Mission Hospital, comprising Mission Viejo and Laguna Beach hospitals in southern California and part of St. Joseph Health System in Anaheim, had a communication problem that was affecting patient care as the nurses were having difficulty coordinating activities.
The nurses were being interrupted almost constantly. They were carrying up to five communication devices with different functionality, such as secure messaging apps, pagers and personal phones, because the organization didn't have a single, enterprisewide communication system.
Nurses were waiting to get critical care information from other nurses and physicians and often did not know the correct team members to contact when necessary.
Further, the communication barriers were delaying patient discharges and transitions to lower cost care settings because nurses did not have all the information they needed to release patients.
“We needed to improve the clinician experience, which would translate to better care and higher HCAHPS patient satisfaction scores and higher reimbursement,” says Kristen Robb, IS strategic partner and director at St. Joseph’s Health. “The biggest pain points were getting messages and the right information out to clinicians at the right point—such as critical alerts—and not having to wait for answers.”
The time had come for a standardized phone policy. Following a pilot program in 2016, the hospitals deployed Myco smartphones from Ascom that Robb calls “a healthcare platform in a smartphone.”
Supporting technology vendors for the new phone policy included a mobile interoperability software platform from AIRSTRIP, a patient monitoring service to send alarms to providers from GE Healthcare, a nurse call system from HILL Rom and a critical event management platform from Everbridge.
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The platform further supports unified communications with talk, text and alert functionality, along with secure messaging, a bar scanner on the phone, an app for taking wound care photos and sending the photos to the electronic health record.
The phones are on the hospital’s Wi-Fi network and work very well, according to Robb. But they also are well beyond being seen as a convenience—they quickly proved to be lifesavers.
The phones receive patient monitor alarms that include waveforms when code red calls come in. “Instantly, everyone can see what’s going on and drop and run to the patient,” Robb says. “The critical team stabilizes the patient and then calls the physician.”
To further improve safety, stat orders that the electronic health record system previously sent to a printer now get sent to clinician phones.
As the smartphone program rolled out, putting it in place and training staff was easier than expected because while the phones were considerably more advanced models older clinicians didn’t like the old phones anyway, and a generation of younger nurses coming in picked up the functionality quickly.
Still, don’t move too fast, Robb cautions. “There’s always a push-back for change in the environment so we were challenged to change clinical workflows and get clinicians to trust the project. Try not to give too much information at once and get some quick wins to find adoption.” The quick win for Viejo and Laguna Beach hospitals was wound care. The older cameras were at the end of their life and working poorly, and clinicians were thrilled with new cameras with great photos and secure messaging.
What did not go so well was the ongoing challenge of the current wireless networks and the stresses being put on the old and new camera, Robb recalls. “We needed better wireless network configurations to improve voice and traffic data.”
Next steps for the project include being able to have federated messaging to other smart phone systems such as TigerText or Mobile Heartbeat, collecting data from infusion and IV pumps, and coalescing alarms in one place to filter the alarms and reduce alarm fatigue. “We also want to use analytics to drive outcomes,” Robb says.
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