At UChicago Medicine, paper-based nurse rounding was not fully capturing patients’ and families’ feedback at the point of care.

THE PROBLEM

The paper documentation was not readily accessible to the entire care team, and it was difficult to use in follow-up calls with patients after discharge. The paper-based rounding method did not enhance the patient experience or provide necessary information for leaders to effect change.

PROPOSAL

The provider organization turned to vendor Vocera to try to resolve this problem. The value proposition of Vocera Rounds, a digital rounding tool, was that it would enable clinicians to capture caregivers’ and patients’ voices in a streamlined manner and share their conversations with patients. Use of the system’s alert notification call technology would help nurses communicate patient requests to other care team members to shorten response times.

MARKETPLACE

There are many vendors in the market with digital rounds technology, including Advisory Board, CipherHealth, GetWellNetwork, Huron Consulting and TruthPoint.

MEETING THE CHALLENGE

UChicago Medicine nurses use the rounds app on their iPads. During the initial training period, nurse leaders who had been coached on use of the mobile app accompanied nurses on their rounds and, where necessary, helped guide their conversations with patients to facilitate meaningful engagement.

"Besides documenting each patient’s plan of care, the nurses also created conversations regarding their positive hospital experiences and what they’d like to see improved," said Sue Murphy, RN, chief experience officer, patient experience and engagement program, at UChicago Medicine. "At the same time, patient requests were communicated more rapidly to the care team, accelerating response times."

The rounds app also helps hospital leaders get ahead of potential service issues, proactively pinpointing opportunities for improvement and identifying high-performing staff members, she added.

"Moreover, digital rounding captures essential data that the discharge care call nurses use when they call high-risk patients to ensure they followed their plans of care after discharge," she explained. "This team also uses the information collected in the rounding app to make sure that patients’ comments and requests during their hospital stays have been addressed. Creating these conversations with patients makes them feel valued and respected."

"Besides documenting each patient’s plan of care, the nurses also created conversations regarding their positive hospital experiences and what they’d like to see improved."

Sue Murphy, RN, UChicago Medicine

If a patient is readmitted, the care team can access the data in the rounds app and the care call technology. The clinicians use this information to be proactive in planning patient engagement based on past experience.

RESULTS

After UChicago Medicine implemented its new patient experience and engagement program, and digitized rounding with the rounds app, the healthcare organization’s HCAHPS patient satisfaction scores jumped by 30 points, Murphy reported.

"Among all the facilities contracted with Press Ganey, our hospitals’ scores increased to the 67th percentile from the 12th percentile," she said. "Within UChicago Medicine’s peer group of 120 academic medical centers and 299 affiliated hospitals, UCM rose from the 17 percent to the 55 percent ranking."

The impact of the rounding and communication technology is a key approach to improving the patient experience, Murphy stated.

"In December 2017, patients who experienced nurse leader rounding with Vocera Rounds had an Overall Rating of Care mean score of 93.62 percent – performing at the 91st percentile among the Press Ganey national database," she said. "Patients who did not experience a daily nurse leader round had an Overall Rating of Care at 80.83 percent – performing in the bottom 5th percentile."

Leader engagement and culture change are creating the profound impact on the patient experience at UChicago Medicine, she added.

"The technology of our iPad rounding is an enabler to assist in achieving our outcomes," she explained. "The work of experience improvement centers on trusting and caring moments. The interactions that patients and families have with doctors, nurses and other care team members give them confidence they are receiving the best possible care from people who care about their well-being."

ADVICE FOR OTHERS

"Create an intentional human-centered culture that is committed to improving the healthcare experience," Murphy said. "Cultivate a team mindset to build connection, communication and care coordination. Make sure that all stakeholders – including clinical, experience and IT staff members – are engaged in the selection, design and deployment of solutions."

Most important, ensure that the technology has the ability to capture patient voices in a streamlined method, she added. The outcome from a streamlined patient-centered approach inspires and helps improve the patient experience, she concluded.

Twitter: @SiwickiHealthIT
Email the writer: bill.siwicki@himssmedia.com