News And Research
Here you will find the latest Vocera news, announcements, customer stories and research.
Health care workers understand that workplace violence, cognitive overload, and burnout have been challenging their safety and wellbeing long before COVID-19 added to their trauma. Bias and inequities in health care environments were also present well before this novel virus began making headlines. The time is now for us to determine what it will take to keep people in their chosen profession and then rapidly make these changes. Failure to do so will cripple our nation’s health care system.
The pandemic placed extraordinary stress on the health care system and its workers, exacerbating long-standing system issues that negatively impacted the physical, psychological, and emotional wellbeing of team members.
Safeguarding and retaining our health care workforce should be our nation’s top priority. It will require a new definition of safety and a renewed focus on care team wellbeing that makes emotional safety as important as physical safety. Health care leaders must uncover what changes are needed to keep people from fleeing their chosen profession and ensure that organizations take the steps to provide the systems, tools, technologies, and resources their team members need and deserve to feel safe at work and make them want to spend the rest of their careers doing what they once loved.
The CEO Coalition was launched because its founders understood that safety is at the heart of health care and that action is needed now to execute on a new definition to ensure a sustainable and safer future. The Coalition was founded by 10 U.S. health system CEOs, who share a mission to protect the physical safety, emotional wellbeing, and just treatment of all who work in health care.
The trauma is real
Physical and verbal violence at work, racial and ethnic biases, patients dying without loved ones by their side: these are only a few examples of trauma that healthcare workers have faced before and during COVID-19. For many frontline workers, what they have witnessed and experienced during the pandemic will have long-lasting effects, including PTSD.
In addition to battling a global pandemic, some health care workers must fight against bias and fight for health justice. A study from the University of California at Los Angeles found that the proportion of Black physicians in the U.S. has only increased by four percentage points over the past 120 years. The share of doctors who are Black men has remained unchanged since 1940. Additionally, many LGBTQ physicians have reported social ostracization in the workplace, including harassment by colleagues and patients. And since the start of the pandemic, Asian American health care workers have reported a rise in bigoted incidents.
Health care workers have suffered more psychological and emotional trauma since the start of the pandemic. According to 2021 survey findings from the Kaiser Family Foundation Washington Post Frontline Health Care Workers Survey, a majority of frontline health care workers (62%) reported that worry or stress related to COVID-19 had a negative impact on their mental health. More than half (56%) reported that worry or stress related to COVID-19 caused them to experience trouble with sleeping or sleeping too much (47%). Frequent headaches or stomachaches were reported by 31%, and 16% reported an increase in alcohol or drug use.
Violence against health care workers follows a similar storyline. A frequently cited survey from 2019 revealed that nearly 50% of emergency physicians reported being physically assaulted at work, while about 70% of emergency nurses reported being hit and kicked while on the job, according to the American College of Emergency Physicians and the Emergency Nurses Association. This type of violence has only intensified since the start of the pandemic.
Research published by the American Association of Occupational Health Nursing found that 44% of nurses reported experiencing physical violence in early 2020, while 68% experienced verbal abuse. According to the study, nurses who provided care for patients with COVID-19 experienced more physical violence and verbal abuse than nurses who did not care for these patients.
It’s time to redefine safety
Our health care workers deserve better. That is why health system leaders from across the country came together to write and sign “The Heart of Safety: Declaration of Principles.” The CEO Coalition is using the Declaration and its key principles to create more awareness about critical safety and wellbeing issues in healthcare and galvanize people to take action to retain and protect healthcare workers by providing them with the right equipment, technologies, support, and resources they need to be and to feel safe at work.
Importantly, the Declaration expands the definition of safety to include equity and antiracism as core components of safety and emphasizes a zero-harm program to eliminate physical and verbal workplace violence. Organizations that sign the Declaration are joining a national movement to accelerate policies and programs that advance these three essential pillars:
Safeguarding psychological and emotional safety. Participants pledge to invest in processes and technologies that reduce emotional and cognitive burdens on team members and restore human connection. This commitment involves creating practices that advance open communication between leaders and team members, so people feel safe to share their voice. It also means providing resources to assess and support team members’ emotional, social, and spiritual health, while at the same time alleviating the stigma and deterrents to seek support.
