Post on 19-Apr-2020
Communication & EHR Integration Improves Patient Experience
March 2, 2016
Liz Michael, RN, BSN, MS, NEA-BC Vice President of Patient Care Services and Chief Nursing Officer
Stillwater Medical Center
Conflict of Interest
Liz Michael, RN, BSN, MS, NEA-BC
Vice President of Patient Care Services and Chief Nursing Officer
Stillwater Medical Center
Has no real or apparent conflicts of interest to report.
Agenda
• About Stillwater Medical Center
• Overview of Learning Objectives
• Communication and Workflow Challenges
• Communication and Clinical System Integrations
• Benefits Realized
• Next Steps for Continuous Improvement
• Q & A
Stillwater Medical Center
• 117-bed acute care general hospital
• Not-for-profit, public trust hospital facility serving patients throughout north central Oklahoma
Essential Values:
• Strive for performance improvement.
• Respect the dignity of every individual.
• Promote an environment that is receptive to new and creative ways to achieve excellence in the services we provide.
Compassion, mutual trust and cooperation are the foundation on which these values are built.
Learning Objectives
• Evaluate how seamless care team communication and collaboration reduces errors and improves patient satisfaction
• Demonstrate how integrating communication technology with the computerized physician order entry system improves workflow efficiency and patient care, allowing clinicians to make more informed decisions and spend more time at the patient bedside.
• Analyze the need to bring a new level of reliability and repeatability to care delivery by helping hospitals standardize processes and hardwire best practices, redefining how organizations connect and share information
Industry Communication Challenges
Hospital
communications
related failures
are the 3rd
highest cause of
death in the
U.S.(1)
SAFETY SATISFACTION
Communication
impacts patient
experience and
CMS revenue
reimbursement(3) $12 billion
is wasted
annually in
U.S. hospitals
as a result of
communication
inefficiencies.(2)
WASTE
(1) New Evidence-Based Estimate of Patient Harms, Journal of Patient Safety, Sept., 2013;
Centers for Disease Control, 2010 data; The Joint Commission (2) Agarwal et. al. Univ. of Maryland, 2010 (3) Centers for Medicare and Medicaid Services (CMS)
Audience Engagement: Question #1
What is your No. 1 Communication Concern or Challenge?
A. Alarm Fatigue
B. Bring Your Own Device-BYOD
C. Care Team Communication
D. EHR Integrations
E. Patient Engagement
F. All of the Above
G. None of the Above
Audience Engagement: Question #2
Which improvement effort is a top focus in your organization?
A. Length of Stay
B. Patient Experience & HCAHPS
C. Patient Safety
D. Physician Engagement
E. Staff Satisfaction & Retention
F. All of the Above
G. None of the Above
“Communication is a foundational pillar
that every hospital should have at the top
of their priority list.
As the speed of staff communication
increases, so does coordination of care.”
Chris Roark
Chief Information Officer
Stillwater Medical Center
Addressing Communication Challenges at Stillwater Medical Center
Mobile
Communication
and
Nurse Call
Systems
INTEGRATE INTEGRATE
CPOE
and
Mobile
Communication
System Implement
Computerized
Provider
Order Entry
(CPOE)
Communication Goal 1 Reduce Response Time, Increase Satisfaction
SOLUTION: Nurse Call Integration
• Automate Patient and Staff Requests
• Enable Direct Nurse and Patient
Communication
• Escalate Requests to the Right Care
Team Member(s)
CHALLENGES:
• Staff Highly-Mobile
• Staff Not Tethered to Nurse’s Station
Communication Goal 2 Improve Workflow Efficiency, Experience
CHALLENGES:
• Physicians wrote paper orders
• Secretaries entered orders into EHR
• Orders were sent to printers in specific
hospital department(s)
• Paper shortages, system failures, and
outages caused further delays
“In health care, changes in the way we
organize our work will most likely be the
key to improvement.”
“It means creating new ways to build
teamwork once doctors and nurses are
no longer yoked to the nurse’s station by
a single paper record.”
Robert M. Wachter, MD
The New York Times
March 21, 2015
Solution: Intelligent Integration CPOE and Existing Communication System
“Would you
like to mark
room cleaning
in progress?”
“Yes”
Real-time EHR Updates Hands-free, Two-way Communication
Clinical system integration delivers the right information to the right person at the right time and place.
Enhance Patient Safety
Increase Patient Satisfaction
Improve Nurse Responsiveness
Improve Workflow Efficiency
Nurse Call
RTLS / RFID
Impact of Integrated Systems
Mobile Communication
System CPOE
Impact on Patient Satisfaction Nurse Call, Mobile Communication Integration
Staff Responsiveness
HCAHPS Scores Increased
74% to
82.4%
Pain Management
HCAHPS Scores Increased
66% to
81.3%
STEPS: SATISFACTION
Improved
reliability of delivering orders,
and improved order-to-response
turnaround times
Reduced Medical Errors
by eliminating handwritten
orders
Impact on Treatment CPOE and Mobile Communication Integration
STEPS: TREATMENT / CLINICAL
Impact on Treatment Eliminating Hand-written Orders, Reducing Errors
Source: Journal of Health Care Finance, Vol. 39, No. 1, Fall 2012,
published by Wolters Kluwer Law & Business
Nearly $1 Trillion
economic impact
200,000 Americans die from preventable
medical errors.
Satisfied Provisions
of HITECH Act to Achieve
Meaningful Use Compliance
STEPS: ELECTRONIC SECURE DATA
Impact on Electronic Secure Data
Increased valuable time that care team members spent at the patient
bedside
Impact on Patient Engagement
STEPS: PATIENT ENGAGEMENT & POPULATION MANAGEMENT
Improved bed turnover rates
and ensured beds were
available for patients
Reduced time
resources, and materials
needed to print and retrieve paper orders
Impact on Savings
STEPS: SAVINGS
“We owe them journeys – not fragments.”
Don Berwick, MD
September 13, 2010
LOOKING AHEAD: Next Steps to Improve Care Team Communication and Collaboration
• Add physician order sets to the
communication cue
• Continue evaluating technologies to
keep caregivers at then bedside
• Improve wireless access points
• Evaluate human-centered
innovations that improve patient care
Goals:
Audience Engagement: Question #3
What unintended impact has occurred due to deploying an EHR?
A. Requires Constant Checking
B. Difficult to Find Time-sensitive Info
C. Distracts from Patients
D. Less Real-time Comm w/Staff
E. Poor or Fragmented Workflows
F. All of the Above
G. None – Don’t Have An EHR
Audience Engagement: Question #4
What tech will make the most impact in the next 2-3 years?
A. Alarm Management & Analysis
B. EHR Integrations
C. Secure Texting Among Docs
D. Texting b/w Patients & Docs
E. Telemedicine
F. All of the Above
G. None of the Above
Questions?
Liz Michael, RN, BSN, MS, NEA-BC
Vice President of Patient Care Services and
Chief Nursing Officer
Stillwater Medical Center
Lmichael@Stillwater-Medical.org