Emergency Departments have a plethora of communications challenges, with more hand offs and methods of communication used than other areas of hospitals. See the full research findings by Cory Mann Market Insight in the attached report.
The impact of abbreviations on patient safety jcfaheta
This document discusses the impact of abbreviations on patient safety in healthcare. It finds that 4.7% of medication errors reported between 2004-2006 were attributable to abbreviation use, with 0.3% resulting in patient harm. The majority of abbreviation errors occurred during prescribing by physicians. While the incidence of harm is low, avoiding all errors is important. The document recommends enforcing policies that prohibit abbreviation use and holding healthcare professionals accountable to improve compliance and patient safety.
e-Marketing: An Approach to Overcoming Non-Financial Barriers to EHR Adoptionkwittman
The document summarizes the results of a survey of 49 medical professionals about their concerns regarding electronic health record (EHR) adoption. The two greatest concerns were compromising patient privacy and clinical staff being reduced to data entry clerks. To address privacy concerns, an advertisement was created emphasizing that paper records are also susceptible to theft or loss. Most respondents rated their computer skills as average or better and were concerned about privacy, workload changes, and autonomy with EHR adoption.
The document summarizes the results of a survey conducted to identify non-financial barriers to adoption of electronic health records (EHRs) among medical professionals. The top two concerns identified were compromising patient privacy and clinical staff being reduced to data clerks. To address privacy concerns, an advertisement was created emphasizing EHR security. Of 49 respondents, 85% were clinical staff concerned with privacy issues and how EHRs may change their roles.
This document summarizes a study evaluating the implementation of an electronic health information system at an opioid treatment program (ARTC) in Brooklyn, NY. The study aims to assess how an integrated electronic system impacts quality, productivity, satisfaction, risks, and financial performance. A staff survey found gaps in orientation and computer skills. Preliminary results show over half of staff need training. Next steps include completing pre-implementation data collection, staff training, selecting and implementing a system, and disseminating preliminary findings. The goal is to understand how electronic systems can enhance outcomes for substance abuse patients, especially underserved minority populations.
Communication: The Key to Unlocking Patient Care ImprovementMichael Peters
This presentation takes a look at the barriers and improvement opportunities that exist within Oncology and Healthcare in general to build a better patient and healthcare provider communication experience.
This document summarizes a quality improvement project at a large oncology practice to reduce the response time for symptom management calls. The project team implemented a case management system, reallocated nursing staff, and developed standardized protocols. These changes increased the percentage of symptom management calls receiving a clinical intervention within 2 hours from 54% at baseline to 73% after implementation. The number of non-clinical calls reaching the triage nurse also decreased significantly. The case management system provided data to identify additional opportunities for improvement beyond triage response times.
Nec report 20040701_online_clinician-pt_messaging-1Michelle Breaux
This document summarizes a report by the National Ethics Committee of the Veterans Health Administration on the fundamentals of ethical online patient-clinician messaging. The report examines the benefits and challenges of online communication between patients and clinicians. It makes seven recommendations to ensure the ethical practice of online messaging within VHA, including ensuring patient privacy and security, voluntary participation for patients and clinicians, and recognition of online interactions as part of clinicians' professional activities. The report provides context on the nature and purposes of online health communication to inform the discussion of ethical challenges.
The impact of abbreviations on patient safety jcfaheta
This document discusses the impact of abbreviations on patient safety in healthcare. It finds that 4.7% of medication errors reported between 2004-2006 were attributable to abbreviation use, with 0.3% resulting in patient harm. The majority of abbreviation errors occurred during prescribing by physicians. While the incidence of harm is low, avoiding all errors is important. The document recommends enforcing policies that prohibit abbreviation use and holding healthcare professionals accountable to improve compliance and patient safety.
e-Marketing: An Approach to Overcoming Non-Financial Barriers to EHR Adoptionkwittman
The document summarizes the results of a survey of 49 medical professionals about their concerns regarding electronic health record (EHR) adoption. The two greatest concerns were compromising patient privacy and clinical staff being reduced to data entry clerks. To address privacy concerns, an advertisement was created emphasizing that paper records are also susceptible to theft or loss. Most respondents rated their computer skills as average or better and were concerned about privacy, workload changes, and autonomy with EHR adoption.
The document summarizes the results of a survey conducted to identify non-financial barriers to adoption of electronic health records (EHRs) among medical professionals. The top two concerns identified were compromising patient privacy and clinical staff being reduced to data clerks. To address privacy concerns, an advertisement was created emphasizing EHR security. Of 49 respondents, 85% were clinical staff concerned with privacy issues and how EHRs may change their roles.
This document summarizes a study evaluating the implementation of an electronic health information system at an opioid treatment program (ARTC) in Brooklyn, NY. The study aims to assess how an integrated electronic system impacts quality, productivity, satisfaction, risks, and financial performance. A staff survey found gaps in orientation and computer skills. Preliminary results show over half of staff need training. Next steps include completing pre-implementation data collection, staff training, selecting and implementing a system, and disseminating preliminary findings. The goal is to understand how electronic systems can enhance outcomes for substance abuse patients, especially underserved minority populations.
Communication: The Key to Unlocking Patient Care ImprovementMichael Peters
This presentation takes a look at the barriers and improvement opportunities that exist within Oncology and Healthcare in general to build a better patient and healthcare provider communication experience.
This document summarizes a quality improvement project at a large oncology practice to reduce the response time for symptom management calls. The project team implemented a case management system, reallocated nursing staff, and developed standardized protocols. These changes increased the percentage of symptom management calls receiving a clinical intervention within 2 hours from 54% at baseline to 73% after implementation. The number of non-clinical calls reaching the triage nurse also decreased significantly. The case management system provided data to identify additional opportunities for improvement beyond triage response times.