Promoting health justice. Equity and antiracism must be considered as core components of safety. Organizations that truly want to protect their team members must have focused policies and practices that advance diversity, inclusion, and belonging. Health care team members deserve to work in environments free from bias and discrimination so they can bring their full selves to work without fear.
Ensuring physical safety. Workplace violence is an epidemic. Health care leaders must commit to implementing zero-harm programs for care team members to eliminate both physical and verbal violence at work, whether from a team member, patient, family, or visitor. The CEO Coalition encourages organizations to provide evidence-based personal protective equipment, technology, tools, and processes that health care team members need to safely do their jobs and care for patients.
As the next COVID-19 variant hits our country, I feel a renewed sense of urgency. We need to move faster to invest in an infrastructure that protects our nation’s health care workforce before we lose more nurses, doctors, and other care team members. Every day they risk their own safety for ours and our loved ones. It is time to reimagine safety and take action to make lasting change. That means investing in new policies, processes, resources, and solutions that ease the burden of team members and safeguard their physical, emotional, and psychological wellbeing. It means coming together as a nation and recognizing that health care is an essential infrastructure and that the people who work in health care are national assets and that their safety and wellbeing matters. We cannot afford to lose another nurse, physician, or frontline care team member.
When I donned my white coat and took the Hippocratic Oath to “First Do No Harm,” I would leave for work every day and pray that I didn’t hurt anyone that day.
My biggest fear was that some decision or action on my part would cause harm to my patients. Never did I have to worry that my own safety or the safety of my family would be at risk because of my career choice. Never did I have to be concerned that I might not have the equipment or technology to keep me safe as I provided care for my patients.
Unfortunately, with the COVID-19 crisis, today’s care team members have had to face that very reality. The consequential mental and physical toll on them will profoundly impact our nation’s healthcare system and the workforce of the future. My colleagues on the frontlines today have had to deal with a novel virus for which we were little prepared, leaving professionals whose whole sense of purpose comes from healing and “helping” feeling unable to help.
Many have had to become ‘doulas for dying,’ providing a loving presence at the bedside and connecting with patient’s loved ones who couldn’t be by their side due to safety restrictions.
COVID-19 exposed flaws in our health system and national health care infrastructure. Not only did we experience shortages of PPE and expose supply chain inadequacies, but we also discovered that our definitions of PPE (gowns, gloves, masks) failed to ensure that frontline care team members could communicate effectively with their teammates and with patients and families without the risk of infection.
That meant more contamination risk in donning and doffing PPE that hands-free communication tools could have prevented.
We also saw broad systemic inequities exposed as COVID-19 disproportionately impacted Black and brown community members, both from a mortality and economic perspective. We learned that racial injustices were also being experienced within our healthcare systems by many of our colleagues. Remarkably, our essential but too often “invisible” workers in housekeeping and food services – disproportionately people of colour – still put their lives on the line every day to care for patients and team members.
A movement to redefine safety for healthcare team members
As a physician whose career has been centered on making sure every human being has access to humane, compassionate, and competent care, and working for a company whose mission is to simplify and improve the lives of healthcare professionals and patients, I saw the need for a new movement in healthcare – one that broadens the definition of workplace safety and elevates team member safety and well-being to a top strategic priority for the nation.
With the support of the senior leadership at Vocera, my team and I quickly assembled a coalition of CEOs from leading health systems, diverse in background, geography, gender, and system type. It didn’t take any convincing. These leaders were seeing the same challenges we were and knew that the future of the nation’s healthcare systems depended on making physical and psychological safety and health justice our nation’s top priority.
