During my 9 years as an ER nurse, I learned to look at the big clinical picture; bearing in mind that the canvas was made up of many smaller brushstrokes. The canvas would be stored in the back of my mind until I had to retrieve it to solve a bigger problem, sometimes examining each brush stroke. As part of Mobile Heartbeat’s Optimization team I take this same approach to advising our customers using data analytics.

In order to help our customers first adopt and then optimize their clinical and operational workflows (the canvas), we utilize CURE Analytics to discover how each user, role, unit or department is performing. We focus on who is communicating, who they communicate with, what type of user role they have, and most importantly, how many users are part of that role. We begin to think in terms of numerators and denominators knowing that rates in addition to raw numbers will help us understand the meaning of this communication picture. Our goal is to assist our customers climb step by step up the clinical communication & collaboration Value Hierarchy. In this post, I will share three data-guided questions to consider when implementing an enterprise clinical communication and collaboration platform like MH-CURE.

 

What are the barriers to utilization?
It’s easy to look at the “good” numbers. Finding the high utilizers can help us understand what works for individuals, departments and roles. High utilizers are often quite verbal about the benefits they reap using MH-CURE. Conversely, those who are not utilizing the platform to its fullest capability are also a source of important information. Consider these people like your best friend who will actually tell you that you probably shouldn’t wear that dress without your Spanx. Drill down into their experiences to discover the source of their adoption woes. Ask the hard questions.

Utilization Analysis Tips:

  • Look for low utilizers, determine if their role should require higher utilization.
  • Speak with them and their leadership to find out why they are not communicating more frequently.
  • Do they need educational reinforcement?
  • Does their workflow require some adaptation?

In one case, we discovered low utilization of users in a role. After presenting the data to leadership, it was discovered that the end users over time lost access to devices, so they were unable to use the application. Leadership arranged for these users to get devices immediately. Within six weeks, the group had an increase of 64% texts/user from the pre-deployment phase.

 

How can we use this data to contribute to operational efficiency?
Let’s look at those brush strokes that comprise the big picture. Carefully evaluate who is texting/talking to whom. Is there anyone left out of the communication loop? Is there a silo? At one site, five users in the role “perioperative turnover assistants” (PTAs) were ranked in the top ten highest utilizers for a particular month. This was unexpected, so we delved into the communication habits of the PTAs. We learned that they were communicating almost exclusively by group text as well as communicating exclusively within their role.  Are your perioperative techs only communicating with each other? Do they require supplies from central sterile, or stretchers from transport? It can be easy for new users to fall into old communication patterns. Encourage communicating outside of their silo to promote greater adoption. Sometimes it’s not the number of communications you send or receive, but also who you involve in the communication.

In most cases, outliers are what encourage me to probe deeper into the data. In one case the outlier was the number of communications in conjunction with the user role. Who would ever imagine that Speech Language Pathologists (SLPs) would be a “power group”? The evidence was clear with over 630 texts per user in the quarter. The next part of the process was to determine who the SLPs were talking to and what they were talking about. Most of their communication was with the nurses, techs, radiology and transport. What they were talking about told a story of not only great communication, but also of enhancing patient safety through communication. Analyzing the communications with our customer, we discovered most of the texts included dietary restrictions that would help to prevent a compromised patient from aspirating. Having this type of information in the palm of your hand can help prevent patient safety events that could potentially lead to patient harm.

 

How can we use this data to promote adherence to benchmarks and KPIs?
How are sites using structured data? Are there quick broadcasts that are relevant to their unit? Examine current broadcasting and text patterns for themes and repetition, consider the service line and acuity of the unit.  It may be helpful to a busy staff for a charge nurse to send out a broadcast as a reminder to change central line dressings if due. But meeting KPIs may not necessarily be a job relegated solely to the clinical staff.

When considering enterprise communication, let’s think about “supply chain” the unsung heroes of patient care. I’d like to submit, for your consideration that no KPIs could be met if we didn’t have the supplies to complete the tasks. EKGs can’t be done without electrodes. ORs cannot function without sterile trays and equipment. Environmental services can’t make “ready beds” without cleaning supplies. With this in mind, each time you think of a KPI, think of how the materials needed to complete the task in the allotted amount of time get to where they need to be. Now think about how the people in supply chain communicate with each other and with their internal customers. Through monthly reporting, we found that 5 out of 10 of the highest utilizers at one site belonged to the supply chain.

 

In conclusion, every bit of data contains some insight into the bigger picture. With CURE Analytics, you have the accessibility to examine your data, own your successes and failures, create a plan and make your path to success as you climb the CC&C Value Hierarchy. The MH Optimization Team is of course, here to help.