Customer Stories: Improving Patient and Staff Safety

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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

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Cullman Regional Medical Center145-bed hospitalCullman, AL

Message:Vocera Good to Go improves patient understanding of care instructions, improves patient experience and impacts readmissions.

EHR

Improved Patient Understanding, Safety, and Experience

Patient Understanding,

Safety, and Experience

• Statistics show that 20% of patients will be readmitted to the hospital within 30 days of discharge.

• CMS to deny payment for Medicare patients readmitted within 30 days for the same diagnosis.

• Complex clinical information can be confusing to patients and families.

• Distractions and/or patient anxiety at discharge can cause missed or rushed discharge instructions.

• No way to track if patients read paper discharge instructions.

• 15% reduction in readmissions when patients use Good to Go.

• HCAHPS increase by 63% for the question about what symptoms to look for after discharge.

• HCAHPS increase by 62% for staff talking with patient about help needed after discharge.

• 100% of inpatients discharged with Good to Go, said hearing “live” instructions improved their understanding.

• Expanding Good to Go to the ED, one-day surgery, pre-admit testing and physical and respiratory therapy.

• Engaging more physicians with the Good to Go solution.

Situation Approach Impact• Caregivers record “live” discharge instructions,

incorporating teach back and spaced repetition.

• Capture instructional videos, pictures, and educational documents

• Create and send text reminders, emails, tasks, and care messages to patients and family members.

• The patient, family, and/or other caregivers can review the multimedia information any time using any phone or computer.

• Auditing tool allows CRMC to monitor discharge sessions and track patient retrieval of instructions.

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EHR

Improving Core Measure Performance

El Camino Hospital 395 bed magnet hospitalMountain View, CA

Challenge:Become Northern California’s preeminent service provider for stroke and chest pain care by providing patients with rapid, highly coordinated MET teams.

PatientSafety

• Stemi-Door to Balloon Time: 112 minutes• Stroke core measures

inconsistently achieved

• 44% improvement in door-to-balloon time: 62 minutes• 3 consecutive months achieving

all 10 core measures • Qualified for US News & World

Report 2009 Top Hospitals

Situation Approach Impact

• Specialty groups developed in Vocera to convene critical care teams:• “Chest Pain Alert” – activates chest

pain team and clears cath lab table• “Stroke Alert” – activates stroke

team and clears CT scanner

EHR

Improving Workflow and Patient Safety

Emerus/Baptist Emergency HospitalsAcute Micro HospitalsMultiple locations in Texas, including joint ventures

Challenge:Improve internal communications and telemetry system to support the Emerus model for patient care

Patient Safety &

Experience

• The Vocera Communication System was integrated with the hospital’s telemetry system with an alarm escalation workflow• The Vocera Badge effectively

replaced overhead paging and is worn by the entire staff

• Traditional centralized telemetry methods did not support the Emerus model of care; it would keep nurses tethered to one place and limit their ability to respond to patient needs• Overhead paging complicated

internal communication; the background noise was disruptive to patients

• Response time for alert incidents reduced by 3-5 minutes, when every second counts• Saved $80,000 to $130,000 per

facility relative to the cost of hiring dedicated telemetry nurses• Direct communication among staff

increased patient safety and care• Clinical staff able to remain with

patients while calling for backup

Situation Approach Impact

EHR

Designing 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• The Vocera Commmunication

Badge was 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

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

Elevating the Patient Experience

Genesis HealthCare SystemNot-for-profit 603-bed community hospitalZanesville, OH

Challenge:To enable a continuous improvement model that infuses the voice of patients and families and allows for real-time service recovery

Patient Understanding,

Safety, and Experience

• Lacked standard and structured way to engage patients and families

• Challenge in defining and measuring accountability

• Inability to track or address trends (HCAHPS scores are a 1-2 month lagging measure)

• Limited ability to capture patient complaints or compliments

• 35% increase in overall rating of the hospital (HCAHPS)• ~90% of comments are now

positive• 40+ positive staff comments per

week, driving a formalized recognition process• Proactively managing gaps in

experience, knowing where the areas of focus are and should be

Situation Approach Impact• Vocera Care Rounds streamlines

and manages nurse leader rounding • The solution captures real-time

feedback, records direct insights from patients and families• Includes ability to provide

meaningful and actionable trending information• Automates patient service

requests to other departments

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

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 Safety

Staten Island University Hospital64-bed hospital unit, two shifts of 28 nurses

Challenge:Mix use of Tele and fixed monitors, monitor watches

PatientFlow

• 13,000 alarm notifications/day• Each nurse receives alarm every two

minutes

• Average daily alarms down to 1,000/day

Situation Approach Impact• Deployed Vocera Clinical Analytics and

Alarm Management

EHR

Enhancing Workplace Safety

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 Safety

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

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13

EHR

Reducing Patient Fall Rates

University of Arkansas for Medical Sciences (UAMS)516 Beds, Level 1 TraumaLittle Rock, Arkansas

Challenge:Leverage existing technologies to reduce fall rates, improve patient response time, and drive efficiencies

Patient Safety

• UAMS was at the 98th percentile of injury falls in their NDNQI* overall comparison • UAMS fall prevention study showed

an opportunity to improve on the existing bed alarm notification time• The move to a patient-centric

design made it more difficult to support the logistics of patient care and for the care team to communicate with each other

• Improved to the 11th percentile in NDNQI overall comparison• 11% reduction in falls, 60%

reduction in fall-related injuries• 88% improvement in ability to

respond when integrated with fall alarm vs. a bed alarm• Estimated savings in fall related

injuries of $1.27m**

Situation Approach Impact• The Hester-Davis Scale was created

to identify patients most likely to fall in the hospital• Clinical chose the B3000 Badge to

integrate with:• Posey Sitter Select• West-Call nurse call lights• Orchestrator middleware• Vocera was also integrated with

Telemetry – Respiratory Therapy, Pharmacy, and others were added to the Vocera ecosystem **Based on estimates by the Centers for Medicare and

Medicaid Services for fall-related injuries in 2011

*National Database of Nursing Quality Indicators

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EHR

Reducing Readmission Rates

University of Chicago Medicine (UCM)532-bed private not-for-profit academic hospitalChicago, IL

Challenge:Decrease unnecessary readmissions by extending its care model out of the hospital and into patients’ homes

Patient Understanding,

Safety, and Experience

• Needed to support the hospital to home transition

• Had no consistent means to capture the voice of the patient post-discharge

• Desired the capability to identify at-risk readmits

• Wanted to provide leaders with a view into patient feedback to enhance employee engagement

• 1.5% reduction in readmission rate after 4 months for adult patients who received a discharge call

• 8 point improvement in overall hospital rating within 6 months

• Provides actionable data for driving significant process improvement and employee recognition

Situation Approach Impact• Implemented Vocera Care Calls

• Developed a centralized clinically-based discharge call center, utilizing care transition coordinators

• Defined Care Call questions focusing on service

• Developed a feedback mechanism

for leadership