Emerus is pioneering a new model for community medical care: acute micro hospitals specializing in emergency care delivered fast and efficiently. Operated as joint ventures with hospital partners such as the Baptist Health Care System in Texas, Emerus facilities use business agility and a strong patient-centric orientation to deliver the highest level of care as well as cost-effective, scalable growth opportunities for large-scale healthcare systems throughout the U.S.
Instead of the typical 4-hour wait in a traditional emergency room, patients arriving at Emerus-affiliated micro hospitals are usually seen within 15 minutes. “Every aspect of the Emerus model is about driving the quickest, most efficient workflows, from the nursing staff to the physicians to all the operational staff, whether it’s human resources, IT or finance,” says Trang Dawson, CIO of Emerus.
Excellent communication among all staff members is key to this model of medical care. Emerus decided to implement the Vocera Communication System, starting in San Antonio with their Baptist Emergency hospitals, not only for its hands-free wireless communication capabilities, but also to integrate with its telemetry system.
Improving Internal Communications to Improve Patient Care
“As an organization, Emerus is completely focused on improving patients’ experience, from the moment they walk through our door to the moment they leave our facility,” says Adolfo Carrasco, Chief Executive Officer for Baptist Emergency Hospitals in San Antonio. “Emerus was founded by six board-certified emergency physicians committed to changing healthcare to a truly a patient-centric perspective.”
The Vocera Communication System effectively replaced the overhead paging system at the five Baptist Emergency Hospitals. “Eliminating overhead paging cut down on the background noise in the hospitals, and the Vocera system provided immediate value in allowing direct communication among staff members,” says David Mitchell, Chief Nursing Officer for all of the Baptist Emergency Hospitals in San Antonio.
The Vocera hands-free communication badges allow for better communication house-wide in hospitals — such as between the front desk and the nursing staff and radiology teams — as well as across sites such as communications to coordinate patient transfers, supplies, and load balancing among Emerus facilities.
Everyone in the hospital uses a Vocera Badge, including ED and in-patient nurses, radiology techs and the lab staff. Soon the hospitalists will start using Vocera via their smartphones, so physicians doing rounds can communicate with care team members regardless of location when they are outside of the acute care facility.
“The Vocera technology supports the people providing the medical care in our hospitals, allowing everyone to be more efficient,” says Dawson. “Vocera is being used daily to directly improve the care provided to patients.”
Emerus recognizes the importance of partnering with patients to drive an optimal healing experience, which in turn improves trust, loyalty and growth. Emerus hospitals have some of the highest customer satisfaction and lowest number of complaints in the industry. “Our number of complaints for all our facilities is less than .5%,” says Dawson
Telemetry Systems Integration Saves Lives
The primary challenge that led to Vocera was that traditional telemetry methods did not support the Emerus model. In particular, a typical telemetry environment centers on a centralized monitoring system requiring the attention of a dedicated telemetry nurse.
“The telemetry nurse is essentially pinned down to one workstation all day; all they do is read the vitals and watch the cardiac monitoring of the patients through the telemetry system,” says Dawson. “But the Emerus way is to have all the nursing staff working hand in hand with all departments throughout the hospital — bedside with a patient one minute, and working with the radiology techs or lab personnel the next minute. We wanted to find technology that would decentralize the process and allow telemetry alerts to reach the nursing staff while they continued in their day-to-day work.”
To ensure an immediate response, Emerus set up an alarm escalation workflow. When there is a lethal heart rhythm detected in a patient, Vocera transmits an alert directly to the nurse who is taking care of that patient. If the nurse cannot respond, the alert then goes to the inpatient department nurse, then the ER technician, and finally the radiology technician.
“Our immediate response and escalation pathway enabled by Vocera results in a higher level of patient safety and a better patient experience,” says Mitchell.
The few minutes saved with this alert system can be the difference between life and death, and most certainly provides the best chance for high quality care and a positive outcome.
“The Vocera telemetry solution might shave three to five minutes off an incident, which is a big deal when every second counts. Vocera not only saves time, it has the potential to save lives,” says Carrasco.
“The immediate response enabled by Vocera’s integration with the telemetry system is a game changer clinically, in my opinion,” says Mitchell. “The nurse’s ability to initiate processes and call for backup immediately — as they’re placing lines or grabbing medication or doing critical procedures, without having to step out of the room — provides a level of control that’s currently unprecedented.”
Driving Efficiencies Promotes Higher Level of Care and Cost Advantages
In addition to improving patient safety, there’s a dollar value that Emerus can attribute to the higher level of care they’re providing now that the Vocera system is in place.
“Using Vocera is basically a 1:1 cost compared to what we used to spend on overhead paging, and we’re saving the cost of hiring dedicated telemetry nurses that range anywhere from $80,000 to $130,000 per facility,” says Dawson. “From my perspective, I spent no additional money to implement Vocera because it replaced overhead paging, plus we got the benefits of messages going directly to the nursing staff and more telecommunications within the hospital.”
Replacing overhead paging, eliminating the need for dedicated telemetry nurses, and being able to handle a higher number of acute-care patients all adds up to improved revenue numbers for the Emerus hospitals.
Extending the Vocera Solution to More Emerus Facilities
Based on the success of the initial Vocera deployments at the Baptist Emergency Hospitals, Emerus is now in the process of rolling out the Vocera solution to other hospitals, beginning with its Dallas facilities. The following year, Emerus plans to expand the Vocera solution to its joint venture hospitals in Denver, Colorado.
“The design of the Vocera technology has enabled us to centralize and template the entire telemetry integration process, so it will be easy to replicate it in the Dallas hospitals and beyond,” says Dawson. “What’s special about Denver is that we’re getting into the surgical arena. It will be a more robust hospital environment that will require surgeons and anesthesiologists in addition to ED nurses and doctors.”
In addition to the technical capabilities of the Vocera solution, Emerus also appreciates the level of support it has received from the people at Vocera.
“The Vocera team has been really, really wonderful — very thorough, very technical and functioning with us as a complete unit and as a team,” says Dawson. “Emerus is at the leading edge of healthcare technology, so we asked a lot of Vocera. We really appreciated working with the Vocera team throughout the implementation. The alignment between Vocera, Emerus IT, and the clinical staff is what has made this project so successful.”