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What Hospitals Want from Clinical Communication Platforms

Ten years after shared smartphones were introduced at Sarasota Memorial Hospital, mobile devices are becoming a mainstay for enabling communications between clinicians. By 2019, 90% of healthcare systems plan significant investments in smartphones and secure unified communications.1

Clinical communication has advanced far beyond the secure texting capabilities of those first smartphones. But what exactly do hospitals want from their mobile communication solutions? More importantly, how can they take advantage of advances in new technology to facilitate timely clinical collaboration, optimize workflows and improve patient care and experiences?

A new report from KLAS, "Decision Insights - Secure Communication 2018,"2 provides some answers. As one of the KLAS survey respondents commented, "We had a whole list of things we were looking for, but at the heart of it, we wanted a clinical communication platform that would work for everybody, including clinicians, nurses, doctors, hospitality staff and materials service folks."

The report found that "hospitals and acute care organizations largely are moving toward broad communication platforms that streamline communication organization-wide." It also noted that "functionality is king" in purchasing decisions and post-purchase satisfaction, especially for EMR interfacing, clinician scheduling and middleware interfacing.

Following are examples and practical guidance to help hospitals leverage the enhanced functionality of today's integrated clinical communication platforms.

Communication Strategies to Optimize Clinical Workflows

According to the KLAS report, "Many acute care organizations are expanding their visions to include interfaces and functionality that improve communication for multiple workflows, thereby improving patient care." To accomplish this, hospitals typically form interdisciplinary smartphone workgroups to:

  • Map current workflow and communication practices (particularly those for alarms)
  • Talk to care team members about their needs and problems
  • Determine how smartphones intersect with and affect workflows
  • Identify opportunities to expedite clinical communication and enable nurses and physicians to securely share EMR information, lab results and other data

Clinical communication is foundational for both patient safety and quality care. An integral component of an effective mobile communication platform is a well-designed, patient-centric smartphone directory that provides clear visibility into the chain of command and workflow. By standardizing these directories across units, departments and systems, clinicians and staff can minimize miscommunication during patient handoffs and signouts, the leading causes of preventable errors and adverse clinical events in various settings.3

Safety Benefits of Integrated Mobile Communication Platforms

By integrating smartphone platforms and apps with data from EMRs, biomedical devices, and hospital pharmacies and laboratories, hospitals empower caregivers to be more connected, informed and responsive to patient needs. For example, at the high-tech Clinical Logistics Center at Nemours Children's Hospital in Orlando, a staff of paramedics monitor the conditions of up to 220 patients at its two facilities. By using a smartphone platform with desk-based messenger capabilities and patient-centric directories, the center can immediately mobilize nurses and clinical teams at the first sign of trouble.4

A top priority for hospitals nationwide is improving communication to reduce the harm associated with clinical alarm systems, one of The Joint Commission's 2018 Hospital Patient Safety Goals.5 The primary goal of many of these initiatives is to minimize "alarm fatigue" that occurs when clinicians receive a high volume of safety alerts that have no clinical value. (A study at one medical/surgical hospital found that only 10% of its alarms were actionable and required clinical interventions.6)

The Johns Hopkins Health System has significantly minimized the number of alarms sent to its nurses' smartphones by:

  • Filtering and bundling high-volume alarms commonly seen in certain populations
  • Customizing algorithms for alarm escalation and thresholds
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  • Creating custom filters to ensure that notifications are timely and meaningful without overburdening caregivers

During just one week, Johns Hopkins had 61,227 warning level alarms on its physiological monitors but only 3,103 of these were messaged out to mobile devices.7

To address its safety concerns, UW Medicine's Valley Medical Center in Seattle integrated its smartphone platform with an EMR mobile app, device middleware, its nurse call system, patient monitoring devices and the hospital switchboard. Since implementing this solution, it has significantly reduced skin integrity events and medication errors.8

A recent global survey of nurse managers found that mobile devices cut medication administration errors by 61% and preventable medical errors by 46%.9

Bringing Physicians into the Communication Loop

Another priority is facilitating better communication with physicians inside and outside the hospital. Although one survey found that more than 75% of physicians use mobile communication in their practice weekly,10 hospital nurses waste countless hours every day trying to find and connect with on-call physicians or specialists.