Together, we drafted a Declaration of Principles that expands the definition of safety to include safeguarding psychological and emotional well-being of team members, promoting health justice by declaring equity and anti-racism as core components of safety, and ensuring physical safety, which includes a zero-harm program to eliminate workplace violence, both physical and verbal. This Declaration extends to all team members, from frontline clinicians to environmental services workers and back-office employees.
Since launching the Declaration in May, we have collaborated with the Institute for Health Improvement to ensure that we can identify and spread evidence- and experience-based practices that advance the six Principles, as well as the metrics that allow us to gauge progress.
I am profoundly grateful to our 10 founding CEOs who are making team member safety one of their top priorities as we rebuild from COVID-19. And I invite others to join the movement to ensure that no healthcare team member will have to sacrifice their personal safety, health, identity, or well-being to do their jobs and care for patients.
Kedar Mate, MD, is President and Chief Executive Officer at the Institute for Healthcare Improvement (IHI), President of the IHI Lucian Leape Institute, and a member of the faculty at Weill Cornell Medical College. His scholarly work has focused on health system design, health care quality, strategies for achieving large-scale change, and approaches to improving value. Previously Dr. Mate worked at Partners In Health, the World Health Organization, Brigham and Women’s Hospital, and has served as IHI’s Chief Innovation and Education Officer.
In this episode, Dr. Mate and I talk about research IHI recently completed into a broadened definition of team member safety and well-being put forth by the CEO Coalition, a group of US-based healthcare CEOs who see team member safety and well-being as an essential component of healthcare efficacy and sustainability. The CEO Coalition’s Heart of Safety Declaration of Principles expands the definition of safety to include protecting psychological and emotional well-being, promoting health justice by declaring equity and anti-racism core components of safety, and ensuring physical safety, which includes a zero-harm program to eliminate workplace violence, both physical and verbal. Dr. Mate shares what he and his team learned through the research process and how improvement science is critical to advancing safety and well-being. He also shares a long-term vision for healthcare in which the traditional locations and relationships of care expand, requiring a renewed focus on adaptive leadership competencies.
Health IT vendor Vocera has announced a collaboration with Amazon to build an ambient clinical intelligence solution in efforts to enhance the patient experience and streamline clinical communication.
The HIPAA-eligible solution will leverage a set of technologies from Alexa Smart Properties to allow patients and families to receive information about their stay through simple voice requests spoken to an Amazon Echo in the patient’s room.
The health IT will automatically answer common questions from patients that do not need clinical intervention, like visitor hours.
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For requests that require clinical intervention, the tool will recognize keywords and phrases to route the message to the appropriate care team member. This is expected to streamline clinical communication by reducing unnecessary care team interruptions.
The system will prioritize patient requests for assistance by relevance and automatically escalate requests as needed. Additionally, the tool will deliver patient requests to team members with accompanying contextual information to improve patient care coordination.
“We believe the intuitive and accessible nature of voice and Alexa has the potential to help and delight customers in many scenarios, in and outside of the home,” Liron Torres, head of Alexa Smart Properties at Amazon, said in a press release.
“We’re excited to work with Vocera and extend the voice experiences customers already love to healthcare systems, and give care providers new ways to save time and personalize care for their patients,” Lorres continued.
The health IT tool will also provide patients with verbal updates about the status of each request to help put them at ease and enhance the patient experience.
“Vocera has more than 20 years of experience in voice communication technology; and with more than 50 clinicians on staff, we understand the benefits of hands-free communication and how it protects and connects patients and care teams,” said Dave Lively, senior vice president of Product Management at Vocera.
“We are excited to collaborate with Amazon to advance the power and convenience of voice communication to elevate the patient experience, improve safety, and save valuable time for nurses and other care team members,” Lively continued.
The health IT collaboration is an example of ambient intelligence entering the healthcare sector. Ambient intelligence refers to physical spaces that are sensitive and responsive to the presence of humans, according to an article published by the National Center for Biotechnology Information (NCBI).
