Revamped smartphone strategy results in safer care, calmer staff
Many nurses and other clinicians use their personal phones to communicate with each other while in healthcare facilities, but such ad hoc approaches often don’t improve care coordination and response times.
That’s exactly what was discovered at Valley Medical Center, a 321-bed hospital in Renton, Wash., and throughout a system that serves 600,000 residents through 50 clinics.
An existing rudimentary communication system at the hospital was not optimal, and nurses were experiencing alert fatigue from too many alarms that were not critical to patient care. The need to enhance communications for caregivers and provide safer patient care compelled a move to a coherent smartphone strategy, says James Jones, vice president of patient care services and nursing operations.
The time had come to develop a standard enterprisewide phone policy, particularly with the Joint Commission pressing providers to enhance staff communication and alarm safety as national patient safety goals.
Under a new hospital policy, most nurses received a hospital-provided iPhone along with software applications from smartphone platform vendor Voalte, although some were permitted to continue to use their personal phone after their devices were updated by the information technology department. The hospital-supplied phones are shared, so nurses and other clinicians leaving a shift give the phone to the clinician coming on shift.
It did not take long for Valley Medical to realize benefits of a coordinated smartphone program. “Only three months after the Voalte smartphone platform went live, an analysis found that an average of 11 hospital-acquired pressure ulcers dropped to one,” Jones explains. “Skin integrity events reduced from 20 to two, and fall and slip events went down from 75 to 11.” A quieter environment for patients from less use of overhead speakers also resulted.
Features on the phones include direct access to the electronic health record, the ability to take high-resolution camera shots of wounds, secure text messaging, nurse call alerts and workflow enhancements such as documenting care and knowing the status of staff availability to respond to patients.
Hospital-issued phones are locked down only for hospital use and won’t work if taken off campus. If a phone is taken out of the hospital but stays on campus, the phone must be returned to the hospital within one hour. If someone loses a phone, on the back of the attached battery pack is the hospital logo engraved to improve chances of the phone being returned.
The hospital pilot tested the new phones and platform for three months in the renal and respiratory care units, which comprised the largest department in the hospital. Overall, the rollout went smoothly as most users already were familiar with smartphones, Jones says. “The adoption was enhanced by the ease of access to communication and EHR applications, as well as real-time patient alerts and direct peer communication.”
One year after rollout, the smartphone program expanded with applications added to alert clinicians if a patient needs to use the restroom, or a bed alert alarm went off in a room because the patient got out of bed or fell, or sensors indicate an abnormal heart rhythm. Since then, the hospital has expanded using the phones to study certain lingering care issues, such as hospital-acquired pressure ulcers and skin integrity events.
As the clinician smartphone program became known in the hospital, staff members elsewhere in the facility have become interested in having their own program, according to Jones. “Everyone that is not yet using the smartphones wants to when it is their turn. The solution is in high demand.”
Looking back, Jones recalls missed opportunities that other organizations should be aware of when building a smartphone program. To have a more formalized approach going forward, Valley Medical Center has created a Mobile Strategy Operations Technology Committee as the governing body for mobile solutions. The committee will develop policies to let all employees understand how to use mobile communications. The governing body includes Jones, the chief medical information officer and the chief information officer, as well as hospitalists, unit managers and front-line staff.