Improving Patient Care Delivery, Quality and Cost
Consistently delivering safe and cost-effective patient care is a challenging task, but essential for the success of all healthcare organizations. Decision making happens in time-sensitive, pressurized-environments. In many instances, clinicians do not have all the patient health and clinical decision support information readily available when and where it is needed.
Recognizing the critical role that information plays in patient care delivery, healthcare organizations throughout the world are increasingly investing in digital technologies to improve the accuracy, immediacy and accessibility of their patient health information. Strategic investments in Electronic Health Records (EHR), Internet of Things (IoT), smart medical devices, artificial intelligence and predictive-data analytics are empowering clinicians and elevating the quality of patient care. Despite impressive advancements, workflow operational barriers remain stubbornly in place and too frequently interfere with the clinician and patient interaction.
This white paper examines the role of Clinical Mobility in the transformation of healthcare and explores the types of workflow barriers; the impact that they have on clinician-patient interactions; and the potential causality relationship between workflow barriers and combined caregiver-patient satisfaction levels. It also presents Clinical Mobility utilization as a strategy to alleviate workflow barriers, and as an emerging discipline within healthcare systems.
Ultimately, this paper helps answer the question of why Clinical Mobility is strategically important to all healthcare provider stakeholders. The goal is to provide vision and inspiration on how advanced technologies, when properly coordinated, can help extend patient centricity and care delivery excellence.
A Changing World
Hospital clinicians operate in a work environment that is very different from just a few short years ago. Acuity levels are higher, length of stays shorter, documentation requirements greater, and technology ecosystems more complex. Collectively, these factors result in increased work, intensified pressure and higher levels of stress for hospital caregivers. It is more critical than ever before to simplify the patient care delivery process and to break down the work flow barriers that impede clinician-patient interactions.
Healthcare workflows are multi-dimensional, complex, fast-paced, overlapping, and often unpredictable. These characteristics create high levels of variance and contribute to inefficiencies in patient care delivery. For purposes of this discussion, we’ve divided workflow barriers into three distinct categories: patient health information data, staff communications and situational awareness. The cumulative impact of these workflow barriers is formidable and disruptive to clinician-patient interactions.
Patient Health Information Data
Within the fast-paced healthcare work environment, it is often difficult for clinicians to access the right type of data in real time. Challenges often occur, including:
- The information does not exist in electronic or digital format.
- Information is available but is not disseminated in a real-time manner, therefore diminishing the value of the information.
- There is seemingly too much information available and locating the relevant information is difficult.
When clinicians leave the patient’s bedside to receive updates from the care team, access lab results, review doctor’s orders or medication changes, care can be compromised. Clinicians must be able to access, locate and retrieve the specific data that they are looking for in a convenient, user-friendly and timely manner that maximizes time with the patient.
Within the hospital environment, it is often difficult for team members to have seamless, non-intrusive and reliable communications with each other. Caregivers commonly struggle to identify which co-workers are on shift, locate them and communicate securely. Often, communication modalities and tools are not compatible and prevent needed interactions from occurring. Even in well-coordinated situations, physical infrastructure can impede effective communication delivery, resulting in poor quality voice transmissions during mobile phone calls and in the unreliable delivery of text messages. Streamlining communications is essential to reducing workflows and improving patient care.
Patient health conditions, the physical environment of care and clinical support functions frequently and unpredictably change. Changing conditions may be time-related and result in a late procedure start time or delayed patient care activity. A changing situation may be attributable to the readiness and availability of medical assets causing the clinician to adjust patient care administration unexpectedly. In other instances, the changing status is patient-related. When the care delivery team is unaware of changing conditions, blind spots occur and can result in compromised patient care delivery.
Nurses: A Day in the Life
As the largest employee group inside a hospital, nurses are especially important and perform critical roles as caregivers, communicators, teachers, patient advocates and decision makers. For nurses, the vocational mission of treating, helping and healing sick patients is increasingly at risk of becoming marginalized due to the modern-day care coordination and workflow document requirements placed upon them.
According to a recent article, nurses spend a mere 18 percent of their time with patients for assessment and treatment. The remaining 82 percent is spent away from the point-of-care walking from patient’s rooms to nurses’ and storage stations, retrieving medications, supplies and recording information into the EHR system.
In a similar study, researchers examined the patient-care workflows of medical-surgical nurses across 36 hospitals and once again revealed that nurses spend the minority of their time on patient care activities.
Nurse retention rates across all hospitals are cause for concern. A recent industry study reported that 43 percent of newly licensed nurses working in hospital settings leave their jobs within three years of employment. Nurse workforce turnover undermines patient care delivery quality and costs a hospital on average between $5.2 million and $8.1 million annually.
There is a direct relationship between nurse staffing levels, burnout and healthcare-associated infections. For every 10 percent increase in the number of high-burnout nurses, one additional catheter infections and two surgical site infections occurred per 1,000 patients.
The Case For Clinical Mobilty
Challenging healthcare workflows place undue burdens on caregivers and negatively impact the level of interaction between clinicians and patients. As a result, patient care delivery can suffer. Clinical Mobility can help elevate patient care, empower clinicians and enhance workflows.