The technology hinges on data collected by sensors and processors imbedded into everyday objects and utilizes machine learning algorithms for data analytics.
Ambient intelligence has several use cases that could potentially improve patient care and mitigate clinician burden in healthcare settings, including streamlined EHR documentation practices.
Ambient clinical intelligence leverages contact-based wearable devices and contactless sensors embedded in healthcare settings to collect information like audio data and imaging data of physical spaces, according to research published in ScienceDirect. Machine learning algorithms then efficiently interpret the data for clinical application.
Amazon partnered with clinical communication platform Vocera Communications to develop a HIPAA-eligible Alexa skill for hospitals to enable patients to submit voice requests to their clinics via the device.
Amazon partnered with clinical communication platform Vocera Communications to develop a HIPAA-eligible Alexa skill for hospitals to enable patients to submit voice requests to their clinics via the device.
Four things to know:
The skill is designed to help patients and their families get information about their hospital stay and reach their care team by giving the device voice requests from their rooms, according to a Nov. 16 news release. The skill was developed to avoid unnecessary interruptions and overwhelming clinicians, according to the release.
The Alexa device will give patients verbal updates about the status of their requests. Frequently asked questions, such as the hospital's visiting hours, will be answered directly by the device. Patients who need assistance will be prioritized, which is expected to improve response times.
In October, Amazon unveiled a skill named Alexa Smart Properties. The skill allows clinicians to call and "drop in" on patients without physically entering their rooms. The skill developed in collaboration with Vocera leverages technologies from Alexa Smart Properties.
"We're excited to work with Vocera and extend the voice experiences customers already love to healthcare systems and give care providers new ways to save time and personalize care for their patients," said Liron Torres, head of Alexa Smart Properties at Amazon.
For many leaders, concern for workforce safety has focused on physical safety — a health care environment with no lift injuries, slips, trips or falls, and sound infection control with appropriate personal protective equipment (PPE). Yet, the COVID-19 pandemic has highlighted the need for a more holistic notion of workforce safety — one that builds on physical safety as a foundation, but also encompasses psychological and emotional safety, including an equitable work environment free of bias or discrimination.
This concept of workforce safety is consistent with the National Action Plan to Advance Patient Safety, and other national efforts to prioritize the safety of the health care workforce. Of note is the vision offered by the CEO Coalition, a group led by Vocera Communications with support from the Institute for Healthcare Improvement (IHI) that includes leaders from prominent health systems, including Intermountain Healthcare, Providence, and others. The CEO Coalition offers six key principles that fall under three domains to address workforce safety holistically: safeguard psychological and emotional safety, promote health justice, and ensure physical safety. The following domains and principles can form the foundation for a workforce safety agenda for health systems:
Domain 1: Safeguard Psychological and Emotional Safety
This domain and its accompanying principles acknowledge the emotional, mental, and cognitive health needs of health care workers:
Principle 1: Invest in processes and technologies that reduce emotional and cognitive burdens on team members and restore human connection to the health care experience.
Principle 2: Create practices and policies that advance open communication between team members and leaders so people feel safe to speak up and bring their full selves to work.
Principle 3: Provide resources to assess and support team members’ emotional, social, and spiritual health, and alleviate the stigma and deterrents to seeking support.
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During the height of the COVID-19 pandemic, many health systems provided increased mental health services to their staff, acknowledging that health systems have a role in alleviating the psychological toll experienced by their workers. In addition to robust mental health services, some hospitals are also working to reduce the burden of the electronic health record (EHR) by limiting notifications. The time saved has allowed health care workers to spend more time with patients and helped them to feel greater work
Domain 2: Promote Health Justice
Principle 4: Declare equity and anti-racism core components of safety, and require explicit organizational and health equity-focused policies and practices to advance diversity, inclusion, and belonging.
