As health systems evolve toward mobile-enabling clinical communication and collaboration (CC&C), one of the most challenging requirements is streamlining the complex, fragmented, duplicative and often manual process of care team assignment. Today’s complicated assignment models run the risk of undelivered alerts and alarms; transmission of nuisance alarms to caregivers; proliferation of inaccurate or incomplete care team contact information; and inefficiencies associated with entering assignment data in multiple systems, multiple times a day.
The solution is to automate manual assignment processes and integrate currently fragmented systems. However, this is no easy task. Fear of adding yet another system, yet another place to manage assignments, can relegate consideration of assignment workflow too late in the technology implementation process. Consequently, without proper planning for care team assignment automation — a key determinant of end user satisfaction – IT projects can stall, are vulnerable to low adoption rates and are likely to fall short of targeted outcomes.
But don’t let the worry about the burden of incorporating another system prevent your organization from unifying its communication and collaboration tools. There is a way to alleviating assignment burden.1. Insist on Integration
As your health system considers implementing a strategic CC&C platform, select one that unites and integrates current assignment systems. This requires careful consideration of existing technologies and processes, and must unite them in a simpler, more automated, state.2. Use the Care Team Assignment Framework Methodology
PatientSafe addresses the assignment integration challenge directly and early in our implementations. Our Care Team Assignment Framework greatly reduces risk related to timely project execution and achieving your health system’s goals. When it comes to assignment management, our guiding principles are to:
- Minimize care team effort to complete patient/location assignment across multiple systems
- Implement automation wherever possible
- Achieve seamless integration between systems
Our approach allows healthcare organizations to determine where it is best to make and manage role-based assignments — be it in the EHR, an alarm management system, via middleware, or within PatientTouch. Every hospital is different, but the goal must always be to minimize the number of disparate systems used to manage and maintain care role assignments.
The Care Team Assignment Framework considers:
- 1. Assignment ownership:
- a. Defining the process both at the start and end of each shift
b. Ensuring that real-time notifications are delivered for patient admission, discharge and transfer, and patient-specific alarms and alerts
- 2. Design of safe alarm and alert workflows, encompassing:
- a. Nurse Call
b. EMR-generated notifications such as sepsis, stat order and discharge
c. Secondary alerts from physiological monitoring systems
d. Critical notifications like lab values
- 3. System variation:
- a. Assignment to the patient, assignment to pod, assignment to or zone (location or geography)
b. Exclusivity of assignment roles like the house supervisor
c. Gaps in the EMR for certain roles required for alerting workflows like the Charge RN
All assignments are not created equal. For high priority alarms and alerts like telemetry and nurse call, routing notifications to the right care team member right away is critical. These alerts must be treated with 100% accuracy to ensure patient safety and satisfaction. The PatientSafe Alerting Framework gives alerting workflows highest priority to avoid risk and ensure alert/alarm delivery to the right caregiver, at the right time, with the right escalation path by the right modality.4. Follow Change Management Best Practice
PatientSafe begins care team assignment consolidation by conducting an assessment of current state. This includes discovery and documentation of all current sources of assignment, including the EMR, and variations by department. We identify current system limitations and alerting role gaps. Next, we develop opportunity statements, by working with clinical stakeholders to identify current workflows as in “ideal state,” a “target for improvement,” or “net new.” These opportunity statements chart a path to assignment consolidation and a strategy to manage gaps. Communication of the new care team assignment strategy across the organization is accomplished by formalizing and documenting clinical use cases which establish project priorities, workflow impact, and expected outcomes. This step springboards the test and implementation phase. Needed integrations are built and validated across vendors to support desired state assignment consolidation.
Once we have completed the process of workflow and use case design to drive how the technology set will work, education and adoption begins. The new and target state workflows identified early in the project now serve as frontline care team training content and Go Live support to ensure that the end users who ultimately will drive those desire outcomes understand and connect to the new workflows. Following Go Live, 30- and 60- day onsite observations are performed to both gauge the stability of assignment integrations and whether the target workflows are taking hold. Any gaps are formalized into an optimization phase that may include modifying training content or pursuing further assignment consolidation opportunities.
Typically, following the PatientSafe Assignment Framework approach results in the consolidation of multiple assignment management systems and processes into just one. To learn more about how to simplify Care Team Assignment in your organization, please contact us. Join us next month for a look at the results and outcomes health systems are seeing from their unified care team assignment management strategy.