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Eliminate Manual Communication Procedures to Achieve High Reliability


How pen and paper can create risks for patient, providers, and visitors.

Paper airplanes flying in different directions

For many hospitals and health systems, creating a culture of high reliability is a priority. As healthcare shifts toward value-based care models that reward strong clinical outcomes, using repeatable, standardized processes to avoid errors and deliver safe, high-quality care is vital.

Despite dedicated efforts, however, the healthcare industry still struggles to achieve consistent, widespread quality. According to the CDC, nearly 1.7 million hospitalized patients acquire healthcare-associated infections (HAIs) annually while being treated for other health issues. One in 17 of these patients die due to HAIs. 

Similarly, fall prevention has been the subject of many hospital quality improvement efforts, yet falls remain a common and devastating complication of hospital admission. The Agency for Healthcare Quality and Research estimates that 700,000 to 1 million hospitalized patients fall each year

Manual processes create failure points

A team approach to standardizing care processes and focusing on relevant, timely, and clear communication about each patient is critical. More and more, hospitals are adopting a culture of zero tolerance for HAIs and avoidable safety events which may cause harm to patients. Care coordination requires multiple people to be on the same page at any given moment. Real-time effective communication among all disciplines, staff, patients, and families is required. Seeing the “big picture” of the patient’s condition and immediate priorities for care requires an automated and reliable approach. 

Many times, though, critical patient information is buried in the electronic medical record (EMR), written on a sticky note or displayed on a paper sign hung on the door. These types of manual communication tactics are often not clearly defined, take extra time to ensure compliance, and are overlooked by those entering the room. That means critical information about a patient’s condition or precautions that should be taken before entering the room can easily be missed.

Related article: Provider Engagement in the New Digital Era

For example, a doctor may put a patient on nil per os (NPO) status before a procedure. Moments after the doctor leaves the room to chart the order, the patient’s nurse comes in and is not yet aware the patient is NPO. When a meal tray is delivered a few minutes later, the patient eats and the surgery has to be canceled, resulting in a delay in care and a potentially poor clinical outcome.

Another obstacle is the significant time demands that clinicians and staff face. Currently, staff must either access patient information from the EMR once they are in the patient room or via a remote workstation-frequently too late to improve preparedness and create efficiency.

As hospitals move toward becoming high-reliability organizations, clinicians and staff need effective tools to gather critical insights on a patient’s condition (e.g., fall risk, infection control risk, NPO status) before entering a room. To actively create awareness of potential risks and points of failure, hospitals must ensure everyone has the information they need at their fingertips in real time to prevent HAIs and injury and mitigate risk.

Automating critical patient information

The answer to these communication challenges is to automate the manual processes that create failure points. With digital health solutions, an automated data feed from the EMR provides a snapshot of what is happening in the room. A quick glance at a digital screen outside the patient’s room raises awareness of critical care instructions and who is at risk for injury or infection, creating a culture of safety and high reliability.

For our NPO patient, the moment the doctor enters the order in the EMR, it automatically populates on a screen outside the patient’s room. Automation makes the communication faster and more accurate, so everyone from the nurse to the person delivering meal trays knows that the patient cannot have any food by mouth.

Related article: Five Ways Digitization Will Impact Healthcare in 2019

Let’s take a patient who has been identified as an infection control risk. As soon as that risk is identified, innovative patient engagement solutions automatically and accurately communicate this critical infection control information, ensuring everyone takes the proper precautions. It allows a nurse to pause and properly prepare to go into the room, and the housekeeping staff understands that they must clean the room differently than they normally would. Increasing awareness at the point of care prevents the infection from spreading among patients, staff, and visitors.

On the journey to becoming a high reliability organization, digital health solutions can help hospitals eliminate opportunities for error or failure points. These types of solutions provide access to automated and accurate patient information, which is a critical success factor in an organization’s transformation.

LouAnn Bala, MSN, RN, is vice president of strategic product management at GetWellNetwork. As an experienced transformational nursing leader and trusted consultant, LouAnn has over two decades of progressive leadership and operational experience in a variety of settings.

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