Integrated Cardiovascular SystemIndianapolis, IN

Challenge:Communicate patient requests directly to the assigned care team to decrease response times

Patient Experience

• Nurses would respond to call lights by walking to the console at the central nursing station or to the patient room, which was not efficient• Nurse response time was

identified as a key component in the hospital’s Culture of Safety program

• 40% improvement in nurse response times• Quieter healing environment

due to reduction in overhead paging• Improved nurse communication

and a quiet environment impact HCAHPs scores

Situation Approach Impact• The team integrated the Vocera

Badge with:• Rauland Responder IV nurse call

system• Philips IntelliSpace Event

Management middleware• Patient’s request is sent directly to

the Vocera Badge — the nurse can choose to accept or reject the request, or call the patient back directly at the pillow speaker

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EHR

Improve Operating Room Efficiency

Cuyuna Regional Medical Center – Minnesota Institute for Minimally Invasive Surgery 5 OR and 2 Endoscopy SuitesCrosby, Minnesota

Challenge:Increase OR throughput and drive efficiencies by improving communication

PatientFlow

• Increased surgical demand without an option to build more rooms drives need to work more efficiently• Longest communication delays were

calls put on hold or transferred (up to 231 sec)• Most significant dissatisfiers were time

spent searching for staff and ineffective communication; information gaps; redundancy, and miscommunication

• Increased throughput by 253 cases/yr with existing space – obtaining their efficiency goal

• Average length of a surgical case was decreased 5% – a saving of 15 minutes

• Average total labor expense decreased 5.6% per case

• Significant improvement in care team satisfaction across all areas measured

• 37% reduction in steps – about 1 mile/person/shift

Situation Approach Impact• Clinical team researched and chose

Vocera to deploy throughout perioperative services• Pre/post Vocera deployment time-

stamped data for cycle time (minutes per surgical case) was compared to show the impact of Vocera on patient throughput• Satisfaction survey data collected• Pedometer readings collected

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EHR

Improve Patient Satisfaction and Streamline Process Flow

DMC Huron Valley-Sinai HospitalPart of Detroit Medical Center

Challenge:Drive a more positive experience for patients, nurses, physicians, and other clinical staff members

PatientSatisfaction

• Nurse call and bed alarms initiated by patients go directly to a unit clerk’s desk• Unit clerk determines the nature

of the event and attempts to notify the right caregiver to respond• Patients are left waiting for help

or a response from caregivers

• Patient perceptions of hospital quietness improved 20% due to reduced overhead paging• Patient satisfaction improved due

to better patient visibility into the responses being made by clinical staff to their requests• Hospital clinical staff mobilized

specialty teams more quickly and efficiently

Situation Approach Impact• Leverage the secure, intelligent

communication of Vocera to streamline process flow• Integrate Vocera with Rauland

Responder® nurse call systems and Hill-Rom® bed alarms to improve response times

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EHR

Increasing Staff Effectiveness and Satisfaction

Eastern Maine Medical Center400 bed community hospitalBangor, ME

Challenge:Increase surgical throughput by one case per day.

Patient Flow

• 44% of cases start on time • 32% of cases turnover outside

acceptable timeframes causing delays and staff overtime

• 80% of cases start on time• $780,000 increase in net revenue

(after expenses)*• $18,500 reduction in afternoon

overtime• Unforeseen issues now receive

quicker attention and resolution

Situation Approach Impact• Vocera Badges are used by the

hospital’s OR secretary, charge nurse, anesthesiologist, Chief CRNA, and 7 supporting departments spread across three floors to streamline communication and prevent delays

*Increase case load by 250 patients; Net revenue $3,129.00 per case

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EHR

Design a Patient Centered Hospital

Franklin Woods Community Hospital80 bed community hospitalJohnson City, TN

Challenge:Design a new community hospital to focus on patient safety, patient-centeredness and effective communication.

Patient Safety

• Average ED nurse to unit nurse call cycle time of 7 minutes and 11 seconds• Inefficient use of time on

communication cycles was keeping staff from care• Internal noise levels of over 60

decibels impacting patient experience

• Average ED nurse to unit nurse call time reduced to 40 seconds• Noise level decreases across the

hospital to as low as 20 decibels• 75% of staff members agreed

or strongly agreed that Vocera makes their job easier

Situation Approach Impact• Vocera deployed upon the

opening of the new hospital:• Cross functional deployment team

in place to train and measure success• “Day in the life” scenario based

training to identify areas for process improvement and optimal impact on patient care

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EHR

Improving Patient Safety with EHR Integration

Genesis Health SystemServing the Quad Cities metropolitan area in 10 counties across Iowa and Illinois

Challenge:Enabling quick and efficient notification of STAT orders to the right person from Cerner’s Millennium EHR