Nec report 20040701_online_clinician-pt_messaging-1Michelle Breaux
This document summarizes a report by the National Ethics Committee of the Veterans Health Administration on the fundamentals of ethical online patient-clinician messaging. The report examines the benefits and challenges of online communication between patients and clinicians. It makes seven recommendations to ensure the ethical practice of online messaging within VHA, including ensuring patient privacy and security, voluntary participation for patients and clinicians, and recognition of online interactions as part of clinicians' professional activities. The report provides context on the nature and purposes of online health communication to inform the discussion of ethical challenges.
Learning from marketing rapid development of medication messages that engage...LydiaKGreen
The document describes a study that partnered healthcare researchers with advertising professionals to develop advertising-style messages to encourage patients with chronic kidney disease to discuss medication options with their doctors. They aimed to assess the feasibility of this partnership approach and test whether the messages would be acceptable and effective. The teams created 11 initial messages, tested them with patients and doctors via surveys, refined 5 messages, and conducted focus groups to identify the 3 most persuasive messages. Focus group feedback suggested the approach could be acceptable if used to support patient-provider relationships and had an evidence base, and that messages were more motivating if they elicited personal identification and clear understanding.
The Impact of Duplicate Medical Records and Overlays on the Healthcare Industry RightPatient®
Duplicate medical records and overlays continue to be two pressing issues for the healthcare industry as we usher in the age of electronic medical records, health information exchanges, and integrated delivery networks. Although these two issues can seriously jeopardize patient safety, increase the likelihood of unnecessary treatments and a misdiagnosis, raise the cost of care, and have a detrimental effect on the revenue cycle for medical facilities, they are different in size and scope and until only recently, have not been getting the attention they deserve from C-level executives.
The Impact of Duplicate Medical Records and Overlays in HealthcareM2SYS Technology
This podcast discusses the issues of duplicate medical records and record overlays in healthcare. It covers how overlays occur when information from two patients is combined into one record, while duplicates are when a patient has more than one medical record. This can cause safety risks if a patient receives care based on the wrong information. The podcast also discusses how duplicates and overlays impact costs, data quality, and revenue for healthcare providers. It explores challenges in accurately measuring the scope of these problems and potential solutions including identity management technologies.
This study examined continued professional development opportunities for healthcare workers in Blantyre, Malawi. The study found that the most common forms of continued development were workshops/seminars and clinical handover meetings. Nearly all participants had attended a workshop in the past year. However, access to professional journals was very low, with few individuals subscribing personally and few health facilities subscribing. Most participants expressed interest in receiving free journals. The study concluded there is a need to improve healthcare workers' access to relevant professional literature and for licensing boards to consider mandatory continuing education requirements.
A study tested whether a secure, HIPAA-compliant smartphone messaging application called Medigram could improve communication among healthcare providers compared to pagers alone. Three hospital teams were given Medigram in addition to pagers, while two control teams used only pagers. Surveys found that Medigram significantly improved providers' perceptions of being able to communicate clearly and efficiently, and of how well communication integrated into their workflow during patient rounds and discharge. Overall satisfaction was higher for teams using Medigram. Most providers said they would recommend using such a secure messaging system in hospitals.
ACA is an alliance of 37 member institutions in 12 African countries established in 1997 to provide sustainable capacity solutions in Africa. It implemented a project in collaboration with AMREF to strengthen the capacity of community health workers in Migori County, Kenya to diagnose and manage HIV/AIDS. A mobile phone application was developed and installed on the phones of 32 health workers to provide remote access to expertise. Evaluation found the application reduced remote consultations and increased health worker knowledge. While useful, connectivity and device issues need addressing to optimize the mobile learning approach.
This document provides an overview of a presentation on the science of safety training. Some key points:
- The presenter has over 24 years of experience in healthcare and various safety-related certifications and memberships.
- The presentation covers topics like historical context of patient safety, learning from defects, and celebrating safety. It also discusses tools to measure safety culture like the Safety Attitudes Questionnaire.
- The presentation describes how the Comprehensive Unit-based Safety Program (CUSP) was implemented at Tawam Hospital. Initial assessments found issues like hierarchies and a tendency to blame individuals for errors. CUSP helped establish a culture focused on systems and teamwork.
Medication Administration Errors at Children's University Hospitals: Nurses P...iosrjce
Medication administration errors(MAE) can threaten patient outcomes and are a dimension of
patient safety directly linked to nursing care. Children are particularly vulnerable to medication errors because
of their unique physiology and developmental needs.
Aims: The present study aims to examine types, stages and causes of medication errors. Barriers of medication
administration errors reporting and its facilitator at pediatric University hospitals from nurses point of view.
Methods: A descriptive study was conducted in Pediatric intensive care units, medical, surgical and urology
ward of children's university hospital at Mansoura University, intensive care units, kidney dialysis at
Abouelrash pediatric hospital and general wards of Elmonaira at Cairo University Hospitals. 80 nurses were
included in the study after fulfilling the criteria of selection. A structured interview questionnaire that consists
of four sections was used.
Results: The highest types of medication errors as reported by studied nurses occurred when the medication is
delivered by the wrong route, the highest stage of medication errors done by nurses was missing of medication
then patient monitoring and administration and the highest cause of medication errors was due to heavy
workload. The results of this study indicated that the strongest perceived barriers to medication administration
errors reporting were fear from consequences of reporting, then managerial factor and then the process of
reporting from the nurse's viewpoint. The nurses agree that identifying benefits of reporting followed agree that
feeling safe about working environment, and agree that good professional relationship with physicians was the
most facilitating factors of reporting medication errors.
Conclusions: It was concluded that medication errors result from interrelated factors, the strongest perceived
barriers to medication administration errors reporting were fear from consequences of reporting, and good
relationship with nurse managers and physicians were the most facilitators of reporting medication errors.
