Safety

Improving communication with technology

Hospital Safety Insider, May 20, 2021

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Can the right tools solve tech-enabled communication challenges?

By Megan Headley

Clear communication—with patients and colleagues—is a critical component of effective healthcare. Yet the sheer amount of information to communicate, not to mention distractions that derail effective discussions, can make achieving this clarity challenging.

Eliminating the technology that has complicated patient care is not an option, so health systems are searching for strategic technology deployments to address some of the challenges that have emerged. The results aim to bring physicians, nursing staff, and patients back into the realm of more meaningful interaction.

Less note-taking drives stronger patient interactions

Too much screen time has made it more difficult for providers to connect with patients. According to a 2005 evaluation of the impact of exam room computers on communication between clinicians and patients, these computers can monopolize the clinician’s attention, to the detriment of their conversation with the patient.

Rather than removing the exam room computers, Rush University Medical Center invested in a technology solution to combat this problem.

The solution in question, Nuance Communications, Inc.’s Dragon Ambient eXperience™ ambient clinical intelligence, moves Rush closer to a voice-enabled exam room. The advanced scribe captures information from patient-provider discussions and uses it to create contextually rich records.

As a result, “the provider feels like they need to attend less to documenting stuff in the computer while they’re in the room with the patient, and their attention can be focused on their conversation with that patient,” shares Anthony Perry, MD, Rush’s vice president of ambulatory transformation.

Bringing the focus back to the patient is key for everyone to get the most out of the conversation. Research indicates that physicians interrupt patients within the first 12 seconds of speaking, jumping in to speed discussions along. Inattentive listening can derail the speaker and compromise the amount of quality information the physician gains during these encounters.

“This is about trying to enhance the experience in the exam room for both the providers and the patients who are in there,” Perry explains. “Part of what we’re trying to do is preserve the relationship between the provider and the patient when they’re sitting in the room together and allow them to focus on the dialogue that they’re having.”

Perry points out that the ability to document these interactions in real time is its own skill set—one that few providers feel they’ve adequately mastered. “How we contextualize our documentation becomes very individualized,” he says. “Figuring out a way to meet those [documentation] expectations in a consistent fashion is part of the process for us.”

Many physicians now tend to take notes home to complete reports, creating a longer lag time that can cloud recollections of the day’s numerous patient visits. Automating this note-taking process allows physicians to prioritize gaining insight over documenting it, and ultimately better serve their patients. Perry hopes it’s just the beginning.

“There’s a path here where we can start to automate certain things in the examination room. Documenting the notes is certainly a component of that,” Perry says. “But can we start to auto-populate educational materials for patients?”

For example, an exam room discussion around high blood pressure that leads to a prescription could spur the system to note that the patient needs relevant educational materials about the medication to understand its potential side effects. “Those are the things that we really want to explore in the voice-enabled exam room,” Perry shares.

Faster communication means better care

Despite the many technology advances in healthcare, communication tools still lag behind. It is estimated that about 90% of U.S. hospitals continue to use pagers for a host of reasons, while some nursing staff might add a flip phone and computer access to these communication options. However, these older technologies can slow down care and response time.

Kim Barnhardt, MHA, MBA, BS, RN, CPSO, manager of clinical consulting and education with Midmark RTLS, a division of Midmark Corporation, sees the company’s real-time location systems (RTLS) acting as a communication tool for nursing staff.

And Stephanie Bertschy, Midmark’s senior marketing manager, explains, “It is about the location driving the event to help communicate out a need: ‘I need help.’ ‘I need more ID pumps on ICU floor three.’ ‘I need the next staff member to come in and see the patient in exam room two.’ Whatever that need may be, we’re trying to communicate that automatically based on the location of somebody.”

“In a clinic setting we can automate visibility,” Barnhardt adds. With location-enabled support, nursing staff knows, for example, when the medical assistant leaves the patient and it’s time to notify the primary provider. “It keeps everybody much more efficient.”

The flexibility of RTLS tools means this efficiency materializes in a number of ways. Asset tracking platforms let nursing staff instantly visualize where carts are located and what materials are ready at hand. In acute care settings, RTLS tools can interface with the nurse call system, allowing nurses to walk into a room and start providing care rather than taking time to move equipment out of the way and hit the cancel button. All of these small benefits mean attending more quickly to patient needs.

That, according to Bertschy, is how technology should be supporting staff. For her, “Going through the COVID pandemic experience over the last year shed light into how much clinicians are not doing the main job that they’re supposed to be doing, which is caring for the patients and being at the bedside. It brought to life the amount of time that they spend doing other things: searching for the equipment around different departments, trying to find another staff member for a readout of a report or to check on a patient.”

Clinicians, and hospital systems for that matter, are reprioritizing the interactions that matter most. “We’re seeing a lot more interest from hospitals that it’s not just all about the cost savings and operational efficiencies, which are huge with RTLS,” Bertschy says. “It’s also about making the day easier on staff so that they have that joy of coming to work. Burnout is caused by many things, but maybe we could bring joy back to the working environment.”

Megan Headley is a freelance writer and owner of ClearStory Publications. She can be reached at megan@clearstorypublications.com. This story first ran on PSQH.com.



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