Northeast Georgia Medical Center is an award-winning, not-for-profit community health system serving more than 750,000 people across a 13-county region. Like other healthcare organizations operating in today’s challenging climate, we work diligently to improve our culture of quality and excellence to provide the best care possible to our patients.
After initially implementing McKesson’s enterprise visibility solution to address bed turnover and patient throughput, we decided to apply the technology to bring greater clarity to the care process. In particular, we thought it could drive targeted efforts to improve the timeliness of care with better patient tracking and care alerts. We implemented a 90-day rapid optimization project to train 2,600 clinicians with three goals in mind:
- Increase information visibility
- Raise awareness and understanding of the tool
- Improve its use in care communication and coordination
We added visual cues using data from the electronic health record (EHR), admit, discharge and transfer, environmental services, transporter and other systems. The selected data is displayed graphically against the hospital’s floor plan on large, electronic white boards located throughout the facility and accessible to the entire care team.
Seeing is Believing
Real-time, at-a-glance information has helped Northeast Georgia Medical Center realize significant improvements in patient safety, care quality, productivity and staff satisfaction.
Patient Safety/Quality: Simple visual icons make everyone – from nursing to lab to radiology to respiratory – more aware of patients who are at risk for critical conditions such as falls, skin ulcers or infections.
If a patient is on a stretcher in Radiology waiting for a procedure, and the tech sees the visual cue for skin breakdown risk, it’s a reminder to turn the patient. This cue has helped us reduce our nosocomial pressure ulcer rate from 23% in 2009 to a current rate of 2.3%. The icons are so successful that leaders of other quality initiatives have asked to add their own visual cues to the tracking board.
The shared visual information has resulted in shorter patient wait times. Care delays are reduced as the result of having timely visibility of information, such as counters to monitor time- sensitive care or notification of blood ready, new orders and critical results. In addition, the technology has helped us improve care team communication, particularly nurse-physician interaction.
Productivity: Teamwork is more efficient. The addition of nursing assignments to the white boards enables physicians and ancillary departments to know who is caring for each patient and quickly find patients on our large campus.
Workflows have greatly improved. Nurses are saving anywhere from 7 to 10 phone calls per shift. They’ve eliminated three to four logins to look for clinical data that is now visible on the tracking boards in real time. As a result, we have recouped an estimated hour of productivity per nurse, per shift, per unit, and nurses share a heightened awareness of patient status across their units.
Staff Satisfaction: Everyone from housekeeping to nursing to medical staff use the system, and satisfaction with the tool is high. In a post-implementation survey, 50% of the staff says it has improved workflow.
Physician feedback is especially positive. They appreciate more efficient patient processing as well as more direct communication with the nurses. They can consult the board to see which nurse is assigned to which patient and call that nurse directly with orders or concerns. Nurses welcome those calls and appreciate that physicians, pharmacists and any other care team member can reach them easily.
Pushing the Envelope
Northeast Georgia Health System continues to optimize the care process using its visibility technology. As part of our CPOE implementation, we’ve added advanced clinical decision support alerts to the information displayed on the white boards. The care team is notified immediately of new physician orders, lab results, and other pertinent clinical information. We will further leverage the benefits of care visibility at our new hospital campus in Braselton, Georgia, which opens in 2015.
Results of Optimizing Use of Patient Visibility Solution Quality
Nurse Sensitive Indicators reported to the National Database of Nursing Quality Indicators (NDNQI):
- Reduced pressure ulcers from 23% in 2009 to 2.3% as of August 2012
- ICU Ventilator Utilization Rate of 0.34 compared to National Healthcare Safety Network (NHSN) rate of 1.2
- Reduced central line bloodstream infections (CLBSI) to zero in all but two units by FY12 Q2
- Reduced nurse calls by 25%
- Gained one hour of productivity per nurse, per shift, per unit
- Higher nurse productivity saves approximately $500,000 per year ($80,200 per unit X 16 units)