Recommendation: The study recommended that the assessment of medication errors should be done
periodically and in- service training program about medication administrations should be applied
This document summarizes research on the use of telemedicine by physicians in rural Michigan. It finds that while patients were generally satisfied with telemedicine, rural physicians have been slow to adopt it. Younger physicians and those employed by hospitals had more positive attitudes compared to independent or more experienced physicians. The top barriers were lack of access to equipment and perceived lack of resources. The document recommends education and training initiatives for physicians and subsidies for equipment to increase adoption of telemedicine in rural Michigan.
Recruitment & Retention: Breaking Down the Barriers to eConsent AdoptionCRF Health
Informed consent is traditionally obtained through lengthy paper processes, but electronic informed consent (eConsent) offers improvements. eConsent uses multimedia to securely obtain and document informed consent, providing clear audit trails and version control. It facilitates participant comprehension and retention of study details. While sponsors are wary of new technologies, eConsent streamlines processes, provides oversight benefits, and aligns with regulators' views that consent should be an educational tool throughout a study. Integrating eConsent requires identifying practical solutions, but its rewards will contribute to improved outcomes in clinical trials.
eConsent: Five (5) Key Areas of Preparation CRF Health
Site recruitment and retention of an adequate study population remains a major determinant of the success of a clinical trial. A recent survey to gather opinions on informed consent related to participant understanding, subject recruitment, and retention from 105 respondents' across site-based roles revealed 5 key areas that all sites should consider when preparing an eConsent.
A presentation showcasing some of the patient recruitment challenges that I encountered as a recruitment manager as well as some of the strategies -- DIGITAL ADVERTISING -- I used to overcome them.
The document describes the development and implementation of enhanced electronic consent (EEC) and educational materials (EEM) for stem cell clinical trials using iPad tablets. Key elements were identified for inclusion based on literature and discussions. Content was sourced from credible groups using free or low-cost resources. A small pilot with patients provided positive feedback on the iPad interface and content. Ultimately, two EECs and three EEMs on clinical trials were created in two months through collaborations that minimized costs. The process may increase patient understanding and protocol adherence in stem cell studies.
CU Errors, clinical governance and patient safetyMedic-ELearning
The document provides an overview of clinical governance, patient safety, and error prevention. It defines key terms like errors, incidents, and near-misses. It describes the National Patient Safety Agency's role in collecting incident reports to identify risks and improve safety. The document also discusses how most incidents are due to failures in systems and processes rather than individuals, and how a culture of learning from incidents can help prevent future harm.
The document discusses decision support in VA clinical information systems. It covers several topics including the diffusion of medical innovations, clinical knowledge as a special case, unexplained practice variation, business drivers for evidence-based medicine, challenges of clinical decision support, and knowledge management throughout the lifecycle of clinical guidelines.
Using eConsent in Clinical Research to Support Patient Understanding and WelfareCRF Health
Deciding to participate in a clinical trial is not risk-free for any participant. Some studies are designed for healthy volunteers and some are designed for participants with certain medical conditions.
- Alerts and reminders have the potential to improve patient safety but can also cause clinician frustration and "alert fatigue" if too many are nuisance alerts that provide little benefit.
- Successful alerts are specific, sensitive, clear, concise and support clinical workflow, allowing for safe, efficient responses. They include drug and lab alerts, practice and administrative reminders.
- Research found that drug interaction alerts, disease-drug contraindication alerts and dosing guidelines improved prescribing behaviors while unnecessary lab test repeats dropped with test result reminders.
1) The organization made progress in 2008/09 by starting local reporting on quality and governance issues but faced challenges around consistency of information.
2) In 2009/10, they aimed to continue improving risk management, evidence-based practices, and outcome measurement across services, while addressing challenges around clinical governance models and staff time allocation.
3) A new integrated risk register system was being introduced that was hoped to provide more dynamic reporting to better inform quality improvement efforts.
This presentation has the measures to be taken for the safety of patients. It covers the 6 goals
Goal 1: Identify patients correctly
Goal 2: Improve effective communication
Goal 3: Improve the safety of high-alert medications
Goal 4: Ensure safe surgery
Goal 5: Reduce the risk of health care-associated infections
Goal 6: Reduce the risk of patient harm resulting from falls
- Surgical site infections (SSIs) develop in 2-5% of surgical patients annually in the US, accounting for 14-16% of all hospital-acquired infections and 3% of surgical mortality. They increase costs by $29,000 per patient on average.
- A survey of 103 healthcare professionals found that most facilities have protocols for preoperative skin cleansing, though compliance levels vary. The majority use chlorhexidine gluconate (CHG) products and require two or more applications.
- Improving patient education and compliance was cited as the most significant obstacle to reducing SSIs. Less than 10% of facilities used digital reminders or referred patients to informational websites.
Learning from marketing rapid development of medication messages that engage...LydiaKGreen
The document describes a study that partnered healthcare researchers with advertising professionals to develop advertising-style messages to encourage patients with chronic kidney disease to discuss medication options with their doctors. They aimed to assess the feasibility of this partnership approach and test whether the messages would be acceptable and effective. The teams created 11 initial messages, tested them with patients and doctors via surveys, refined 5 messages, and conducted focus groups to identify the 3 most persuasive messages. Focus group feedback suggested the approach could be acceptable if used to support patient-provider relationships and had an evidence base, and that messages were more motivating if they elicited personal identification and clear understanding.