The health inequities exposed by the COVID-19 pandemic and increased attention to racism in our societies have highlighted the need for health systems to take a firm stand on racial justice and health equity. Health systems must look at their own internal practices to ensure they are creating an anti-racist and equitable environment for both patients and staff. An example of this includes incorporating equity into existing practices, such as root cause analyses conducted after workplace injury or harm. Some health systems have begun to include questions specific to equity, such as whether the incident suggests any possibility of biased behavior on any individual’s part, or whether the incident suggests system-level barriers to an equitable workplace, such as impediments to transportation, childcare, or other supports.
Domain 3: Ensure Physical Safety
Principle 5: Implement a zero-harm program for care team members to eliminate workplace violence, both physical and verbal, whether from team members, patients, families, or community members.
Principle 6: Ensure that all health care organizations can procure and provide evidence-based PPE, technology, tools, and processes that health care team members need to do their jobs safely and care for patients.
While important progress has been made to protect the physical safety of workers, recent events have shown the need to scale up efforts related to workplace violence and injury prevention. This includes implementing the US Occupational Safety and Health Administration (OSHA) Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers, forming a behavioral response team to de-escalate workplace violence events, and implementing safe patient handling protocols.
The CEO Coalition now includes a learning community where system leaders can understand evidence-based practices in areas such as workplace violence prevention and reducing the mental burden for health care providers.
Other Efforts to Expand the Scope of Workforce Safety
Multiple national initiatives are converging to broaden the understanding of workforce safety:
Safer Together: A National Action Plan to Advance Patient Safety makes several recommendations for health systems that go beyond physical safety, including:
Assume accountability for physical and psychological safety and a healthy work environment that fosters the joy of the health care workforce and
Develop, resource, and execute on priority programs that equitably foster workforce safety.
The National Action Plan authors also developed an organizational assessment tool and implementation resources.
IHI’s Joy in Work Results-Oriented Learning Network (ROLN) has highlighted interventions that go beyond typical notions of employee satisfaction. These changes encompass physical safety, improved communication, and reducing unnecessary work and workarounds. In the coming year, the Joy in Work ROLN will also benefit from IHI’s efforts to more explicitly incorporate equity into the joy in work change package.
In the coming year, IHI’s Leadership Alliance — a dynamic collaboration of health care executives — will assemble a workforce well-being workgroup after convening a year-long workgroup in 2021 focused on physical safety.
IHI’s overall efforts to advance equity increasingly focuses not only on patients, but also on health care staff. Examples of changes introduced by leading health systems include workforce diversity targets, implicit bias training for all staff, and executive coaching to ensure C-suite leaders have personal goals to promote equity for their system.
How to Take Action Now
Health systems can address workforce safety more holistically in a number of ways:
Create robust measurement and reporting systems that prioritize workforce safety but go beyond physical safety.
Regularly report incidents of physical injury, workplace violence, and verbal aggression experienced by the workforce to the C-suite and board level (e.g., as part of an executive dashboard).
Make workforce safety one of a small number of strategic system priorities, and adopt an investment mentality. This means allocating the time, equipment, and staffing necessary to promote workforce safety. These investments pay off in lower turnover and other avoidable costs.
Stratify workforce safety data by race, ethnicity, gender, age, and specialty, and also survey the workforce on whether they perceive leadership as prioritizing equity across initiatives.
Focus on creating a safety culture. As the Joint Commission and others have recognized, the foundations for workforce safety — such as psychological safety, transparent and regular reporting, a focus on identifying root causes and structural factors, as well as working to build a just culture — are much the same as the foundations for patient safety. Leaders must commit to these foundations to make workforce safety sustainable.
Commit to listening to frontline workers to understand their needs, what matters to them, and what would make them feel safe when thinking about physical safety, psychological safety, and an equitable work environment.
The safety of the health care workforce is essential for safe, high-quality patient care. Yet, harm to the workforce remains a challenge across all settings. The solution, according to an increasing number of organizations, is to take a wider view of workforce safety to include the physical and psychological safety and well-being of workers, including equitable work environments free of discrimination and bias.
