Applying Analytics to Clinical Communication

How Hospitals Can Gain Actionable Insights from Their Smartphone Platforms

Information is the lifeblood of healthcare. Only recently, however, are hospitals and health systems leveraging this voluminous data through increased investments in analytics for clinical, operational and financial functions. According to a recent survey of health system CIOs, CTOs and chief analytics executives, “analytics is one of the backbones for health systems seeking to use emerging technologies to transform their care delivery or workforce.”

Analytics also are beginning to be applied to one of the most important yet overlooked functions in care delivery – clinical communication. Research studies consistently show that communication failures cause errors or delays in care, impede workflow efficiency, increase physician and staff workloads, and negatively affect patient experiences. These failures contribute to between 50% and 80% of hospitals’ most serious and harmful sentinel events.

A potential solution to this long-standing problem may be embedded in the smartphones and apps that many nurses and physicians now use every day. Today, new sophisticated analytical tools let hospitals “look under the hood” of their integrated smartphone platforms. By making clinical communication data readily available and easy to understand, analytics provide actionable insights on how to improve clinical communication processes and workflows.

Clinical Communication: What’s Really Happening?

The ability to quickly and efficiently connect and share actionable information is as vital to patient care as medicine. Each day, physicians, nurses and hospital staff might receive hundreds of voice calls, pages, text messages and alarm and alert notifications.  And every one of these could affect workflows, safety protocols, staff workloads and patient experiences.

Yet most hospitals have no way to get answers to important questions such as:

  • Are our nurses finding and connecting with the right person at the right time?
  • Are any of our nurses or units at high risk of alarm fatigue?
  • How often and how fast are clinicians responding to pages?
  • Are text messages being read and responded to in a timely manner?
  • Which physicians are not using the smartphone communication platform? Should we reach out to help them?

The data to answer these questions often can be found in some communication systems. But it’s not readily accessible, and standard reports are confusing data dumps, not dashboards. Custom building a report can take weeks or months.

For example, to measure the impact of its secure text messaging system, a large academic pediatric medical center had to manually extract paging and text message data and develop an algorithm to unify and contextualize the information. It found that that 1) using smartphones for secure text messaging reduced communication failures by 59% compared to paging communication, and 2) 15% of pages from nursing staff to residents went unanswered. In a study on this do-it-yourself analytics solution, the authors noted that:

“Secure, bidirectional communications to our inpatient general pediatrics teams resulted in more reliable communication between team members … More work is needed to understand the data underlying communication patterns and workflows in hospital systems.”

Analytics Reveal the Stories Behind the Data

Broadly speaking, clinical communication analytics is a decision-support tool that reveals the story behind the data. In practical terms, an “ideal” analytics solution would enable informaticists, clinicians, managers and executives to gain insights that would help them:

  • Track and resolve communication problems in real time
  • Identify, address and manage workflow bottlenecks and breakdowns
  • Anticipate problems before they occur
  • Refine alarm management practices and escalation pathways for notifications
  • Implement, track and manage process and behavioral changes and their impact on the staff and patient care
  • Develop evidence-based strategies to leverage or expand the capabilities of a hospital’s integrated smartphone platform

To deliver on all this, an analytics solution must provide contextual, big-picture data on metrics such as call and alert volume, texting trends and call rescues. It also should enable users to access granular details such as text response times between nurses and physicians. For example, one hospital uses response data to coach its staff to respond faster to certain texts.

An analytics solution also should include a comprehensive set of pre-built reports that offer overviews, workflow analyses and audit logs for calls, text messages and alerts. Perhaps most important, an analytics tool should have various dashboards that present easily understood data in a way that leads to faster and smarter decisions. With just a cursory look at these pre-built dashboards, an informaticist or nurse manager should be able to answer fundamental questions about a hospital’s clinical communication such as:

  • What’s happening right now? Is that good or bad compared to previous data?
  • Are things getting better or worse? What patterns are emerging?
  • What could be causing these trends?
  • Who needs help, and what changes should we make?

Analytics Reduce Alarm Fatigue at Blessing Health System

The Joint Commission has cited medical alarm fatigue as a major contributing factor in 80 deaths over a three-year period and identifies the safe use of alarms as one of its 2019 National Patient Safety Goals. A recent survey of more than 1,200 nurses and other clinicians found that 87% agree that nuisance alarms occur frequently, disrupt patient care and cause caregivers to inappropriately turn off alarms.

In an interview at HIMSS19, Jacob Campbell, a systems/applications analyst for Blessing Health System, talked about how the Voalte Insight™ analytics solution is helping to reduce alarm fatigue at its facilities in Illinois and Missouri.

“Before we had this tool, we were struggling to understand how many alarms people were getting,” said Campbell. “Now we can confidently say that people are receiving ‘X’ number of alarms, which helps us decide whether to add new alarms or change workflows.”

Blessing doesn’t require its physicians to use the Voalte Me™ app to connect to its smartphone platform, and Campbell mentioned that the new analytics dashboard shows which providers rarely connect through the platform.  The medical staff just got access to this data and are thrilled to use it to figure out what steps need to be taken to improve physician adoption. For example, if a physician is struggling, someone could reach out to help them use the app.”

Opening the Window into Real-World Clinical Communication

For too long, the clinical communication that underpins the safe, effective and efficient practice of medicine has been a black box. Analytics provides hospitals with a much-needed window into what’s happening in this unseen world. The solutions and tools available today can empower them to not only reduce communication and workflow breakdowns but also spark insights to drive clinical performance improvement initiatives.

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