Gain Better Visibility to Improve Clinical Workflow · Ashley Simmons, Director, Performance...
Transcript of Gain Better Visibility to Improve Clinical Workflow · Ashley Simmons, Director, Performance...
Gain Better Visibility to
Improve Clinical Workflow
Patty Jo Toor, Chief Nursing Officer
Ashley Simmons, Director, Performance Improvement
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Today’s Webinar
Understand the reasons for real-time staff workflow, and learn the keys to
successful implementation of an RTLS solution that will meaningfully impact
staff efficiency and satisfaction, care delivery and the patient experience:
• Building a team - who you need to have at the table?
• Critical steps for success with an RTLS staff flow solution
• Developing a positive, non-punitive culture using RTLS
• Defining and measuring success
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Florida Hospital Celebration Health
“RTLS…a Strategy”
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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
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Change is here
“We know we have to cut 20-40% of costs”
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Evolution of Healthcare
Quantity Vs. Quality
Era of Quantity Era of Quality
Advance planning emphasis Customer feedback emphasis
Mechanical Technology Programmable control
Economies of Scale Economies of speed
Hierarchical organizations Team-based organizations
Value from volume Value from performance
Technology islands Technology overlaps
Environmental exploitation Environmental concern
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Industry Pulse
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Poll Question #1
• What’s your main tool to drive improved workflow?
(check all that apply)
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Evolution of Data in Healthcare…
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…Big Data Analytics
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RTLS Data Provides the Context
It meets 2 critical needs:
1. Event DataAdding context to the patients pathway, trending and predictive
modeling, actionable data at the right time to the right person
2. Customer SatisfactionReal time access, information and flow – engagement in care process,
alerts for wait states, knowledge of their progress in their care
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Our Today
Temp and Asset Tracking…it’s a no brainer and critical to
efficient use of resources…but think beyond that!
Capacity and Throughput
• Patient Flow – OR to Unit
Staff Workflow
• Efficiency
• Standardization
• Productivity
• Unit Design
Patient Experience
• Rounding
• Bedside Report
• GWN Integration
Safety
• Hand Hygiene – Patient Contact based
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Patient Transitions
Takeaway: Built transparency between PACU and UNIT for
patient flow and communication
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Patient Flow
Patient Average Hour Spent in PACU
Takeaway: Leverage the data to improve and validate
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Staff Workflow
Takeaway: Real time access
to their data and flow
Takeaway: Improve the daily
flow thru assignments and
organization
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Staff Workflow
Before Workflow Coaching After Workflow Coaching
Takeaway: Reduce burn out!
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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 4.73.7
4.4 4.04.6
4.54.5
4.7
5.14.9
4.84.8
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
ER
AG
E M
INU
TE
S S
PE
NT
Average Minutes Spent By Age Group By Gender
Female Male
Takeaway: Dissect nurse rounding to proactively manage
workflow
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Analysis by Service Line
69% 82%105% 96%
80%
83%72%
78%
72%
0%
20%
40%
60%
80%
100%
120%
140%
160%
180%
200%
EAR,NOSEAND THROAT
GENERALSURGERY
GYNECOLOGYORTHOPEDICS UROLOGY
RO
UN
DIN
G %
Rounding % By Service By Gender
Female Male
3.7 3.95.6
4.5 4.4
5.0 4.8 4.4 5.0
0.0
1.0
2.0
3.0
4.0
5.0
6.0
7.0
8.0
9.0
10.0
EAR,NOSEAND THROAT
GENERALSURGERY
GYNECOLOGY ORTHOPEDICS UROLOGY
AV
ER
AG
E M
INU
TE
S S
PE
NT
Average Minutes Spent By Service By Gender
Female Male
Takeaway: Again, dissect nurse rounding to proactively manage
workflow
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5.5%5.6%4.8%4.7%4.9%4.9%3.6%3.8%4.9%5.0%4.5%4.8%
6.3%6.0%4.6%
3.1%3.9%3.0%2.1%2.0%2.8%3.4%3.2%2.7%
7AM
8AM
9AM
10AM
11AM
12PM
1PM
2PM
3PM
4PM
5PM
6PM
7PM
8PM
9PM
10PM
11PM
12AM
1AM
2AM
3AM
4AM
5AM
6AM
0.0%
2.0%
4.0%
6.0%
8.0%
10.0%
12.0%
14.0%
16.0%
18.0%
20.0%
Hourly Chart
Nu
rse M
inu
tes S
pen
t P
erc
en
tag
e
Nurse Minutes Percentage By Hour By Month
December
November
September
Bridging Cultures
0
200
400
600
800
1000
1200
1400
1600
1800
2000
Day Night
Min
ute
s
Patient Room BoxPlotMax
Min
Median75%
25%
Takeaway: Understand
the age old question…
“what’s the difference
between night and day
shift workflow?”
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Patient Experience
Rounding Compliance
0
1000
2000
3000
4000
10% 40% 70% 100% 130% 160% 190% 220%
Min
ute
s S
pe
nt
Rounding %
Day Shift – NurseRounding Compliance
Takeaway: Understand team variation and compliance
0
500
1000
1500
2000
2500
3000
3500
4000
4500
30% 50% 70% 90% 110% 130% 150%
Night Shift - Nurse Rounding Compliance
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Our Tomorrow
Value Based Purchasing & Pay for Performance
Capacity and Throughput
• Patient Flow – OR Expansion to all patients, ER to Unit Tracking,
Wait State Alerts, Obs Patient Tracking, Core Measure Patient
Alerting
• Capacity Management – Cerner Integration
Staff Workflow
• Integration of EMR and Bed Management Data (3 D!)
Safety
• Falls Prevention (Stryker Integration)
• OR Suite and Sterile Supply Temp/Humidity Monitoring
Patient Experience
• Continued GWN Integrations
• Waiting Room Real Time Flow Data
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Poll Question #2
• What is your biggest barrier to improving workflow?
(check all that apply)
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Key Stakeholders
• IT
• Sr. Leadership
• Nursing Leadership
• Finance
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IT Support Model
• Support model includes dedicated and shared staff
• Server team oversees the Windows Server
• Server maintenance, patches, and updates
• STANLEY Healthcare/AeroScout team oversees deployment and use
• Technical staff to help design and manage
• Tag provisioning, user activities, escalations, etc..
• Field staff to deliver and replace tags, batteries
• Analytical staff to help with reporting
• Domain experts should “own” many of these aspects
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Operations Support Model
• System Deployment of Learnings
• Base and Change measures for improvements
• Staff Workflow Analysis
• Patient Flow Analysis
• ROI
• Invested People, Time and Product
• Savings due to RTLS
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The Goal
Questions?
Patty Jo Toor, Chief Nursing Officer
Ashley Simmons, Director Performance Improvement
Joel Cook, Director Healthcare Solutions, STANLEY Healthcare