The Impact of Duplicate Medical Records and Overlays on the Healthcare Industry RightPatient®
Duplicate medical records and overlays continue to be two pressing issues for the healthcare industry as we usher in the age of electronic medical records, health information exchanges, and integrated delivery networks. Although these two issues can seriously jeopardize patient safety, increase the likelihood of unnecessary treatments and a misdiagnosis, raise the cost of care, and have a detrimental effect on the revenue cycle for medical facilities, they are different in size and scope and until only recently, have not been getting the attention they deserve from C-level executives.
The Impact of Duplicate Medical Records and Overlays in HealthcareM2SYS Technology
This podcast discusses the issues of duplicate medical records and record overlays in healthcare. It covers how overlays occur when information from two patients is combined into one record, while duplicates are when a patient has more than one medical record. This can cause safety risks if a patient receives care based on the wrong information. The podcast also discusses how duplicates and overlays impact costs, data quality, and revenue for healthcare providers. It explores challenges in accurately measuring the scope of these problems and potential solutions including identity management technologies.
This study examined continued professional development opportunities for healthcare workers in Blantyre, Malawi. The study found that the most common forms of continued development were workshops/seminars and clinical handover meetings. Nearly all participants had attended a workshop in the past year. However, access to professional journals was very low, with few individuals subscribing personally and few health facilities subscribing. Most participants expressed interest in receiving free journals. The study concluded there is a need to improve healthcare workers' access to relevant professional literature and for licensing boards to consider mandatory continuing education requirements.
A study tested whether a secure, HIPAA-compliant smartphone messaging application called Medigram could improve communication among healthcare providers compared to pagers alone. Three hospital teams were given Medigram in addition to pagers, while two control teams used only pagers. Surveys found that Medigram significantly improved providers' perceptions of being able to communicate clearly and efficiently, and of how well communication integrated into their workflow during patient rounds and discharge. Overall satisfaction was higher for teams using Medigram. Most providers said they would recommend using such a secure messaging system in hospitals.
ACA is an alliance of 37 member institutions in 12 African countries established in 1997 to provide sustainable capacity solutions in Africa. It implemented a project in collaboration with AMREF to strengthen the capacity of community health workers in Migori County, Kenya to diagnose and manage HIV/AIDS. A mobile phone application was developed and installed on the phones of 32 health workers to provide remote access to expertise. Evaluation found the application reduced remote consultations and increased health worker knowledge. While useful, connectivity and device issues need addressing to optimize the mobile learning approach.
This document provides an overview of a presentation on the science of safety training. Some key points:
- The presenter has over 24 years of experience in healthcare and various safety-related certifications and memberships.
- The presentation covers topics like historical context of patient safety, learning from defects, and celebrating safety. It also discusses tools to measure safety culture like the Safety Attitudes Questionnaire.
- The presentation describes how the Comprehensive Unit-based Safety Program (CUSP) was implemented at Tawam Hospital. Initial assessments found issues like hierarchies and a tendency to blame individuals for errors. CUSP helped establish a culture focused on systems and teamwork.
Medication Administration Errors at Children's University Hospitals: Nurses P...iosrjce
Medication administration errors(MAE) can threaten patient outcomes and are a dimension of
patient safety directly linked to nursing care. Children are particularly vulnerable to medication errors because
of their unique physiology and developmental needs.
Aims: The present study aims to examine types, stages and causes of medication errors. Barriers of medication
administration errors reporting and its facilitator at pediatric University hospitals from nurses point of view.
Methods: A descriptive study was conducted in Pediatric intensive care units, medical, surgical and urology
ward of children's university hospital at Mansoura University, intensive care units, kidney dialysis at
Abouelrash pediatric hospital and general wards of Elmonaira at Cairo University Hospitals. 80 nurses were
included in the study after fulfilling the criteria of selection. A structured interview questionnaire that consists
of four sections was used.
Results: The highest types of medication errors as reported by studied nurses occurred when the medication is
delivered by the wrong route, the highest stage of medication errors done by nurses was missing of medication
then patient monitoring and administration and the highest cause of medication errors was due to heavy
workload. The results of this study indicated that the strongest perceived barriers to medication administration
errors reporting were fear from consequences of reporting, then managerial factor and then the process of
reporting from the nurse's viewpoint. The nurses agree that identifying benefits of reporting followed agree that
feeling safe about working environment, and agree that good professional relationship with physicians was the
most facilitating factors of reporting medication errors.
Conclusions: It was concluded that medication errors result from interrelated factors, the strongest perceived
barriers to medication administration errors reporting were fear from consequences of reporting, and good
relationship with nurse managers and physicians were the most facilitators of reporting medication errors.
Recommendation: The study recommended that the assessment of medication errors should be done
periodically and in- service training program about medication administrations should be applied
This document summarizes research on the use of telemedicine by physicians in rural Michigan. It finds that while patients were generally satisfied with telemedicine, rural physicians have been slow to adopt it. Younger physicians and those employed by hospitals had more positive attitudes compared to independent or more experienced physicians. The top barriers were lack of access to equipment and perceived lack of resources. The document recommends education and training initiatives for physicians and subsidies for equipment to increase adoption of telemedicine in rural Michigan.
Recruitment & Retention: Breaking Down the Barriers to eConsent AdoptionCRF Health
Informed consent is traditionally obtained through lengthy paper processes, but electronic informed consent (eConsent) offers improvements. eConsent uses multimedia to securely obtain and document informed consent, providing clear audit trails and version control. It facilitates participant comprehension and retention of study details. While sponsors are wary of new technologies, eConsent streamlines processes, provides oversight benefits, and aligns with regulators' views that consent should be an educational tool throughout a study. Integrating eConsent requires identifying practical solutions, but its rewards will contribute to improved outcomes in clinical trials.
eConsent: Five (5) Key Areas of Preparation CRF Health
Site recruitment and retention of an adequate study population remains a major determinant of the success of a clinical trial. A recent survey to gather opinions on informed consent related to participant understanding, subject recruitment, and retention from 105 respondents' across site-based roles revealed 5 key areas that all sites should consider when preparing an eConsent.