Clinical Mobility is the use of mobile devices, such as handheld mobile computers, tablets and mobile printers, by physicians, nurses and other healthcare professionals at the point-of-care. Clinical Mobility workforce solutions have had an under-appreciated value in the past and offer a surprisingly high ability to positively transform patient care delivery within a hospital.
This perspective is more fully understood when one considers that a single handheld device is both a fully functioning, high-powered mobile computer and simultaneously a multi-dimensional clinician workflow tool that automates and executes critical workflow tasks such as barcode scanning, medical image capture, secure text messaging and mobile voice communications.
With appropriate ecosystem coordination, Clinical Mobility solutions not only unify disparate clinician work tools, but more importantly, disparate patient health information sources as well. By combining and integrating Internet of Things medical devices, health information software systems, and co-worker communications, Clinical Mobility solutions can help usher in a new era of smarter, dynamic, and more flexible patient care delivery processes. Higher quality, lower cost delivery and patient care centricity are the promises of this system and will be powered by:
- Strengthened clinical integration among all functional teams and disciplines.
- Elevated patient care delivery coordination.
- Improved visibility to changing circumstances and deteriorating patient conditions.
- Greater staff productivity and hospital operational efficiency.
- Increased clinician-patient interaction time.
Clinical Mobility adoption rates are increasing exponentially in both the number of hospital employee users and in the intensity of use. In a recent global study, over 1,500 respondents were surveyed on their current and future practice of Clinical Mobility.9 The results depict a future healthcare delivery system where mobile device usage is widespread throughout the hospital and well-coordinated across both clinical and support-services employee groups. By 2022, global mobile device usage is expected to exceed 95 percent by nurses, physicians and pharmacists.
Clinical Mobility helps improve the patient care delivery process. When implemented effectively, hospital employees cite reduction in costs, enhanced patient safety, and quality improvements. The development of an enterprise-wide Clinical Mobility solution is important for the future success of healthcare organizations.
An Integrated Ecosystem of Healthcare Technologies
Clinical Mobility solutions, when implemented effectively, integrate with health information software systems and IoT medical devices. As clinicians adjust to the robust capabilities of the solution, the mobile device becomes increasingly more central to the way in which patient care is administered. Let’s consider three application categories: communication and collaboration, data management and workflow efficiency.
Communication and Collaboration
- VoIP Reliable Voice Communication
- Secure Text Messaging
- Digital Image Capture and Delivery
- Data Capture
- Patient Identification
- Barcode Medication Administration
- Specimen and Tissue Labeling
- Inventory Management
- Data Retrieval
- Medical and Drug Database Reference
- Patient Records
- Lab Diagnostics
- Patient Vital Signs
- Nurse Call Alerts
- Biomedical Device Alarms
- EMR Text-Based Notifications
- Work Rule and User Group Routing
- Employee Locationing
Communication and Collaboration
A properly integrated enterprise-wide Clinical Mobility solution enables healthcare team members to communicate seamlessly with each other in a unified and diverse manner; have high-quality voice communications; transmit and receive secure text messages; send patient care related digital camera photos; and conduct telehealth video conferences.
The demands and complexity of the patient care delivery environment require pinpoint precision when matching patients to records, medications, specimens and medical assets. Through advanced mobile device data capture tools, workflow steps can be automated and preventable medical errors reduced. Best in class Clinical Mobility solutions also make clinical decision support data readily available to the clinicians in real time and directly at the point of patient care.
Healthcare professionals have the complex task of managing multiple patients and situations simultaneously. A high performing Clinical Mobility implementation helps improve workflow efficiency, reduces unnecessary alerts, call alarms and notifications. Integrating algorithm-driven alert and alarm management software capabilities directly into the clinician’s mobile device helps reduce unnecessary and disruptive interruptions and helps the clinician focus their attention on the most critical patients with the highest prioritized activities.
The Future of Healthcare
The purpose of a health system organization is to treat sick patients and to restore and manage patient health and wellness within their given community. While most healthcare providers are well equipped to fulfill this purpose; it is becoming exceedingly difficult for many to do this cost-effectively and sustainably within today’s economic environment.
Healthcare organization success and survival depend on the quality of their patient care workflow. Patient workflow variance is the enemy for healthcare provider organizations and is a root-cause contributor to higher operating costs, higher employee job dissatisfaction levels and lower standards of care delivery.
The future healthcare delivery landscape will require leading institutions to become technology organizations who embrace Clinical Mobility and redefine core capabilities. Removing the disruptive and chronic workflow barriers that wedge between clinician and patient interactions is ultimately a people, process and technology equation. Achieving a harmonious balance among these factors is critical to the long-term success of all hospitals.
Tomorrow’s leading health system organizations will competitively differentiate themselves through continuously benefitting and reinforcing a loop of tension-free patient care delivery workflows, satisfied employee team members and enhanced patient experiences. The development of an enterprise-wide and holistically integrated Clinical Mobility solution is essential for hospital executives to create and a necessary component for the future success of their organization.