Efficient care team communication improves patient safety and experience

Halifax Health simplifies workflows with secure texting and hands-free communication 

Communication matters, especially in hospitals and healthcare systems where patient care, safety and well-being are the No. 1 priorities. As the chief information officer of Halifax Health, one of my top priorities is to ensure care teams connect quickly and securely at every step along the patient journey. To be successful, my team and I must stay ahead of healthcare technology trends. The emergence of “bring your own device” could have presented a potential communication risk, but we used it as an opportunity to provide another valuable communication tool to our care team members, and ultimately improve patient care delivery.

Mapping Gaps in Communication
Prior to implementing a secure texting solution at Halifax Health, the process for reaching the right physician was often time consuming. When clinicians needed to consult a physician who wasn’t immediately available or offsite, the communication workflow involved a staff member calling the unit clerk, who would call the hospital call center, who would then call the physician to relay the message from the unit. It could take almost 15 minutes for the right physician to receive the original message. When response time is factored in, the entire process sometimes took an hour.

We needed a better, faster way for clinicians to communicate with each other and various units. For me and other leaders at Halifax Health, the goal was also to ensure the security of every message by putting a communication app in place that would enable clinical staff to text each other about information in a secure, compliant way. To accomplish this goal, we needed clinician adoption—and that meant providing an intuitive solution.

The immediate challenge when we launched a search for a secure texting solution was to ensure we could accommodate the scope of our clinical communication needs while addressing physician preferences. In addition to being secure, the text messaging solution needed to be easy to use and have the functionality our physicians wanted and needed. Without simplicity and the right user interface, we knew clinician adoption would be tough. Ultimately, we were looking for a secure solution to improve both the clinician and patient experience. Because of our past success, we partnered again with Vocera for a solution to do both.

Getting More than a Secure Texting Solution
In 2009, Halifax Health began using the Vocera Communication Badge, a voice-controlled device that allows for hands-free communication. Before adopting badges for the emergency department (ED), overhead paging was the de-facto method of communication between staff members– that is, when yelling down the hall wouldn’t work. To put it bluntly, the noise in the ED often added to stress levels of everyone in the department, including patients and families. So, when we built a new ED, we eliminated overhead paging and equipped staff with wearable communication badges that enable them to quickly communicate without disrupting patient care.

With the absence of loud overhead paging, the ED is a quieter, calmer place for healing. It also is a more ideal working environment. I’m convinced it’s the quietest ED in the world. One thing is for sure: Our clinical team members are now able to locate one another almost instantly, without the need for walking long distances to locate colleagues or waiting for responses from overhead pages. More importantly, the efficiency has freed up staff to spend more time with patients, which is so important for improving the overall healthcare experience.

As we saw patient and employee satisfaction increase, we expanded use of Vocera badges to other clinical departments and now have more than 3,000 staff members communicating via the hands-free devices. There is no other communication system I am aware of that can send a notification as closely and instantly to a nurse. That’s why, when it came time to select a text messaging solution, we chose the Vocera Collaboration Suite. It enables voice communication and HIPAA-compliant texting as well as alert notifications via smartphones, hands-free badges or web console. The intelligent software system routes the right information to the right care team member based on his or her name, role, group or availability. During the initial six months of implementation, care team members engaged in more than 16,000 secure text conversations via the smartphone app, and nearly 18,000 alerts were sent to the hands-free badges.

Our search for a secure texting solution turned out to have even more benefits than we had hoped. With the implementation of the Vocera Collaboration Suite, Halifax Health also simplified communication, sped up care team collaboration, and improved care delivery. Staff members no longer need to call an operator to relay a message and wait for a response. Instead, they now send and receive direct, secure messages. A process that previously took upwards of 30 to 45 minutes has been reduced to seconds.

The new process has improved workflow, staff response times and patient experience. In turn, just as we saw in the ED, improved care team communication also increases satisfaction among patients, families and staff. I believe when patients see communication happen in real time, it strengthens their trust and makes them feel more comfortable knowing their well-being is our primary goal.

Integrating Technology to Expedite Patient Care
The entire healthcare IT industry is focused on interoperability. This focus is needed and important, but healthcare IT must also focus on connecting systems within the hospital to improve clinical workflows. I needed a great name for this concept, so I coined the term “intraoperability.”

At Halifax Health, we are focused not only on interoperability, but also on intraoperability. The Vocera system has allowed us to expand connectivity between systems enabling direct communication of clinical information quickly, ultimately letting clinicians and physicians spend more time with the patient instead of being in front of a computing device. Intraoperability capabilities also enable faster staff communication and response times.

Integration with the hospital’s MEDITECH electronic health record (EHR) enables patient discharge notifications to be sent automatically to the right care team members via their Vocera smartphone app or hands-free badge as soon as the physician’s orders are entered into the EHR. The integration accelerates the entire patient discharge process. Our oncology unit reported an 8 percent decrease in the time it takes to discharge a patient. That means about 80 patients within a four-month time frame were able to go home or get the next level of care sooner. A similar integration with our TeleTracking patient flow system helps staff optimize bed management by alerting them about bed availability and the exact location of patients as they move through the hospital to receive care.

We are also integrating the Vocera system into our new point-of-care decision support application, which leverages about 300 patient data points in the EHR. We can use this data to look for early signs of an infection and initiate care quickly. If the decision support tool identifies that a patient could become septic, an alert is automatically sent to our sepsis care team and the patient’s nurse via their Vocera smartphone app or hands-free badge. With early warning, this important information allows hospital staff to treat the patient quickly, and hopefully puts the patient on a path to a speedy recovery. This is predictive analytics with instant alerting at its finest. Going forward, we hope to expand this alert system to monitor for other medical concerns.

Making Meaningful Connections in Healthcare
What started as a project to simplify communication between care team members has evolved into an initiative that is transforming the way clinicians and physicians communicate to deliver care. In addition to using Vocera technology to improve communication among our team members, we use it to improve patient communication and engagement. Vocera Rounds, a mobile rounding application, enables our nurses to have meaningful interactions with patients at the bedside and address their feedback and requests quickly. It also helps us manage patient experience throughout a hospital stay and close the loop with patients when they leave.

Prior to implementing Vocera Rounds, our nurses documented patient requests, concerns and questions on paper. This traditional method of rounding was not efficient because patient feedback could not be tracked or measured. The application enables our nurses to manage, monitor and act on patient feedback immediately. Depending on what’s going on with the patient during rounding, the nurse can use the app to escalate a request or concern to the right department or team member via hands-free badge communication.

In addition, patient feedback captured in the application is accessible to our nurses who make patient follow-up calls 24 to 48 hours after discharge. They can use the information to make the conversation more personal and form better connections with the patient. The feedback patients provide during a hospital stay also can help the nurses better understand the patients’ stories, their willingness to comply with the care plan, and the potential risk for readmission.

Communication matters. It is important to building trusted relationships with patients and providers inside and outside the four walls of the hospital.

stafford tom

Tom Stafford has been the CIO at Halifax Health since 2011. In his role, he leads all of the health system’s information technology functions, seeking ways to leverage technology for better clinical and financial outcomes. Stafford first joined Halifax Health in 2007, serving as the leader of the Project Management Office. He holds a bachelor’s degree in aerospace engineering from Embry-Riddle Aeronautical University and a master’s degree in mechanical engineering from the University of Central Florida.


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