A presentation showcasing some of the patient recruitment challenges that I encountered as a recruitment manager as well as some of the strategies -- DIGITAL ADVERTISING -- I used to overcome them.
The document describes the development and implementation of enhanced electronic consent (EEC) and educational materials (EEM) for stem cell clinical trials using iPad tablets. Key elements were identified for inclusion based on literature and discussions. Content was sourced from credible groups using free or low-cost resources. A small pilot with patients provided positive feedback on the iPad interface and content. Ultimately, two EECs and three EEMs on clinical trials were created in two months through collaborations that minimized costs. The process may increase patient understanding and protocol adherence in stem cell studies.
CU Errors, clinical governance and patient safetyMedic-ELearning
The document provides an overview of clinical governance, patient safety, and error prevention. It defines key terms like errors, incidents, and near-misses. It describes the National Patient Safety Agency's role in collecting incident reports to identify risks and improve safety. The document also discusses how most incidents are due to failures in systems and processes rather than individuals, and how a culture of learning from incidents can help prevent future harm.
The document discusses decision support in VA clinical information systems. It covers several topics including the diffusion of medical innovations, clinical knowledge as a special case, unexplained practice variation, business drivers for evidence-based medicine, challenges of clinical decision support, and knowledge management throughout the lifecycle of clinical guidelines.
Using eConsent in Clinical Research to Support Patient Understanding and WelfareCRF Health
Deciding to participate in a clinical trial is not risk-free for any participant. Some studies are designed for healthy volunteers and some are designed for participants with certain medical conditions.
- Alerts and reminders have the potential to improve patient safety but can also cause clinician frustration and "alert fatigue" if too many are nuisance alerts that provide little benefit.
- Successful alerts are specific, sensitive, clear, concise and support clinical workflow, allowing for safe, efficient responses. They include drug and lab alerts, practice and administrative reminders.
- Research found that drug interaction alerts, disease-drug contraindication alerts and dosing guidelines improved prescribing behaviors while unnecessary lab test repeats dropped with test result reminders.
1) The organization made progress in 2008/09 by starting local reporting on quality and governance issues but faced challenges around consistency of information.
2) In 2009/10, they aimed to continue improving risk management, evidence-based practices, and outcome measurement across services, while addressing challenges around clinical governance models and staff time allocation.
3) A new integrated risk register system was being introduced that was hoped to provide more dynamic reporting to better inform quality improvement efforts.
This presentation has the measures to be taken for the safety of patients. It covers the 6 goals
Goal 1: Identify patients correctly
Goal 2: Improve effective communication
Goal 3: Improve the safety of high-alert medications
Goal 4: Ensure safe surgery
Goal 5: Reduce the risk of health care-associated infections
Goal 6: Reduce the risk of patient harm resulting from falls
- Surgical site infections (SSIs) develop in 2-5% of surgical patients annually in the US, accounting for 14-16% of all hospital-acquired infections and 3% of surgical mortality. They increase costs by $29,000 per patient on average.
- A survey of 103 healthcare professionals found that most facilities have protocols for preoperative skin cleansing, though compliance levels vary. The majority use chlorhexidine gluconate (CHG) products and require two or more applications.
- Improving patient education and compliance was cited as the most significant obstacle to reducing SSIs. Less than 10% of facilities used digital reminders or referred patients to informational websites.
Did you know that among high-developed countries,
the U.S. ranks last in health system performance while spending the most per capita on healthcare?! Here are some key metrics and analysis that were made to reveal the reasons why patients are unhappy with the provided service!
Here is a professionally written paragraph on the topic with an APA formatted citation:
Alarm fatigue poses a significant patient safety risk in healthcare facilities. When nurses are inundated with a high volume of alarms, some of which are clinically irrelevant, it can lead to desensitization and delays in response to critical alarms (Sendelbach & Jepsen, 2013). Nuisance or false-positive alarms are a key driver of alarm fatigue, as they do not indicate an actual adverse patient condition but still interrupt care providers (Graham & Cvach, 2010). The overuse of alarms has created a "cry wolf effect" wherein nurses start to mistrust clinical alarm systems due to the frequency of irrelevant alerts (Cvach, 2010
Improving Patients’ Health Acute Care FinalmHealth2015
mHealth strategies have the potential to improve patient health and outcomes before, during, and after emergency department visits. By facilitating patient triage and decision making before visits, improving communication during visits, and enhancing health literacy and behavior change support after visits, mHealth can help emergency departments improve throughput and post-discharge outcomes. This can increase revenue, avoid penalties, and improve patient satisfaction. Two case studies show that text messaging improved satisfaction scores and appointment adherence for discharged patients from emergency departments.
Improving Patients’ Health Before, During, and After an Acute Care VisitmHealth2015
mHealth strategies have the potential to improve patient health outcomes before, during and after emergency department visits. By facilitating patient triage and decision making before visits, improving communication during visits, and enhancing health literacy and behavior change after discharge, mHealth can help emergency departments improve throughput, post-discharge outcomes, revenue, penalties and patient satisfaction. Text messaging in particular has been shown to significantly increase follow-up appointment adherence and patient self-efficacy.
