Improving patient safety while simultaneously reducing clinician workloads, increasing efficiency and elevating the patient experience is an almost impossible task. Yet the team at University of Washington Medicine, Valley Medical Center found a way to do just that. Using a secure communications platform from Voalte, the Valley Medical Center team implemented processes that not only reduced the occurrence of pressure ulcers but also improved staff morale.
It is not obvious that improving the communication between patients, clinicians and administrators can lead to better outcomes, but for James Jones (BSN, MSN, NEA-BC), Vice President PCS & Nursing Operations at UW Medicine, Valley Medical Center, he believed it could:
“Being a nurse I realized that if you want patient care to be successful, better patient outcomes and improve the patient experience, you need to start with clinicians first. Without the clinicians, you cannot be successful. They are the entryway for the patient into the organization.”
Jones felt that by investing in clinicians and reducing their workload, they would have more time and energy to focus on improving patient experience as well as patient outcomes. To verify his theory and to gain buy-in from the organization, Jones and his team met with clinicians to ask what they wanted and how THEY would go about improving patient outcomes.
After many meetings, the Valley Medical Center team found that improving internal communications was high on everyone’s priority list. Many clinicians truly believed that better communication would lead to safer patient care – especially in the area of skin-integrity related adverse events (medical errors).
The impact of adverse events and medical errors on US Healthcare are staggering:
- 10% of all US deaths, approximately 250,000 per year, are due to medical errors 
- $20.8 Billion annually in additional (direct) healthcare costs 
- $250 Billion annually in additional (indirect) healthcare costs 
One of the best ways to improve patient outcomes is to reduce the number of preventable adverse events. Pressure ulcers, skin wounds that are caused by sustained pressure on area of the skin – usually as a result of sitting or lying in the same position for long periods of time, are classified as a preventable adverse event.
“Prior to the implementation of Voalte there was a 10-step process to document and assess a pressure ulcer,” explained Jones. “With Voalte we were able to streamline the time and workflow related to pressure ulcers by 40%. Our Wound Care NRP is now able to be anywhere in the hospital and still be able to help patients and clinicians.” Something that would have been impossible with their legacy processes and communication technologies.
The streamlined process and improved communications not only improved patient outcomes, it also had an impact on staff morale and clinician burnout in two specific ways.
First, clinician workload is often cited as a leading cause of burnout. According to a JAMA study published last year, the 25% of physician that felt burnout cited the following contributing factors:
- 1 percent felt their job environment led to symptoms of burnout
- 1 percent felt a lack of time for documentation
- 4 percent reported stress as a common factor
- 1 percent reported spending time on electronic medical records (EMRs) at home was a significant contributor
When clinicians feel burnt out, it has an impact on patient safety. A Swiss study published in 2014 found a linkage between burnout and adverse events. The Agency for Healthcare Research and Quality (AHRQ) issued the following comment on the study:
The investigators propose that the linkage between burnout and safety is driven by both a lack of motivation or energy and impaired cognitive function. In the latter case, they postulate that emotionally exhausted clinicians curtail performance to focus on only the most necessary and pressing tasks. Clinicians with burnout may also have impaired attention, memory, and executive function that decrease their recall and attention to detail. Diminished vigilance, cognitive function, and increased safety lapses place clinicians and patients at higher risk for errors. As burned out clinicians become cynically detached from their work, they may develop negative attitudes toward patients that promote a lack of investment in the clinician–provider interaction, poor communication, and loss of pertinent information for decision-making. Together these factors result in the burned out clinician having impaired capacity to deal with the dynamic and technically complex nature of ICU care effectively.
Second, by reducing the occurrence of adverse events at Valley Medical Cetner, Jones and his team were helping to reduce clinician anxiety and improve mental health. A report published in 2007 measured the emotional impact on physician that were involved in an adverse event or near miss (adverse events that were caught BEFORE harm came to a patient). The findings were stark:
This study, combined with the prior body of work, shows that there is a “virtuous cycle of benefit” when it comes to burnout and adverse events. Reducing workload and improving morale means clinicians are less likely to feel burned out which in turn means they are less likely to be involved in an adverse event, which means they are less likely to suffer the deep negative emotions associated with medical errors…and round and round it goes.
The team at Valley Medical Cetner is beginning to reap the benefits of being in this cycle. By focusing on improving communications, streamlining documentation requirements and reducing skin-integrity related adverse events, they are directly impacting a key contributing factor to burnout.
“Our goal is to help make it easy for clinicians to do the right thing for patients,” said Jones. “Clinicians are on the front lines. It’s the job of IT to give them the tools and the resources they need to be successful.”
For Valley Medical Center, one of those tools was the Voalte Platform which simplifies care team communication and collaboration. Deployed through smartphones, the Voalte solution gives physicians, nurses and administrators a secure way to communicate via voice and text within the walls of the hospital – eliminating the need for pages over the PA system.
Jones disclosed that Valley Medical Center chose the Voalte Platform because they believed “it was the best platform to help clinicians” and that culturally the team at Voalte was the one most closely aligned to Valley Medical Center’s patient-first approach.
“Voalte was really great to work with,” Jones stated. “They helped us through the transition and through the change management process. They were there in the command center, working alongside us during the initial roll-out. That was huge. It really helped with buy-in and with addressing the small changes that came up during that roll-out.”
In the three months following the roll-out, Valley Medical Center saved more than $50,000 just on their Renal Respiratory Unit and their patient satisfaction scores climbed to the 99th percentile.
Better patient experience. Improved patient outcomes. Lower costs. Reduced workloads. Valley Medical Center has definitely scored a quadruple-win.
You can watch my interview with James Jones on the Healthcare Scene YouTube channel or the embedded video below.
Voalte is a proud sponsor of Healthcare Scene.