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Nurses Find Simple Ways to Improve Satisfaction June 1, 2010 Topic: Outcomes in the News Healthcare leadership is well aware that many tasks keep nurses away from the bedside. There are the obvious ones, such as documentation, collecting medications, and hunting equipment. And there are the not-so-obvious ones, such as answering phone calls from patients’ concerned relatives. Although a relatively minor clinical concern in a nurse’s day, relatives tend to call to check on patients right when nurses are first beginning their shift, when they are trying to hear reports and check in on their patients for the day. To make the process simpler, nurses at Chilton Memorial Hospital in Pompton Plains, NJ, decided to designate a specific time for relatives to call. The decision is part of the organization’s larger Transforming Care at the Bedside initiative, says Joanne Reich, VP and chief nursing officer at Chilton. The TCAB initiative is sponsored by the Robert Wood Johnson Foundation and the New Jersey Hospital Association with a goal to improve the quality of care on medical/surgical units. “Our emphasis is on nursing staff taking a critical look at their care environment and how they can increase their satisfaction and effectiveness in care delivery,” says Reich. “Nurses have many interruptions, so they have been working on increasing time at the bedside.” Nurses began tracking the number of calls they were receiving from families of patients and discovered the calls used up a significant amount of time and called them are away from the bedside just as they had started assessing their patients or receiving reports. Having a designated time for families allows patients and families to coordinate the best time in the morning for them to call. Nurses now can plan their mornings better. They can accomplish what they need to do at the start of the shift, and they can ensure they are ready with the information needed when they know the call is coming. The change was supported by leadership and has worked very well. “Nursing leadership recognizes the leader within each nurse,” says Reich, “and that each nurse is a professional and can bring to the table what they feel works best.” Nurses also revamped how patient call bells are treated. In a collaborative project with other disciplines, such as physical therapy and respiratory therapy, the hospital created a “no pass zone.” “It’s a commitment by all of the staff that if patient call bell is lit, no one will pass that room,” says Reich, “without going in and introducing themselves and seeing what’s the patient needs.” Often, the staff member will be able to help the patient, such as by refilling a water pitcher, which increases patient satisfaction. If the staff member can’t help, he or she quickly takes the issue to the patient’s nurse. Reich says the next project nurses are tackling will examine patient environment. This more in-depth project requires consideration of different concepts and ideas to determine what is best for patients and what is needed to implement the ideas. “They want to ensure the patient environment is prepared in the manner that works best for patients,” says Reich. “They’re examining if patients have what they need in the way of water, tissues, food tray, etc. Our goal continues to be providing quality, personalized care to each of our patients. ” [Nurses Find Simple Ways to Improve Satisfaction] via HealthLeaders Smartphones save money and stave off staffing shortages, study finds May 17, 2010 Topic: Outcomes in the News
So say the findings of a white paper published today by Voalté, a Sarasota, Fla.-based developer of point-of-care communications software for iPhones and BlackBerry devices. “Smart Hospitals – Embracing Smartphones at the Point of Care” highlights communication inefficiencies within hospitals that cause confusion and reduce effectiveness. It concludes that smartphones offer a comprehensive and easy-to-adopt solution. Researchers have found that ineffective communication wastes as much as $12 billion nationwide each year, and that frustrations with outmoded systems can lead to nurse dissatisfaction and, ultimately, exacerbate the hospital staffing shortage. But “smartphones offer a solution to many of today’s healthcare communication issues,” the study finds. “With PC-like functionality and advanced capabilities, smartphones provide a single interface to make calls, send texts, manage schedules, organize tasks, view online literature, and receive alerts. Most clinicians are already familiar with smartphones and the devices easily integrate with hospital networks, providing a solid platform for application developers. Mobile healthcare applications allow physicians and nurses easy access to medical information, bringing faster, more informed decision-making to the point of care.” For a typical, 500 bed, acute-care hospital, communication problems between physicians and nurses create an annual $4 million economic burden, the white paper reports, and often needlessly increase the length of hospital stays. Worse, poor communications can adversely impact care. Noisy overhead paging systems can cause nurses to miss calls – particularly when working within patients’ rooms. In addition, most point-of-care staff are saddled with multiple devices – a nurse may carry a pager, PDA and a mobile phone, with each device providing specific functionality and generating its own alarms. The nurse can’t prioritize alarms according to criticality, so a pager buzzes the same tone when a patient wants ice or for a code blue alert. Due in part to these inefficiency and communication problems, nursing dissatisfaction is on the rise. According to a recent study of 43,000 nurses from 700 hospitals, more than 40 percent of U.S. nurses reported being dissatisfied with their jobs – three to four times higher than the average worker. The problem can be self-perpetuating, the study finds. “Nursing shortages and communication problems negatively impact patient safety and increase patient dissatisfaction.This in turn can affect a hospital’s overall rating and reputation, which can drive down HCAHPS and Press Ganey scores and directly impact a hospital’s ability to stay profitable and recruit talented staff.” As smartphones grow increasingly feature-rich and easy-to-use, the devices offer a solution to many of these serious communication shortfalls. Their functionality make them tantamount to “a miniature computer that combines phone, e-mail, texting, and Internet service.” And since they’re already in common use, the learning curve that usually occurs when new equipment is introduced to a workplace would prove minimal. (According to a study by Manhattan Research, 64 percent of U.S. physicians own smartphones and analysts predict penetration will increase to 81 percent by 2012). [Smart Hospitals: Embracing Smartphones at the Point of Care] via Voalté How Quality Will Pay for Hospitals Under New Reform Measures May 13, 2010 Topic: Outcomes in the News A recent article in HealthLeaders Media outlines how new reform measures will affect hospitals. While most hospitals have focused on promoting quality care at their facilities to help decrease costs, quality care will take on a somewhat different meaning under the new healthcare reform law: Hospitals will feel the pressure to maintain continuous quality improvement or risk being penalized under reform incentives scheduled over the next several years, according to a PricewaterhouseCoopers’ Health Research Institute report titled “Health Reform: Prospering in a Post-Reform World.” According to the report, the new law can be expected to impact hospitals in three main areas:
The message hospitals need to pay attention to is “don’t get stuck in the bottom quartile, and work towards continuous quality improvement,” according to the report. The bottom quartile will change from year to year as the quality performance of hospitals change. However, at least 1,000 hospitals will end up in the bottom quartile—regardless of the quality provided. Beginning in 2013, high scoring hospitals under VBP will receive a higher payment of 1%—which rises to 2% in 2017 and beyond. In addition to the direct financial impact, the reform law will require that an organization’s quality metrics be publicly available and accessible. In addition to the direct financial impact, hospitals also could feel the impact of consumerism. For years, healthcare has lagged behind in making information easily accessible to consumers, but this has been changing. According to a 2009 PricewaterhouseCoopers consumer survey, individuals are using the Internet as a source for making decisions. Online content was found to edge out physicians as an information source: For instance, 48% of consumers said they use health websites to find information to make decisions about their healthcare. Within this consumer realm, hospital quality information will move “beyond the organization and government websites” to health websites and consumer advocacy sites, the researchers note. In addition, making more quality information available to consumers could impact a system’s perception in the community and payers’ contracting strategies with them. More informed decisions by patients could lead them away from organizations listed as “poor performers”—or those in the bottom quartile of hospitals. For the typical hospital, being on the bottom quartile in terms of quality could mean millions of dollars lost annually. For instance, for a 300-bed community hospital with $50 million in Medicare inpatient net revenue, failure to improve on hospital readmissions (a loss of about $96,780), failure with VBP (a loss of $750,000), and ending up in the lowest quartile for HAC ($500,000), would create a drop of $1.35 million in income. In addition to Medicare, hospitals also will have to learn to live with cuts in Medicaid. Hospitals that care for high numbers of uninsured and Medicaid patients currently receive extra funding from Medicare and Medicaid under the disproportionate share program. But in 2014, Medicare DSH will be reduced 75%—the same year that the insurance exchanges and individual and employer mandates go into effect. [How Quality Will Pay for Hospitals Under New Reform Measures] via HealthLeaders Healthcare Isn’t Like Other Industries When It Comes to Communications April 28, 2010 Topic: Benefits & Outcomes Given the serious nature of their role, hospitals need to approach communications differently from other industries. Because of this, a different type of communications infrastructure is required. Why is this? Consider the following: Communications can mean life and death: First and foremost, communications are mission-critical in a hospital. We are not talking about a message going to voicemail or someone missing a meeting. Lives are on the line.
The Six Ways Leading Hospitals Use Unified Communications to Improve Patient Care, Safety, and Satisfaction Given the clear need for accurate, streamlined communications, below are the ways your hospital can leverage today’s unified communications capabilities to improve your patient care, safety, and satisfaction.
Enabling Care, Safety, and Efficiency Through Unified Communications April 19, 2010 Topic: Benefits & Outcomes Mary, a patient at your hospital, wears a heart monitor. Her physician sets up a communications alert to ensure he is notified if it goes off. At 10 p.m. it does. The nurse on duty is notified immediately on an in-house wireless telephone and quickly assists Mary. But the doctor needs to be alerted, too. The technology behind the scenes instantly checks the communication rules regarding whom to contact, where, and on what device. The system indicates that Mary’s doctor left the hospital at 9 p.m., so an urgent message goes to his smartphone instead of his onsite pager. If it’s not read quickly, a text-to-speech message is sent to his home phone. If unanswered, the contact center agent is notified and the message is escalated to another on-call physician. Sound futuristic? It isn’t. Because everyone is mobile and everyone has at least one communications device, reaching the right person in a time of critical need can be a complex process. Technology with intelligence is key to patient care, safety, and satisfaction—as well as optimized workflow and staff efficiency. Unified Communications: It’s All About Managing the Details The potential of communications has expanded beyond the realm of simply making a connection between two people in static locations. In healthcare, a myriad of clinical, safety, and other communication systems constantly generates updates, alerts, and key pieces of information. This is in addition to your staff’s ongoing need to connect directly with one another to collaborate on patient care. But unless the right data is gathered and delivered to the right person, at the right time, on the right communications device, it’s useless. People and technology now need to communicate flawlessly to speed response times and keep safety and satisfaction in the forefront. Given this vast amount of information, the way your organization communicates needs to change every minute—but seamlessly and behind the scenes—in order to rally the right caregivers to help patients. Doctors go in and out of surgery and staffing assignments change around the clock. So when a patient comes to the emergency department with heart attack symptoms in the middle of the night, are you quickly gathering all the right people when the code STEMI is called? Patients’ lives depend on the coordination and management of details like this. |
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Outdated hospital communications systems — based on blaring PAs and multiple, often incompatible mobile devices – are causing confusion, reducing efficiency, wasting money, and helping contribute to serious staffing shortages.
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