This problem can be resolved by including physicians' schedules in a unified, comprehensive smartphone directory. For example, the University of Kentucky HealthCare has integrated its smartphone platform with physician on-call scheduling software, enabling its nurses to easily find and call/text on-call physicians from various departments and groups. This simple solution reduced the time to reach a provider from 8:13 minutes to only 1:01 minute.11

What's Next? Communication Analytics Tools

As more robust communication platforms play an expanding role in patient care and safety, hospitals will need better ways to manage their communication workflows and prevent communication failures that contribute to 50 to 80% of the most serious and harmful patient events.12 New tools for communication workflow analysis13 are available to help hospitals:

  • identify and proactively resolve workflow breakdowns
  • provide contextual insights on KPIs relating to alert and notification data, texting trends, response times and call rescue data
  • compare performance across units and buildings

By diligently monitoring and managing patient-centric and workflow-driven mobile communication platforms, hospitals will be well-positioned to facilitate fast, easy, efficient and informative communications throughout their organizations.

References
  1. The Spyglass Group. Study: Hospital IT Smartphone Investments are Driving Clinical Transformation. April 4, 2018. www.spyglass-consulting.com/press_releases/SpyglassPR_CLINICAL_COMM_2018.v1.0.pdf Accessed November 10, 2018.
  2. Hess, P. and Warburton, P. Decision Insights - Secure Communications 2018. October 30, 2018. https://klasresearch.com/report/decision-insights-secure-communication-2018/1308 Accessed November 5, 2018.
  3. AHRQ Patient Safety Network. Handoffs and Signouts. August, 2018. https://psnet.ahrq.gov/primers/primer/9/handoffs-and-signouts Accessed October 7, 2018.
  4. Peco, Dana. How "Smarter" Smartphones Help Hospitals Safeguard Patients. Patient Safety & Quality Healthcare. July 10, 2018. https://www.psqh.com/analysis/how-smarter-smartphones-help-hospitals-safeguard-patients/?utm_source=silverpop&utm_medium=email&utm_campaign=ENL_PSQ_PSQHI_180711%20(1)& spMailingID=13853776&spUserID=MjQ2MDUxMzQwNTM2S0&spJobID=1440918662&spReportId=MTQ0MDkxODY2MgS2 Accessed November 11, 2018.
  5. 2018 Hospital National Patient Safety Goals. The Joint Commission. https://www.jointcommission.org/assets/1/6/2018_HAP_NPSG_goals_final.pdf Accessed October 7, 2018.
  6. Condra, David. Using Technology to Turn the Tide on Alarm Fatigue. Nashville Medical News. February 3, 2017. https://www.nashvillemedicalnews.com/using-technology-data-to-turn-the-tide-on-alarm-fatigue-cms-1586 Accessed November 11, 2018.
  7. Frank, Robert "Jeff." 5 Technology tools for reducing alarm fatigue. Becker's Health IT & CIO Report. July 9, 2018. https://www.beckershospitalreview.com/healthcare-information-technology/5-technology-tools-for-reducing-alarm-fatigue.html Accessed November 11, 2018.
  8. Jones, James. How smartphones helped Valley Medical Center ease clinicians' workload, improve outcomes and achieve 99% patient satisfaction. July 24, 2017. https://www.beckershospitalreview.com/healthcare-information-technology/how-smartphones-helped-valley-medical-center-ease-clinicians-workload-improve-outcomes-and-achieve-99-patient-satisfaction.html Accessed October 7, 2018.
  9. Zebra Technologies. The Future of Healthcare: 2022 Vision Study. Mobile Technology Elevates Patient Care, Empowers Clinicians and Enhances Workflows. https://www.zebra.com/content/dam/zebra_new_ia/en-us/solutions-verticals/vertical-solutions/healthcare/white-paper/2022-hospital-vision-study-en-global.pdf , Accessed October 4, 2018.
  10. 2018 Mobile Health Survey Results. Physicians Practice. February 20, 2018. http://www.physicianspractice.com/mobile/2018-mobile-health-survey-results Accessed November 12, 2018.
  11. VUE 18 recap. Why care team communication is so critical. Voalte blog. October 18, 2018. https://www.voalte.com/blog/vue18-recap-why-care-team-communication-is-critical Accessed November 12, 2018.
  12. Patient Handoffs. The Gap Where Mistakes are Made. Patient Safety and Quality Healthcare. November 21, 2017. https://www.psqh.com/analysis/patient-handoffs-gap-mistakes-made/ Accessed November 12, 2018.
  13. Voalte Insight drives workflow improvements. Voalte blog. October 24, 2018. https://www.voalte.com/blog/voalte-insight-drives-workflow-improvements Accessed November 12, 2018.
  14. Alex Brown is Director of Strategy at Voalte.


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