Vice president of patient care services and chief nursing officer Jennifer Woods, has been with McLaren Northern Michigan for 21 years. She spoke with HealthCare Business News to detail what’s led to her history with the organization and the innovative work McLaren continues to push today.
HCB News: Who or what inspired you to pursue a career in healthcare?
Jennifer Woods: I actually knew I wanted to go into nursing at age 14. I remember being a freshman in high school and my parents were always teaching me to think ahead in life. I happened upon an article that was talking about neonatal nursing. I remember being really drawn to what they were doing, the differences they were making in the lives of those tiny little people and the important work they were doing. I turned to my mom and told her, “This is what I want to do.” And I knew it from that point.
Being in nursing school and learning all of the roles of nursing and our influence in healthcare broadened that for me. I did not go into neonatal nursing; however, I actually changed over to adult critical care and that’s where I started my career. I could see early on the privilege it was to care for people in their most vulnerable times and how important those moments are to their long-term health and well-being.
HCB News: What drew you to McLaren Northern Michigan?
JW: We had family in Northern Michigan. When we moved and we were just starting our family, I did look at other organizations. But I can tell you, it was palpable. When I walked into this organization, I could feel the community atmosphere, the welcoming of the colleagues, and the engagement. I worked in several large facilities, which were amazing as well, but I always felt the difference. I felt when I walked in the door how engaged everyone was. It opened my mind to the possibilities.
HCB News: During your time in healthcare, have you seen an improvement in collaborative practices — nurses and support teams having more of a say for example?
JW: Yes, I have seen it advance. I’ve felt very fortunate in my career to always be valued and respected for what I could contribute. That said, as healthcare professionals, I think we have gotten better at recognizing all of the professional roles and their expertise and the contributions they provide to driving outcomes for our patients. Even within our academic institutions, we’ve started to teach that way. We’ve learned we can get better outcomes for patients when we have that multidisciplinary approach. We’re able to think collaboratively, set goals, improve best practices and enhance each other’s skills and abilities. Over time, there’s been better recognition of that, and I see it throughout our organization on a daily basis.
Medical communication company Vocera is teaming up with Amazon to build a new skill on Alexa aimed at making patients’ hospital experience more connected.
The new skill will be focused on keeping patients and caregivers connected to their clinical team. Patients will also be able to use the combined technology to ask questions about their hospital stay. Tapping into an Amazon Echo in their room, patients will be able to just speak requests for a care team member.
On the other end, care team members will get the request for care on either their Vocera Badge, Smartbadge or Vina app. Employing Vocera Engage software, the new skill will be able to decipher phrases and keywords in order to contact the appropriate caregiver for the patient’s request. Caregivers will be able to respond verbally to the patient’s request over an Alexa device.
WHY IT MATTERS
It’s no secret that the U.S. is experiencing a nursing shortage in the midst of the COVID-19 pandemic. According to the American Nurse Association, 500,000 RNs are expected to retire by 2022.
This shortage has put more pressure on the healthcare system. A slew of new technologies are looking to help assist healthcare providers in their work.
“We believe the intuitive and accessible nature of voice and Alexa has the potential to help and delight customers in many scenarios, in and outside of the home,” said Liron Torres, head of Alexa smart properties at Amazon.
“We’re excited to work with Vocera and extend the voice experiences customers already love to healthcare systems, and give care providers new ways to save time and personalize care for their patients.”
THE LARGER TREND
Amazon Alexa has been used for a variety of healthcare functions. Earlier this month the company unveiled its connected home air quality monitor, which works with Alexa virtual assistant.
At the end of October Amazon announced that its Alexa voice assistant would be open for use in senior living communities and health systems. The tech giant also launched subscription service Alexa Together, which lets family members and caregivers remotely monitor aging families in their home.
Vocera has also been growing. In 2020 the company purchased patient-messaging technology company EASE Applications.