DMC Huron Valley-Sinai Hospital combines large-hospital resources—it is part of the Detroit Medical Center System—with the intimacy of a community hospital. The awardwinning general medical and surgical hospital has 153 beds, it admits approximately 10,000 patients a year, and its emergency room is kept busy by nearly 35,000 visits annually.
Still, the hospital continued to look for ways to improve patient services. For instance, it was disappointed with the intrusiveness of overhead paging, and was determined to address patient concerns that nurse responsiveness was inconsistent and the environment was often considered noisy and difficult for patients to get the rest they needed to recuperate.
“Our nursing staff is recognized as being at the top of its field, and the hospital is extremely dedicated to providing patients with the highest quality of care,” said Karen Fordham, VP and Chief Operating Officer (COO) of DMC Huron Valley-Sinai Hospital. “We knew we needed to find out what was causing patients to have anything less than a stellar experience in our hospital.”
In 2012, Huron Valley-Sinai distributed the Vocera® B3000 Communications Badge to its nursing staff. The hands-free, light weight, wearable device enables nurses to talk directly with each other simply by speaking the name of a specific person, team, or function, rather than having to page a person or look up a phone number.
Nurses soon discovered Vocera could help them become more efficient, as they no longer had to stop what they were doing to reach each other or the patient and physician directly. In addition, the hands-free nature of the system is ideal for uses such as patient isolation areas, where protocols prevent pulling cell phones or pagers out of a pocket.
The hospital also uses Rauland Responder® nurse call systems and Hill-Rom® bed alarms. When patients initiated a nurse call or triggered their bed alarm, the call or alarm went to a unit clerk’s desk, who would determine the nature of the event and notify the right person to respond. For instance, if the patient was in pain, the unit clerk would receive the nurse call notification and find the patient’s primary nurse, who would then attend to the patient. For bathroom requests, a patient care associate (PCA) could manage the task; or to adjust the room temperature for a patient, facilities would be contacted. Each request required the unit clerk to locate the appropriate person to help the patient, leaving them waiting for help or for a response.
“We realized that leveraging Vocera with our existing infrastructure could improve the overall workflow of the clinical staff,” said Fordham.
To that end, Huron Valley-Sinai is integrating Vocera with the Rauland systems, and Vocera will be deployed to PCAs as well as nurses, allowing care givers to respond to patient requests immediately, saving time, and improving patient care. These two steps are integral improvements that will drive a more positive experience for patients, nurses, physicians, and other clinical staff members alike.
By using Vocera to streamline the communication process flow between not only nurses and physicians, but also patients, Huron Valley-Sinai has been able to eliminate most of its overhead pages. One direct effect has been to create a quieter environment, which is conducive to healing. According to standardized HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) surveys, inpatient perceptions of the quietness of Huron Valley-Sinai’s hospital environment has improved 20% since overhead paging was reduced.
Also, because patients’ calls and alarms are integrated with Vocera rather than going to centrally monitored desks, unit clerks are no longer tied to their desks, meaning they have more flexibility to perform other functions in their units. For their part, physicians appreciate being able to use a single Vocera number to reach anyone they need in the hospital, whether they are inside or outside of the facility. Because they typically do not wear a Vocera Badge, the physicians leverage the ability of Vocera to call into the system as a gateway to the system’s convenient find-and-call features.
The hospital’s clinical staff can mobilize specialty teams quickly, such as for cases of stroke or cardiac arrest. A clinician can simply broadcast “Stroke team” or “Code Blue team” into the Vocera Badge, and automatically all the members of the Stroke or Code Blue teams receive the message.
Patients now have greater visibility into the responses being made by clinical staff on their behalf, which has increased their overall satisfaction with the care they receive. “Before, a PCA would have to use a desk phone to call for a nurse, which meant stepping out of the patient’s room, or use the paging system from inside the patient’s room, which would increase the noise level throughout the unit,” said Fordham.
Since expanding its use of Vocera, as well as implementing related processes to provide patients with information and education, DMC Huron Valley-Sinai has seen a steady rise in its patient satisfaction scores, as measured through the HCAHPS surveys.
“Our process flow has improved, so now we’re sending the right response to the right person, without middlemen or delays,” said Fordham. “Nurses can spend more time at bedsides doing things that directly improve patient care, without having to leave the current patient’s bedside to assist another patient. And from the patients’ perspective, we’ve eliminated the perception that ‘no one is responding to me in a timely manner’ and these perceptions are crucial to patients’ ability to experience and appreciate the excellent quality of care they’re receiving at our hospital.”
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