Sustainability Problem

The looming cost and labor crises impact the healthcare industry. ¹  From the back office to the doctor’s office, how can we deliver more effective, efficient and affordable healthcare?

Technology Article: Accenture transforms nursing practice with digital technologies and process innovation. 

Source: IDC Health Insights, “Business Strategy: How Third-Party Consultants Helped Unify Communications in a Major U.S. Hospital Organization,” by Sven Lohse, June 2015. 

https://www.accenture.com/us-en/success-catholic-health-initiatives-accenture-health-analytics

Summary

This report describes how Trinity Health (Trinity) and Accenture identified and remedied challenges to hospital communications, to remove impediments to care delivery in terms of both cost and quality. The case study supports enterprise-wide efforts to improve and standardize communications processes, implement business rules to prioritize communications, and make better use of technology tools that manage communications across stakeholder groups.

Failures in communication is among the top three root causes of sentinel events. A typical 500-bed acute care hospital will average an annual economic burden of about $4 million due to wasted communication time.²

Technology that was supposed to be linking people was sometimes creating redundancies, interruptions, and getting in the way of quality care delivery. One clinician might interrupt workflows by responding to every interruption immediately, while another might not respond immediately to any messages, impairing clinical decision-making and team communications.

Uncoordinated communications channels in use included landline and mobile phones, voicemail, text messages (SMS), pagers, email, patient-tracking systems, geo-location technology, digital signage, whiteboards, and even hand-carried notes. As a result, cascades of redundant messages followed clinicians to and from the office by phone, text, voicemail, and pager. Unstandardized, uncoordinated communications caused unnecessary interruptions to workflows, misidentified the priority of specific work-related information, and created negative compensatory behaviors, feedback loops, and process workarounds.

Technology Stakeholders

1. Trinity Health (hospital)
2. Doctors
3. Nurses
4. Clinicians
5. Administrators
6. Patients (residents, tourists, visitors)
7. Caregivers
8. Government

Implementation

Trinity Health worked with Accenture to plan and implement new processes and technology across their healthcare organization.³

1. Accenture investigated Trinity’s network to explore similarities and differences that might exist in processes, technologies, and organizational cultures between different hospital departments and their associated technology platforms.
2. Accenture evaluated and benchmarked communications technology and processes, developed a road map to a future strategy and used cases, and advised on technology and process reorganization to achieve Trinity’s organizational goals.
3. Through situational observation and shadowing of nurses, Accenture studied separate hospital facilities to identify and remove impediments to coordinated communications.
4. Accenture documented and analyzed the frequency and duration of communications and technology contacts, categorized the different types of contacts, and determined the impacts of these contacts on care delivery.
5. The resulting data was organized to expose findings related to patient safety and quality of care (e.g., turning and repositioning), hourly rounding, and patient/caregiver experiences, especially in the operating room and intensive care unit.
6. Clinicians and Accenture observed the wide range of information technologies that were used in uncoordinated way and identified suboptimal practices as contributing factors in the interruption of workflows, degradation of the quality of information being communicated among clinicians, and delays during unit and shift handoffs.
7. Accenture studies supported enterprise-wide efforts to standardize communications processes, implement business rules to prioritize communications, and make better use of technology tools that manage communications across modalities and stakeholder groups. The key benefits that Accenture and Trinity are working toward include:
   • Optimizing clinical workflows with improvements to cost and quality of care;
   • Improving the quality of hand-offs between units and shifts, with reduction in time lags and interruptions;
   • Streamlining and prioritizing provider workflows;
   • Improving patient/patient caregiver satisfaction ratings.
8. Trinity is taking steps at the enterprise level to empower local decision makers to streamline stakeholder communications.
9. The communications priorities of the organization are now under review and reorganization to facilitate better integration of communication needs at centralized and local levels. More business rules and automated technology are implemented to better manage and prioritize communications across modalities.
10. Trinity integrated technology into their operations and leveraged digital communications into planning for future patient satisfaction initiatives and into the architectural plans for new hospital facilities.

Other References:

1. Health Care Costs: A Primer, Key Information on Health Care Costs and their Impact, Henry J. Kaiser Family Foundation. May 2012

2. The Complexities of Physician Supply and Demand: Projections from 2013 to 2025, American Association of Medical Colleges, March 2015

3. https://www.accenture.com/us-en/success-how-accenture-helped-unify-communications-in-a-major-us-hospital