When most of us think of surgeries, we think of an Operating Room (OR). But the OR represents only one aspect of an intricate web of places, care providers, and equipment that must be coordinated on behalf of every surgical patient.
Communication among the various individuals involved in the surgical process—which can encompass admissions staff, clinical charge nurses, anesthesiologists, lab and radiology techs, endoscopy techs, surgeons, Post-Anesthesia Care Unit (PACU) nurses, phlebotomists, IT specialists, and more—is crucial not only for optimal patient care, but also for optimal efficiency of the hospital’s operations.
Health First’s four hospitals on East Central Florida’s Space Coast have been using the Vocera Communication System, which has had a profound impact and benefit, notably at Health First Holmes Regional Medical Center in Melbourne and Health First Palm Bay Hospital in Palm Bay.
Facility Sizes and Surgery Volumes Impact Communication
Health First Holmes Regional is East Central Florida’s premier tertiary referral hospital, with 514 beds, a Level II Trauma Center, renowned Heart & Vascular wing, and Brevard County’s first Level II Neonatal Intensive Care Unit (NICU). In the past, coordinating surgical patients and activities at Health First Holmes Regional was complicated by the hospital’s physical size and volume of surgeries.
“We perform 9,000 to 10,000 surgeries a year in 18 ORs at Health First Holmes Regional,” said Barbara Pattison, the Director of Surgical Services. “Our ORs are spread across two wings of the hospital, with a quarter mile separating the two ORs that are the furthest apart.”
At Health First Palm Bay Hospital, new communication challenges arose when the 60-bed hospital expanded to 152 beds in 2009. Even with a more compact layout than at Health First Holmes Regional, the expansion at Health First Palm Bay created the need for the OR staff to establish integrated, consistent communication processes within the Surgical Department and with the hospital’s other departments.
“Our Surgical Departments are very process-driven environments, with clearly defined steps that must be followed, in order,” said Karie Ryan, Chief Clinical Informatics Officer for Health First. “If the OR gets backed up because you are waiting for any one of those steps, it costs the hospital money.” Backups and delays can also diminish the quality of patient care that the hospital staff is able to deliver.
Vocera Voice Solution Takes Hold
“Over the years, we had tried a number of communication technologies—cordless phones, paging systems, cell phones,” said Pattison. Then the Vocera® System was implemented among the clinical and administrative staff in endoscopy, special procedures rooms, PACU, and to nurses working at patient bedsides. “We essentially have Vocera everywhere now,” said Pattison. “Vocera has spread organically, rather than being mandated from the top down. Once people see how Vocera improves communication, almost everyone wants to use it.”
Individuals log into Vocera once a day and are then reachable via their hands-free Vocera Badges by name, position/role, and group. Anesthesiologists, who work on-site at a particular hospital most of the time, rely on Vocera. Surgeons and other physicians, who generally split their time across multiple hospitals and medical offices, rarely take advantage of Vocera directly, but they still benefit because the hospital’s more efficient operations mean fewer delays of scheduled surgeries and in moving patients through the various pre-surgical, OR, and post-surgical areas.
Because HIPAA privacy laws prevent people from potentially disclosing a patient’s identity or any personal or medical information, Health First took special care to train its staff to use the Vocera Badge appropriately within the hospital context.
“We all had to learn not to use patient names or to describe specific medical details over Vocera,” said Pattison. “It’s not like talking on the phone, because everyone within earshot of the Vocera Badge can hear what is said. With Vocera, staying mindful of confidentiality, someone might say, ‘I need help turning a patient in room 123,’ or ‘X-ray to room 6,’ or ‘Code Blue in ICU.’”
Reaching—and Being Reached—Almost Instantly
On the second floor of Health First Holmes Regional, the charge nurse on duty is stationed at the intersection of the two surgical wings in front of the OR workboard. From this centrallylocated position, the charge nurse uses Vocera to call for assistance for patients in any room, simply by stating what’s needed into the Vocera Badge. Conversely, nurses or other staff at patient bedsides or in PACU can alert the charge nurse to their needs.
“The Anesthesia Department loves Vocera,” said Linda Varley-Klein, head of Perianesthesia Nursing at Health First Holmes Regional Medical Center. “Instead of having to know the name and phone number of who’s on duty in a particular position, or the location of a piece of shared equipment, or calling into an overhead paging system and waiting minutes for the page to be broadcast, Vocera allows us to jump straight to an instant response or answer. We can find anyone, or be reached ourselves, no matter where we are during a health crisis or emergency, the convenience of Vocera can turn literally into a lifesaver.”
The ability to quickly and easily communicate what’s needed and when with Vocera has improved the workflow within all the Health First hospitals’ ORs.
“When you can cut out 2 or 3 minutes from a workflow, such as making a phone call to a particular care provider and being put on hold, it’s better for the nurses and staff, it’s better for the hospital’s productivity, and it’s better for the patient,” said Ryan. “Vocera saves at least 10 minutes per nurse per shift. When you multiply that by the number of nurses on duty on any given day, that’s a huge time savings.”
“Vocera helps us put patients back at the center of care, because we can focus on being fully present with patients yet still know we can get immediate help if it’s needed,” said Pattison. “It’s really gotten to the point where we think: you’ve got your stethoscope, you’ve got your Vocera, you’re good to go.”