How to solve healthcare’s on-call management problem
On-call management’s long tail
At its best, on-call management in healthcare can be labeled as inefficient. Yet, on-call has a long tail. Poor communication starts with poor on-call hygiene which hinders subsequent communications. Physicians, nurses and other caregivers do not spend enough time communicating about the patient’s needs because they have difficulty reaching other clinicians and have difficulty finding time to spend communicating with the patient.
These breakdowns in communication come with a cost. In fact, $765 billion of healthcare spending was wasted in 2010, with more than half attributable to unnecessary and inefficiently-delivered communications, as well as missed prevention opportunities.
Improved patient care requires understanding on-call management as the entire process of taking care of the patient by receiving the immediate call for care and addressing the need for continued care of the patient.
On-call management begins with asking:
- How does the healthcare provider receive information about the patient’s condition?
- Who does he or she receive it from?
- What is the method of requesting clarification?
- How does follow-up occur?
Ditch the pager
Inevitably, pagers are a great source of inefficiency because they lack the ability to use text messaging and Wi-Fi availability. Effective communications begin with taking alerts off of pager platforms and moving them to smartphones. That way, only one device is used for communication among hospital staff. Staff no longer need to use a pager to receive alerts and a smartphone to respond to them.
The problems of pagers have been highlighted by the Ponemon Institute which notes that pagers cost the healthcare industry approximately $11BN per year. These costs were the result of pagers causing delays in providing patient care as well as in wasted time from using pagers to coordinate care. Waiting to get access to the right doctor as well as exchanging the correct information were all delayed due to pagers.
Additionally, it has been noted that inter-professional communication between clinicians that has traditionally relied on numeric paging systems was riddled with numerous problems. These include difficulty in identifying and contacting the right clinician, limited capability as a one-way receiver of information, and frequent interruptions. These may contribute to medical error and often result in increased frustration among clinicians. There is a significant impact—poor communication practices with the resulting breakdowns in health care delivery.
Enable use of smartphone communication devices throughout hospitals
The Joint Commission includes “improving staff communication” as one of its National Patient Safety Goals, emphasizing the importance of communicating test results accurately. Poor care coordination processes lead to failures in transmitting critical patient information. Clearly, providing devices which facilitate the exchange of information serve to enhance this goal.
One major motivation driving the widespread adoption of mobile devices by healthcare providers has been the need for better communication and information resources at the point of care. By ensuring teams across the hospital have access to smartphones, better patient care can follow. Collaboration technology connects the dots between patients and health providers regardless of distance while it improves workflows.
Allow for communications with individuals outside of the hospital
On-call management can also be improved by using a technology that enables coordination with physicians and nurses beyond the hospital’s care providers. Care coordination is a priority to many administrators in health care but one that unfortunately remains abstract to many physicians.
An article in the New England Journal of Medicine highlighted how one over the course of 80 days, a patient’s PCP need to work with 11 other clinicians, oversee 5 procedures and 11 office visits. As the complexity of the patient’s care increased, the tasks involved in coordinating it multiplied. However, there was not tool to enable coordination of care or way to message the PCP with results.
Clearly, facilitating the electronic exchange of information is key to patient care. As improved patient outcomes are the ultimate goal of doctor’s work, healthcare needs to focus on how to implement systems that have a goal of doing just this. By implementing a platform that enables persistent communications among physicians in addition to on-call capabilities, improved communications becomes embedded throughout the course of the patient’s care.
On-call doesn’t simply start and end with the receipt of a need for care. It start’s when for example a doctor or nurse is alerted to the need for their assistance in caring for a patient. The more information available to facilitate their care of the patient, the better the outcome for the patient.
The potential impact for On-Call Management
By using smart on-call platforms to better manage messaging and alerting of those on the frontlines of healthcare, patients are likely to see better coordination of care as well as better outcomes. Additionally, hospitals are likely to save costs and improve efficiency.
Effective on-call management platforms are essential to driving better quality care both in the short term and in the years to come.
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