Florida Hospital Center for Innovative Patient Care

Improving Quality…

Lowering Cost…

Changing Healthcare Together.

IoE in Healthcare: At the Nexus of Technology, Strategy and Culture

Learning Objectives

• Making the right technology choices

• Aligning organization strategy and future healthcare landscape

• Managing the culture to embrace technology and change acceleration

Who we are

• Part of the Adventist Health System

• Mission – “To extend the healing ministry of Christ”

• 1 of 7 Florida Hospital Campuses making up 1 license in Central Florida with over 2400 beds, founded in 1908

• Market Leader in Central Florida

• Most Wired Award Recipient

• HIMSS Level 6

Living Laboratory Location

Florida Hospital Celebration Health

“RTLS…a Strategy”

Driving Excellence in Operations

Strategy

Goals, Objectives, ST/LT Plans, Alignment to

Healthcare needs, etc..

Technology

Integrated, Enhances Process Design, Reduces

defects, Creates efficiency, etc..

People

Culture, Mission, Communication,

Leadership Visibility

Antiquated Design

Nexus of Success

Technology Choices

Technology Partnership Chasms Strategic Vision &

Relationship

Culture Adaption

Capability/ Functionality

Infrastructure/ Flexibility

Innovation

R&D Focus Mission

Culture

Intuitive

Agile

User friendly

Scalable

Customizable

Improves workflow

Reduces Waste

Inspires Creativity

Strategy Alignment

Internet of Things, Meeting Triple Aim

COURSE

Clinical Data/Roadmap, Wellness Plan, EMR,

Labs, Imaging…

CONNECTION

Pt Exp & Outcomes, Social media data, geographic/socio-

economic data

CONTEXT

RFID/RTLS/UWB, Behavior,

Wearable’s Data…

No foundation or basis for the

relationship

Consumer Fellowship

People - Culture

Image from http://www.headshift.com/blog/images/user%20adoption%20curve.jpg.

Goal: Managing technology across generations to operational performance!

Appropriate Utilization

Does it make life better?

Finding Value

What can it provide I don’t already know?

Example

FH / STANLEY Healthcare RTLS Partnership

2010-2011 2012-2013 2014 – 2015+

Image from http://www.kassblog.com/wp-content/uploads/2010/11/techy_diffusion_across_org-1.jpg.

Methodical Approach Staff Workflow

• Efficiency

• Standardization

• Productivity

• Unit Design

Patient Experience

• Rounding

• Bedside Report

• Time with Care givers

• GWN Integration

• Patient Family Waiting Room Board

Capacity and Throughput

• Live Patient Flow Monitoring through OR

• Equipment Tracking (beds, pumps, etc…)

Safety

• Hand Hygiene – Patient Contact based

• Falls Prevention (Stryker Integration) (Live 08/18)

• OR Suite and Sterile Supply Temp/Humidity Monitoring (iPads)

Staff Workflow

Takeaway: Real time access to their data and flow

Takeaway: Improve the daily flow thru assignments and

organization

Unit Nurse Rounding Percentage (%)

Analysis by Patient Type

78% 91% 83%

109%

79% 91%

78%

74%

79% 80%

69%

74% 75%

79%

0%

20%

40%

60%

80%

100%

120%

140%

160%

180%

200%

20-29 30-39 40-49 50-59 60-69 70-79 80-90

RO

UN

DIN

G %

Rounding % By Age Group By Gender

Female Male

4.6 4.1 4.7

3.7 4.4 4.0

4.6

4.5 4.5

4.7

5.1

4.9 4.8

4.8

0.0

1.0

2.0

3.0

4.0

5.0

6.0

7.0

8.0

9.0

10.0

20-29 30-39 40-49 50-59 60-69 70-79 80-90

AV

ERA

GE

MIN

UTE

S SP

ENT

Average Minutes Spent By Age Group By Gender

Female Male

Takeaway: Dissect nurse rounding to proactively manage workflow

Original 3rd Floor Unit New 5th Floor Unit

Unit Design Changes

How alike are the 2 units, what

impact is the 8 hour shift making?

0

500

1000

1500

2000

2500

3000

3500

4000

SHIFT PATTERN COMPARISON BY DAY - C3IU .VS. C5SU

C3IU C5SU

0

500

1000

1500

2000

2500

3000

3500

4000

7 AM 8 AM 9 AM 10 AM 11 AM 12 PM 1 PM 2 PM 3 PM 4 PM 5 PM 6 PM 7 PM 8 PM 9 PM 10 PM 11 PM 12 AM 1 AM 2 AM 3 AM 4 AM 5 AM 6 AM

SHIFT PATTERN COMPARISON BY HOUR - C3IU .VS. C5SU

C3IU C5SU

C5SU Shift 1

C3IU Day Shift C3IU Night Shift

C5SU Shift 2 C5SU Shift 3

OR Throughput – Patient Flow

Family Facing Board

Real Time Flow Management and Alerts

OR Suite Live Flow Management

https://mvchdev.flhosp.net/asset-manager-web/

High Level Review of Throughput Status

Monitoring for PACU capacity and bottlenecks

Unit View – Transparent process and communication

Analytics Drill Down and Comparison Capability

Analytics on patient stay

Where we look to go… Value Based Purchasing & Pay for Performance

Capacity and Throughput • Patient Flow – ER Patient and Staff Flow Monitoring (Q3 2015) • Expansion to more nursing units (Q3) • Capacity Management – Cerner Integration

Staff Workflow • Integration of EMR and Bed Management Data (3 D!)

Business Intelligence • Real time decision making capabilities • Predictive modeling

Safety • Wait State Alerts • Obs Patient Tracking • Core Measure Patient Alerting (integrate with EMR)

Patient Experience • Continued GW/IPC Integrations

Key Learnings • Mapping: I would highly recommend starting to build upon solid maps that are clear and functional.

Making changes to maps after exciters, cells, and zones have been added will create major challenges.

• Network components: RTLS technology relies very heavily on back-end network infrastructure, so it is important for teams supporting the network and RTLS components to work hand-in-hand. A good RTLS implementation requires a strong and reliable network infrastructure.

• Data management: Taking good back-ups of the data on a regular basis and understanding the structure of the RTLS database(s) are crucial when it comes to analyzing the RTLS data gathered.

• Support documentation

• Stakeholder involvement: It is very important to involve the key stakeholders in the earliest stages of any RTLS implementation because it is always better/easier to make changes before go-lives.

• Various RTLS components: It is not always easy to identify or anticipate how changes to one area/module of the RTLS environment will affect others whenever upgrades or changes take place.

“Key” Key Learnings

• Adoption/Culture – requires rigorous and continuous plan to sustain engagement in the process. I.e. onboarding process, communication methods, can’t let up!

• Culture – The “Gotcha” if you’re not prepared

• Surprises – Nurses actually like it and will leverage it, surprising finds in the data that drive new questions and information, patients love it!

• Resource Requirements

Questions?

• Ashley Simmons, Director of Innovation Development

• Ashley.Simmons@flhosp.org