By Michelle Gjerde
Hospitals around the country need a fast, accessible way to accurately communicate with their on-call staff. Patients’ lives depend on it. Poor communication is the leading cause of death and serious injury to hospital patients, according to a study by the Joint Commission of Accreditation for Health Care Organizations. A communications system that gets the right people into the right place at the right time can mean the difference between life and death.
Unfortunately, that’s not the kind of communication system every hospital has. In many facilities, telecommunications operators are responsible for maintaining on-call schedules, as well as for using multiple databases and directories, and making multiple telephone calls to page providers.
At many of those institutions, there is no single source of information. Instead of accessing a central database, many facilities still use multiple paper directories. That can cause confusion even in the smallest facilities and still bigger, compounded delays in large hospitals, which might have dozens of operators, hundreds of departments, and thousands of on-call providers. The process is cumbersome and difficult to maintain; it leads to lost time and effort that diverts attention from other calls, consumes employee time, and leads to confusion when schedule or contact information isn’t accurate. In the worst cases, inefficient communication affects patient care and slows responses.
The Solution: For many of America’s best hospitals, the solution is a Web-based, on-call scheduling and messaging communication system that’s tailored to the mission-critical needs of the health care industry. A Web-based communication system relies on a single, centralized employee information database, which any authorized employee can access using any Web browser or Web-enabled wireless device. Employees may have different access levels, with some allowed to view the system and others allowed to page providers or make scheduling changes. Administrators with the highest access levels can access confidential employee information.
Hospital staff can use such a system to check physician availability and page doctors without going through the facility’s telecommunications operators. “Our critical areas love it,’ says Janet Olmstead, Telecommunications Manager at Gundersen Lutheran Health system in La Crosse, Wisconsin. “A nurse can go to any PC or wireless device, bring up any on-call service, and page the provider without having to wait for the health unit coordinator to look it up and place the page.” The previous protocol – finding potentially outdated information in a paper directory, or calling an operator and perhaps spending precious time on hold – was much less effective.
Staffers click an icon to send a page. Providers receive those pages in whatever way they prefer, whether that’s a telephone call or an electronic text message. If a provider is unavailable, the system automatically pages the person covering for that provider. It can also leave a message for the original provider to pick up later.
Staff can page a specific provider or search the database by job title, department, work site, a partial name, an identification number, or a team affiliation. One of America’s top-ranked major children’s hospitals uses a Web-based system to deploy members of a crisis-response team. Since implementing the system, team members are able to respond faster and more consistently. The change has reduced the hospital’s mortality rate by 21 percent, saving the lives of nearly two extra children every day.
Other hospitals page groups of providers when severe weather is on the radar, when a multi-victim traffic accident has taken place, when a child has been abducted, or when healthcare commissions are visiting the facility.
A Web system can often link to a disaster response plan, automatically paging medical personnel to a crisis situation. This connection helps hospitals better respond to large accidents, terrorist attacks, and severe weather casualties, when normal communications may be chaotic and time is of the essence.
The improved efficiency not only saves lives, it also lessens the burden on telecommunications staff because individual providers, departments, and schedulers use the system to create their own on-call schedules. They can write and update schedules that every other system user can see. Changes appear across the network as soon as they’re made.
Some systems allow staff to leave messages for other employees. That lets doctors easily swap on-call shifts, offer comments on a patient, or ask colleagues in another specialty to consult on a case.
Finally, these systems automatically create a permanent, unalterable archive, noting each worker who uses the system, every scheduling change made, and every page sent. Hospital administrators can use that archive as part of an overall system audit, creating statistics and analyzing what’s going well and what needs improvement within their facility. That, too, helps create better patient care and employee satisfaction.
The Results: Hospitals that use Web-based communications systems find that staff members send pages more quickly and that providers respond faster. Overall, facilities spend less time creating and maintaining on-call schedules – 140 hours less per month at one hospital.
Health care providers receive their pages with greater accuracy. A physician might have one telephone number during the work week, another on the weekend, a third pager number, and a Blackberry address. A Web-based communication system accurately routes pages to the provider’s correct location. At Peninsula Regional Health System in Salisbury, Maryland, the 9,000 pages staffers send every week find the correct recipients 99.6 percent of the time.
Employee stress goes down and confidence increases when staff know they have a reliable way to access providers. That creates a healthier, more desirable working environment – a big plus in an age of highly mobile health care workers.
Relieved of scheduling and paging duties, telecommunications operators experience increases in customer service quality and productivity. At the St. Louis Children’s Hospital in St. Louis, Missouri, ring time (the amount of time a caller spends waiting for a call to be answered) dropped from 17.7 to 9.7 seconds after the facility switched to a Web-based communication system. Call abandonment (the number of callers who hung up before getting the answers they needed) dropped from 5.3 to 3.36 percent. Plus, each full-time operator was able to answer nearly 1,000 more calls a month. Other staffers realize new efficiencies, too. At Peninsula, employers no longer have to find the group in which a provider works before accessing the provider’s contact information. That saves a lot of time.
Hospitals that implement Web-based systems tend to see good employee adoption rates. “In the beginning we probably had five people who knew how to use the Web communication,’ says Judy Bailey, Communication Center Supervisor at Peninsula. “But now at least 40 percent of our employees use the system. Anyone can use it – it’s extremely user friendly.”
“Everybody loves our Web-based system,” agrees Paul Wainwright, Telecommunications Supervisor at Orlando Regional Healthcare in Orlando, Florida. “We now have directory lookup and text paging on every desktop in the organization. It couldn’t be easier to access and use.”
That ease of use means quick implementation – and hospitals that quickly realize their goals of a more efficient workplace and better patient care.
[From the June/July 2007 issue of AnswerStat magazine]