Halifax Health, the largest medical provider in east central Florida, with two hospitals, 678 licensed beds, a medical staff of 500 physicians, and a group of community care centers, wanted to increase the communication efficiency between clinicians and physicians, with the goal of an overall better experience for patients.
When Halifax Health clinicians needed to consult a physician who wasn’t physically present in the unit, they were required to call a central operator who would then call the physician, relay the query, and coordinate a response. Because this was an inefficient process, care teams naturally turned to their personal smartphones. Halifax Health wanted to improve this situation and enable clinical staff to text each other securely so they could better communicate about patients.
Halifax Health information technology leaders immediately launched a search for a solution that would provide secure communications among all patient care providers. By the time they had solved the problem, they had uncovered additional unexpected benefits that transformed how the hospital delivers patient care.
Halifax Health looked to Vocera for its secure communications smartphone solution because of its long and successful partnership. In 2009, it began using the Vocera® Communication Badge, a wearable, wireless, hands-free, voice-controlled device that enables instant twoway or one-to-many conversations. The solution quickly reduced overhead paging noise in a new 99,000-square-foot emergency department. The result is, as Vice President and Chief Information Officer Tom Stafford describes it, the world’s quietest emergency unit.
“All the overhead pages that used to make it so intense and chaotic now go through Vocera Badges. It’s actually quite calm in the emergency department,” says Stafford.
With this success, Halifax Health expanded its Vocera Communication Badge program to more than 3,200 mobile personnel and almost every clinical department. In the hospital’s France Tower, where each floor is the size of a football field, the Vocera system makes it far easier for clinical staff members to locate their colleagues and greatly reduces the distances they walk each day.
“Before we turned on the Vocera system, I was exhausted by 10 in the morning,” recalls Kim Jones, manager of medical telemetry. “The day after, I could stand in one place and find every one of my team members.”
To tackle the issue of clinicians communicating efficiently with physicians on their smartphones, Stafford and his team wanted to test the capabilities of Vocera Collaboration Suite, a HIPAA-compliance-enabling mobile application for iOS and Android™ smartphones. The solution combines secure text messaging and alerting, and enables voice calls with intelligent routing by name, role, group, and availability.
It operates inside and outside the hospital over cellular and Wi-Fi networks, and features built-in integration with more than 70 major clinical systems.
The Halifax Health team launched a single-unit pilot project. They expected some minor benefits from the tight integration with the Vocera Communication Badge, but what they actually discovered amazed them.
By putting in place direct, secure communication between clinicians and physicians, Vocera Collaboration Suite bypasses the call center, simplifies the workflow, and eliminates most delays.
“Initially, we weren’t really focused on the workflow,” explains senior business analyst Ryan Ellerton. “We were just trying to secure our communications, but now a nurse can text a physician directly and receive a direct call in response. A process that used to take 30 to 45 minutes is now almost instant.”
Improving care team communication immediately benefitted Halifax Health’s patients, who now receive faster responses to their treatment needs.
“It’s an instant fix,” says Jones. “We communicate an issue to the physician and he texts us back immediately, telling us what orders will be entered into the EHR [electronic health records] system. In most cases, he doesn’t need to visit the floor to assess the patient or enter the order. He can do it immediately wherever he is.”
Vocera Collaboration Suite also improves patient care by returning to clinical communications something lost in the transition from paper charts to EHR systems.
“In the past, clinicians could flip through the paper chart and read until they understood the whole story,” Stafford says. “Today’s EHR gives you so many different views of the data, but it’s harder to read the whole story. Clinical communication fills in those gaps. When it occurs in a timely and effective manner, patients get better care and experience better outcomes.”
Both Vocera Collaboration Suite and the Vocera Communication Badge integrate with key Halifax Health clinical systems through its Corepoint integration engine. For example, one integration converts patient discharge orders in the Meditech EHR system into email alerts that the Vocera Badge and mobile apps deliver to clinical staff.
“The CNA can go straight to the room and start prepping the patient and family to go home,” Stafford says. “That’s very satisfying for our patients because the physician has already told them they’d be going home. So to see a CNA show up minutes later, and to know they don’t have to wait to be discharged, has to brighten their day. They know we’re serious about getting them to the proper next level of care, which is not within the hospital anymore.”
Speeding up discharge notifications doesn’t just brighten the patient’s day, it accelerates the entire discharge process. “In our oncology unit, discharge durations of up to five hours have been improved by 8 percent,” Stafford says. “That means about 80 patients within a four-month time frame were able to go home or get the proper level of care sooner.”
A similar integration between Vocera and the hospital’s TeleTracking patient flow system helps the staff optimize bed management and makes communication more reliable.
Finally, Vocera Collaboration Suite has reduced the use of overhead paging, sending those alerts quietly to the appropriate users’ phones instead. “Within the next year, we hope to reduce overhead paging across the entire hospital by 90 percent. That’s our goal,” says Nancy Jeffreys, IT security risk manager at Halifax Health.
Based on these successes, Halifax Health is rolling out Vocera Collaboration Suite to all of its nursing floors and on the smartphones of several additional physician groups, including medical oncologists, obstetrics, hospitalists, intensivists, and residents. It is also expanding the use of direct, non-email notifications for several new events, including emergency department alerts and several types of physician orders.
One of the most interesting new alerts connects the Vocera Communication System to a new point-of-care decision-support application from Lippincott Solutions. The software monitors patient data gathered from the EHR system, looking for early signs of a developing infection. When it sees trouble, the system automatically sends an alarm to the appropriate nurse’s Vocera Badge. With this early warning, the hospital staff can act immediately to accelerate treatment and ensure a patient’s speedy recovery.
When hospitals improve communication among caregivers and even monitoring systems, patients reap the rewards of better, more timely treatments and a quieter healing environment.
Vocera empowers people in mission-critical environments to instantly connect via secure, mobile, integrated and intelligent communication solutions.