The Remote Monitoring System
Michelle L. Wallace
Sentara College of Health Sciences
Pro Phillips
The Remote Monitoring System
Internationally, patient care facilities and healthcare systems are steadily executing organizations that record the patient health in the home setting. The patient avoids unnecessary doctors’ visits, hospital stays and visits to emergency care department (Emani, 2017). Healthcare is providing your patient the best quality of life possible. Concerning individuals particularly patients with heart failure problems, remote monitoring plays a major role in the being afforded to live somewhat of a normal life. Also, with the increase in the baby boomer generation attaining retirement age, there is high demand for the availability of enough and quality home health care (McGonigle & Mastrian, 2017). Unfortunately, heart failure affects many people in the United States. Subsequently, the incidence and prevalence are increasing even with the option of heart failure therapy. The admission of a patient with heart failure is trending daily. Sadly, this effects the elderly more than any other population. The consequence of heart failure is increased instances of disease and or death. Increased debt is also a precipitating factor of heart failure, due to an influx of necessary treatment. To decrease the instances of the over population in the acute care setting, meanwhile eliminating the significant load of substantial cost to the patient, healthcare facilities have implemented the remote monitoring systems.
Promoting the remote health monitoring is one of the most prevalent factors, that provides more enough outcomes for the heart failure patient. Remote patient monitoring can improve patient results by improving to their responsiveness in the instances of emergency. Remote patient monitoring intensifies medical specialists to assist in following the patient biometric real-time and offer solutions immediately (Emani, 2017). Remote patient monitoring boosts suitable escalation mainly with the nervous patients who are very responsive. By surging quickly, the patient may suffer large medical bills that may negatively impact their quality of life. Furthermore, taking responsibility in monitoring is vital in adequately ensuring the patient has soaring results. Appropriate medication is an essential part of treatment regimens, though it is challenging to understand with certainty if the patient id complying with the prescription (Emani, 2017). The remote health monitoring system is arranged to give patients a reminder on the appropriate time to take their medicines. This system also alerts the physician, if the patient isn’t compliant with treatment.
While the remote patient monitoring is designed for patients with heart problems, this system is key in accessing health care services, appropriate care, and regulation, the program must meet a certain legal and regulatory compliance especially with the privacy and data security.
#2 Development of a traffic light alert system to improve referral processes ...RecoveryPackage
The document describes the development of a traffic light alert system to improve referral processes for a Macmillan Acute Oncology Service (MAOS). The system was designed to accurately reflect the service's availability to accept referrals, ensure accountability, and expedite discharges. It uses a single web page with color-coded statuses (green, amber, red, black) and corresponding actions to guide referrals. Early results suggest the system improves communication between referrers and MAOS and engagement in expediting discharges. If successful, the alert system may be adopted by other acute assessment areas and oncology services.
This document summarizes a survey of over 1,500 family physicians on their use of and attitudes towards telehealth. Key findings include: 15% of respondents use telehealth, primarily those in rural areas, younger physicians, and those practicing for 10 years or less. Common telehealth services included video consultations for diagnosis/treatment and chronic disease management. Both users and non-users saw benefits of telehealth but agreed patients prefer in-person visits. Barriers to wider adoption included costs, training, and reimbursement issues.
This document discusses strategies for standardizing handoff processes throughout healthcare organizations. It explains that standardizing handoffs is challenging but important for patient safety, as ineffective handoffs can lead to medical errors and other issues. The document outlines some key steps for organizations to take, such as developing and implementing a standardized process, obtaining leadership and staff buy-in, and addressing hierarchical relationships among staff that can hinder communication. Standardizing handoffs requires significant cultural change across an entire organization.
Healthcare providers took an average of 8.1 minutes to complete scheduling calls, which was longer than the cross-industry average of 3.7 minutes. Calls were frequently transferred, occurring 63% of the time for providers compared to best practices of 5.7%. Despite long wait times and transfers, only 59% of calls resulted in a scheduled appointment on the first attempt, falling below cross-industry averages.
This document discusses telemedicine, which is the delivery of healthcare via electronic services. It notes that patients, doctors, and insurance companies benefit from telemedicine. Patients find it more convenient than visiting a healthcare facility. Doctors can monitor remote patients and save time on cancellations. Insurance companies can process claims faster. The document outlines how telemedicine works from the patient's perspective and its benefits, such as improved access to care and cost efficiency. Potential challenges are also presented, such as electronic glitches, physician resistance, and inadequate assessment or training. Federal guidelines and advocacy groups help ensure telemedicine is safe and effective for patients.
MHA6999 SEMINAR IN HEALTHCARE CASES-- WEEK 2 LECTURE, DISCUSSION, DioneWang844
MHA6999 SEMINAR IN HEALTHCARE CASES-- WEEK 2 LECTURE, DISCUSSION, AND PROJECT INSTRUCTIONS
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Quality
Nearly fifteen years ago, the Institute of Medicine published the “To Err Is Human” report, which exposed the substantial impact of medical errors in the US healthcare system and called for a dramatic system change, including an improved understanding of those errors (McCarthy, Tuiskula, Driscoll, & Davis, 2017). Medical errors are considered to be failure to achieve the original goal or plan of action, and these errors may range from a patient falls to a mistake in the operating room. Not only do medical errors cause harm to the patient and jeopardize the patient’s trust, but they also cause a financial strain for the health system (“To Err is Human,” 1999). One of the contributing factors to medical errors is the lack of effective communication between doctors who are treating the same patient. This results in healthcare providers overprescribing medications for patients as well as increases the possibility of a patient having unnecessary tests or procedures performed. The report’s four-tiered approach includes:
· Focusing on creating a stronger foundation of education on patient safety
· Mandating a nationwide reporting system to encourage timely reporting of errors
· Increasing the standards of performance for healthcare providers
· Taking advantage of the security that safety systems offer (“To Err is Human,” 1999)
Creating a strong educational foundation for patient safety is most important. Healthcare personnel are much more likely to actively participate in reporting systems, encourage one another to perform at a higher level, and take advantage of safety systems when they are well educated on patient safety and the implications of medical errors. The reporting system seems to provide the least amount of impact on patient safety as they can result in losing patient trust in certain healthcare systems. The healthcare system as a whole has made progress in establishing a safe environment for patients when they are in need of care.