PatientSafety

• With CPOE, physicians place STAT orders electronically• Orders would be made available

in Cerner• STAT orders could be sent to

printers or email addresses, but were not regularly checked

• Any order with a STAT status triggers Cerner to send a message via Vocera to the charge nurse for the appropriate unit• Orders are sent within 10 to 30

seconds of physicians placing them, and can be carried out nearly instantaneously• This method of guaranteed

communication can be reviewed later

Situation Approach Impact• Leverage the secure, intelligent

communication from Vocera with Cerner’s Discern Expert clinical decision support system

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EHR

Improve Staff Engagement and Patient Experience

Guadalupe Regional Medical Center125-bed community hospital, Seguin, Texas

Challenge:Automate rounding practices to improve communications and the patient experience

Patient and Staff Experience

• Patient and staff rounding processes were manual, paper based, and labor intensive

• Logistical issues in the rounding process made it hard to ensure patient needs were being promptly addressed

• Patient requests and feedback were difficult to track and analyze for trends

Situation Approach Results• Implemented Vocera® Rounds, a

secure, configurable software-as-a-service platform for patient and staff rounding that is tailored to hospital goals and industry best practices

• Standardized on more assertive phrasing during patient rounds so that patient needs could be met more proactively

C

• Improved patient experience with proactive rounding and better communication

• Accelerated care team process improvements with real-time rounding data

• Improved staff engagement with hospital leaders to drive satisfaction and loyalty

• Improved HCAHPS scores across multiple units. Achieved an overall improvement of 11.8%

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EHR

Improve Care Team Communication Security and Efficiency

Halifax Health678-bed community health systemEast Central Florida

Challenge:Improve care team communication security and efficiency

Operational Excellence,

Patient Satisfaction

• To contact off-site physicians, clinicians had to use an inefficient call center system

• Frequent delays in the call center communications process often affected response times to patient needs

• Care teams often resorted to personal smartphones and unsecured messaging services

• Reduced patient wait times and delays in care team communications: process that used to take 30 to 45 minutes is now almost instant.

• Improved care team responsiveness and patient experience

• Accelerated discharge notifications; discharge durations of up to five hours have been improved by 8 percent

Situation Approach Results• Implemented Vocera®

Collaboration Suite

• Deployed with the Vocera Communication Badge, integrated to MEDITECH EHR, and TeleTracking patient flow systems

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EHR

Improve Communication Efficiency

Health First Holmes Regional Center514 Bed, Level II Trauma and Referral Hospital Melbourne, FL

Challenge:Improve communication efficiency of the surgical department with other departments that impact surgical patients

Operational Excellence

• Hospital group performs over 9000 surgeries a year in 18 ORs • Perioperative area spread over

2 wings with ¼ mile distance between furthest points• Communication breaks cause

back ups and delays in OR that impact quality of care and cost money

• Vocera cut out 2 to 3 minutes from the workflow saving at least 10 minutes per nurse per shift• More efficient cases resulted in

fewer delays of surgery and more efficient movement through the perioperative area• Improved hospital efficiency

allows caregivers to provide better care for patients and reduces operating costs

Situation Approach Impact• Implemented Vocera across

clinical and administrative staff in endoscopy, special procedures rooms, PACU, anesthesiologists and nurses on units

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EHR

Improving Communication in the OR

North Shore University Health System900 bed hospital systemEvanston, IL

Challenge:Communication inefficiencies in the OR presented significant frustrations and challenges for physicians and patients.

Staff Empowerment

• Approximately 100+ overhead pages per hour• Pagers caused 2-3 minute delays• Patients dissatisfied in the PACU• Communicating with off-site

resources difficult (MRI, IR, Cath Lab)

• Overhead paging was reduced to approximately 10 per hour• Communication was

instantaneous both inside the OR and with off-site facilities and resources• Patient satisfaction improved

from reduced noise levels and faster response times

Situation Approach Impact• The hospital implemented

Vocera, and partnered with Northwest Engineering students in a three-month communication study involving surveys, observation, and test phone calls to evaluate the situation

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EHR

Improving Patient Safety with Alarm Notification

Pella Regional Medical Center25-Bed Critical Access Hospital

Challenge:Improve capabilities and accuracy of infant protection system

InfantProtection

• Deployed Vocera Badges and STANLEY Hugs • Leveraged Vocera Groups to

deliver alarms to the appropriate OB and PCT teams• Alarm notifications include the

reason for the alarm, enabling the team to respond appropriately• Enabled ability to cancel alarms

from Vocera

• Previous system not designed for infant use• Did not support alarms for tag

tamper/removal• System required manual

cancelation from the alarming source• Broadcast alarms added noise

to environment

• Provides greater protection for newborns• Saves footsteps for nurses• Promotes quiet healing

environment• Supports improved family

experience

Situation Approach Impact

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EHR

Increasing Staff Effectiveness and Satisfaction

Royal Victoria HospitalBelfast, N. Ireland

Challenge:Improving internal communications in order to provide better patient care, improve staff efficiency and increase staff satisfaction.

