Dashboards are extremely valuable when the data is meaningful. I believe if the dashboards are utilized and disseminated at multiple forums throughout the hospitals and health system there is greater buy. In addition, we are recently also focusing on the value of the numerator. Rates can be analyzed in many different ways, but the absolute number is real and when it comes to mortalities and HAC’s it means an individual patient. That resonates with the providers.
I think the important element is not to choose, but the are all interconnected to become a priority. THe intersection of safety, quality and patient experience, with the overlay of employee engagement, elevates the importance of all of the elements. In terms of staff acceptance this also comes from elevating the importance of patient experience to that of safety and quality and giving patient experience forums the same visibility of the other forums.
I agree as well and we all face the long and frustrating holds in the ERs. We have done significant work on increasing efficiencies on the inpatient units to help this. One thing we have done is standardize the rounding on the medical units, so all teams, interdisciplinary, are rounding at the same time and gives structure and more efficiency. In addition, we have created a standard rounding tool that enhances the structure. We have also identified physician leaders for each unit that are held acountable for delivering the process. In general this has improved our throughput significantly.
Obviously, the EMR has been one of the biggest dissatisfiers for physicians due to frustrating systems and time spent away from engaging with the patient. Now that EMRs are the given, if we focus on tech solutions that will enhance the efficiency of physician and add to engagement rather than detract. I think at this point doctors are hungry for great tech solutions as opposed to our initial bad experiences with EMRs.
We have set up triggers in our ICU’s for a palliatative care consult to be called. It has been extremely effective for earlier involvement with the palliative care team and it removes the individual physician beliefs. We are trying to expand these triggers to patients in the inpatient units as well. Some hospitals allow the nursing team to ask for the palliative care consult as well. We have also received Joint Commission Certification for our palliative care program, and this has helped put additional structure in place