Challenges for Patient Safety and Steps for Improvement
Despite continuing evidence of problems in patient safety and gaps between the care that patients receive and the evidence about what they should receive, efforts to improve quality in healthcare show mostly inconsistent and patchy results.
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Data Collection and Monitoring Systems
This always takes much more time and energy than anyone anticipates. It is worth investing heavily in data from the outset. Assess local systems, train people, and have quality assurance.
Tribalism and Lack of Staff Engagement
Overcoming a perceived lack of ownership and professional or disciplinary boundaries can be very difficult. Clarify who owns the problem and solution, agree roles and responsibilities at the outset, work to common goals, and use shared language.
Convince People That There's a Problem
Use hard data to secure emotional e ...
The document discusses challenges for rural physicians in adopting electronic medical records (EMRs) and improving healthcare through technology. It presents results from case studies and surveys of rural physicians that suggest physicians' perceptions of technology directly impact their willingness to adopt EMRs and perceptions of patients' needs. While rural medicine lags in EMR implementation compared to urban areas, the technologies are the same and continued research can help address challenges of the transition to digital healthcare in rural communities.
5 annotated bibliographies #1 As much as we try to preve.docxtroutmanboris
5 annotated bibliographies
#1
As much as we try to prevent them, medication errors happen everyday. It is especially
common in skilled nursing facilities because many of them still use paper charts for
medication administration or documentation and do not have access to the newer
technology that other medical facilities do.
According to a study performed in 2014, medication distribution technology has been
proven to be effective in automatically detecting medication errors so that nurses can
have more of an opportunity to focus on their patients. Working on a long-term care unit,
most of my time is spent passing medications and doing treatments since I have 19
residents to tend to. Depending on how “smooth” the night goes, I sometimes do not get
a chance to spend that extra time with my residents as I would like to. This medication
distribution technology includes a mobile medication dispensing cart for long-term care
units. The medications would be pre-packed for each patient by the pharmacy and able
to be dispensed when needed. This would allow nurses to provide more one-on-one
time with their patients while also increasing the prevention of medication errors. It also
will help to lighten the nurses’ workload. Research shows that these mobile medication
cart have been successful. Medication error rates decreased from 2.9% to 0.6% (Baril,
Gascon & Brouillette, 2014).
Reference
Baril, C., Gascon, V., & Brouillette, C. (2014). Impact of technological innovation on a
nursing home performance and on the medication-use process safety. Journal of
Medical Systems, 38(3), 1–12. https://library.neit.edu:2404/10.1007/s10916-014-0022-4
#2
Adverse drug effects due to medication errors are estimated to cost the United States
$2 billion every year. After reviewing patient reports and reviewing charts, it was
discovered that 44% of these occur after the prescription was written. These errors were
found to be from registered nurses, licensed practical nurses and pharmacy technicians.
Therefore, the problem comes from administration of the medication. However, these
numbers only account for the errors that are actually reported. It is the more serious and
harmful errors that are recorded, probably because they are harder to hide. The Health
Care Finance Administration of the United States made it standard for hospitals and
skilled nursing facilities to have no more than 5% of medication error rates a year.
In a study conducted in 2014, researchers decided to put a hold on reviewing incident
reports and patient charts. Instead, they decided to directly observe medication
administration over 20 different hospitals or skilled nursing facilities. Other methods
included: attending medical rounds to see if a medication error had occurred,
interviewing health care workers to see if they would report anything, testing patients
urine to see if they had any unauthorized medications in their system, and comparing .
Medication errors are a serious issue that compromise patient safety and result in harm. Some contributing factors include high patient acuity, heavy nursing workload, distractions during medication administration, and failure to follow safety policies. Proper staffing ratios and limiting workload are needed to decrease errors by reducing nurse fatigue and allowing them to focus on medication administration. Involving patients can also help catch errors and improve safety.
FAMILY-CENTERED CARE DURING OUTPATIENT SURGERY1FAMILY-CENTERED ChereCheek752
FAMILY-CENTERED CARE DURING OUTPATIENT SURGERY1
FAMILY-CENTERED CARE DURING OUTPATIENT SURGERY2
This sample paper gives students an idea of how to address the content of the CAP. Please be sure to focus on the content and not the formatting. This paper has not been updated to reflect the 7th edition APA rules! See Prof. Piccinini’s side notes in the margins.
Family-Centered Communication in Day Surgery
Three Quality of Care key drivers for Our Lady of the Resurrection (OLR) Medical Center’s Surgical Services department are measured quarterly. The Surgical Services Department has met or exceeded targets for two of the three key drivers. However, for the past six months, the department has not met the goal for a third key driver: explanations provided about progress following surgery. Meeting the goal for the third key driver is dependent on effective communication processes from staff and surgeons to patients and their families. A communication process exists, but by looking at areas in which the process is broken, relatively easy and effective fixes can be put into place. Comment by Carina Piccinini: Topic introduction, overview of issue, choice of topic.
The charge nurse for preoperative and recovery care has identified difficulty in adhering to the current process due to difficulty in locating family members if they leave the waiting room and due to the volume and acuity of patients that enter the recovery area. The nurse manager has also identified meeting the third key driver as a priority for the institution and supports the project.Comment by Carina Piccinini: Pertinence of issue to the unit and preceptor and unit manager buy-in
Increasing patient satisfaction—and thereby increasing the likelihood of returning to the facility for healthcare needs—can benefit the unit and the organization by increasing revenues. The profession of nursing can also benefit by increasing staff and improving technologies for patient care with additional revenues.Comment by Carina Piccinini: Benefit to the unit/organization
Literature Review of Problem
Much research on factors influencing patient satisfaction in perioperative care has been conducted. A driving factor identified is communication to patients and families during care.