Resource Utilization

• 4,000 hours annually saved in Emergency Department alone by reducing amount of time required to communicate with colleagues• Represents about 4% of total

ED clinical resources• 100% of consultants and 96% of

nurses report improvement in communications• Time to locate bed managers and

find available beds reduced by 2 hours per day

Impact

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EHR

Accelerating Alert/Alarm Response Time

Saint Barnabas Medical Center597-bed non-profit teaching hospital Livingston, NJ

Challenge:Reduce communication time between Centralized Telemetry Monitoring Center and clinical staff to expedite response to critical alarms and alerts.

Patient Safety

• Centralized Telemetry Monitoring Unit monitors 158 beds for 7 units• Critical alarms, alerts and values

are recorded by the telemetry unit staff then immediately communicated to clinical team via phone, cell phone or pager• Communication process could

take up to 12 minutes to close the communication loop

• With Vocera in place closed loop response time is under 30-seconds.“If you can shave 11.5-minutes off of the time it takes to establish communication with the care giver, you can drastically change outcomes,”

Malachy McGrathBarnabas Health

Situation Approach Impact• Vocera integrated into the call

flow process:• Bed groups allow nurses and

auxiliary staff to be notified immediately on their Vocera Badge• Nursing station phone rings as

back-up

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EHR

Improve Patient Flow and Staff Efficiency

St. Thomas Elgin General Hospital166-bed hospital, 850 staff membersSt. Thomas, Ontario, Canada

Challenge:Raise standard of care by:

1. Increased time caring for patients 2. Improved emergency department patient throughput

PatientFlow

• 42,000 ED patient visits a year • Inefficient pager system used to

coordinate the preparation of beds for new admissions • Connectivity issues caused delays in

housekeeping response time and ED bottlenecks• Staff spent significant time finding out

the status of rooms before patients could be admitted

• Reduced admit-to-bed time to 60 minutes • Spent less time on logistics and at

least 80% of time with patients • Faster admission-to-bed and discharge

times positively impact total length of stay and improve patient satisfaction• Improved communication between

housekeeping and floor nurses decreased bed turnover time and improved staff satisfaction

Situation Approach Impact• Replaced overhead paging with Vocera

and integrated with Cerner and Medworxx Bed Board bed optimization system

• Vocera Messaging was introduced for caregivers with smart phones

• Vocera was deployed to the hospital’s entire nursing staff, administrative staff, respiratory therapy, maintenance, and security

EHR

Enhancing Workplace Safety with a Proactive Approach

Toronto East General Hospital (TEGH)Urban, full-service community teaching hospital, providing comprehensive care to a diverse population of 400,000, representing over 45 cultural and linguistic groups. Challenge: Take proactive steps to prevent and mitigate potential threats to staff by further enhancing its preventive security measures.

Patient and Staff Experience

• In 2008, TEGH conducted research regarding security response times.

• The hospital performed well in comparison to industry statistics, however management wanted to further enhance its preventive security measures.

• Vocera streamlined communications, increased productivity, and improved patient care.

• Staff can ask questions related to a patient’s care and get an immediate answer.

• Staff finds it to be a significant enhancement to efficiency, and it contributes to making them feel safe.

Situation Approach Impact• Vocera offered a way for security

and staff to communicate hands-free anywhere in the hospital.

• Security is able to speak directly to staff throughout the facility.

• The Badge is used by approximately 80 percent of TEGH staff and is considered part of staff’s daily operations.

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EHR

Improve Discharge Process for Transplant Patients

University of Wisconsin Hospital & Clinics592 Bed, Academic Medical CenterMadison, WI

Challenge:Improve transplant patient discharge communication to reduce readmissions

Patient Understanding & Satisfaction

• Nationally, 30% of kidney transplant patients are readmitted to acute care hospitals within 30 days• Patients easily become overwhelmed

with information and instructions following a transplant

• The discharge process is better organized; Vocera Good to Go fits easily into workflow• Usage among kidney patients

averaged 33% in the first 6 months, double the typical usage rate for new technologies• Being able to check medication and

other discharge information empowers patients and their supporting circle of care

Situation Approach Impact• Vocera Good to Go® is utilized within

the patient discharge process• Personalized discharge info and

instructions are recorded and compiled at the bedside; patients and families can access at any time from computers and mobile devices• Began with kidney transplant

patients; extended to other patient populations including pancreas/liver transplant patients