Yellen (2003) surveyed ambulatory surgery patients to determine the influence of the nurse-sensitive variables of age, gender, culture, previous hospital admissions, nurse communication, pain, and satisfaction with pain management on overall patient satisfaction. Results showed that nurse communication was the most significant indicator of patient satisfaction, and satisfaction with pain management was the second most significant indicator. Furthermore, patients who were satisfied with nurse communication also reported satisfaction with pain management.
Fry and Warren (2005) conducted a qualitative study to determine the needs of family members in the waiting room of a critical care unit. Results showed that all pa ...
This document summarizes a study that assessed the knowledge of surgical errors and attitudes towards surgical safety checklists among surgical team members in Port Said public hospitals. The study found that surgical team members had very good knowledge of surgical errors and good attitudes towards surgical safety checklists. Specifically, 98.2% knew about surgical errors, and 90% stated that checklists improved team communication. However, the study had limitations as the sample size was small and most respondents were nurses from public hospitals. The conclusions recommend increasing training, reporting near misses, and emphasizing team members' safety responsibilities to further reduce errors.
Write a 2 Paragraph response (with 2-3 sources) to this post offerin.docxlindorffgarrik
Write a 2 Paragraph response (with 2-3 sources) to this post offering additional/alternative ideas regarding opportunities and risks related to the observations shared.
Healthcare system presently is faced with challenges to improving quality of care and controlling costs and according to the Institute of Medicine, electronic health records (EHR) serve as a solution to these challenges (2001). The Health Information Technology for Economic and Clinical Health Act (HITECH) passed by President Barack Obama promotes the adaptation of EHR system by providing health organizations and providers with incentives through Medicare and Medicaid for meaningful utilization of EHR systems (McGonigle&Mastrian, 2017). Technology in nursing has evolved and transformed the way nurses work and continues to grow, along with the role’s nurses play in today’s health care environment (Melissa Wirkus, 2016).For many years the paper chat served as the patient’s primary medical records such as medical histories, medical diagnosis, medications, and other pertinent patient information. In the future, an expected healthcare technology trend in nursing practice will be a significant increase in the use of the Electronic health record (EHR) instead of the traditional paper charting As technology continues to grow so does additional information technology that helps caregivers, engage patients and improve efficiencies and better patient outcomes (Laureate Education, 2018). For example, patients can now have access to their medical health records at their own convenient through online portals and can effectively communicate with their health care provider. In addition, patients are also using social media platforms like Facebook and twitter to get/communicate with others with the same health-related diagnosis.
According to McGonigle & Mastrain “Public health information systems represent a partnership of federal, state, and local public health professionals” (2017). In the present-day majority of health care organizations are embracing the implementation of electronic health records. In the hospital I work, we are making use of the Meditech operating system. Patient medical histories, diagnosis, home medications, and current medications are updated and readily available. During patient’s hospital stay, all health care providers can log in with their personal access codes to document as well as view patients’ labs, patient notes, care plans and so on. More so, one intriguing benefit for the patients is during the patient’s hospital stay and at discharge, patients are educated about our patient portal where they can easily log in to look up their personal medical records.
Potential Risk/ Challenge Associated with data Safety.
A potential risk associated with data and or technology safety is the lack of patient confidentiality. For example, when a nurse who is from a different unit assesses patient medical records they took care of three days before, that is considered a.
Similar to Communications in US Emergency Departments (20)
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Health Tech Market Intelligence Prelim Questions -Gokul Rangarajan
The Ultimate Guide to Setting up Market Research in Health Tech part -1
How to effectively start market research in the health tech industry by defining objectives, crafting problem statements, selecting methods, identifying data collection sources, and setting clear timelines. This guide covers all the preliminary steps needed to lay a strong foundation for your research.
This lays foundation of scoping research project what are the
Before embarking on a research project, especially one aimed at scoping and defining parameters like the one described for health tech IT, several crucial considerations should be addressed. Here’s a comprehensive guide covering key aspects to ensure a well-structured and successful research initiative:
1. Define Research Objectives and Scope
Clear Objectives: Define specific goals such as understanding market needs, identifying new opportunities, assessing risks, or refining pricing strategies.
Scope Definition: Clearly outline the boundaries of the research in terms of geographical focus, target demographics (e.g., age, socio-economic status), and industry sectors (e.g., healthcare IT).
3. Review Existing Literature and Resources
Literature Review: Conduct a thorough review of existing research, market reports, and relevant literature to build foundational knowledge.
Gap Analysis: Identify gaps in existing knowledge or areas where further exploration is needed.
4. Select Research Methodology and Tools
Methodological Approach: Choose appropriate research methods such as surveys, interviews, focus groups, or data analytics.
Tools and Resources: Select tools like Google Forms for surveys, analytics platforms (e.g., SimilarWeb, Statista), and expert consultations.
5. Ethical Considerations and Compliance
Ethical Approval: Ensure compliance with ethical guidelines for research involving human subjects.
Data Privacy: Implement measures to protect participant confidentiality and adhere to data protection regulations (e.g., GDPR, HIPAA).
6. Budget and Resource Allocation
Resource Planning: Allocate resources including time, budget, and personnel required for each phase of the research.
Contingency Planning: Anticipate and plan for unforeseen challenges or adjustments to the research plan.
7. Develop Research Instruments
Survey Design: Create well-structured surveys using tools like Google Forms to gather quantitative data.
Interview and Focus Group Guides: Prepare detailed scripts and discussion points for qualitative data collection.
8. Sampling Strategy
Sampling Design: Define the sampling frame, size, and method (e.g., random sampling, stratified sampling) to ensure representation of target demographics.
Participant Recruitment: Plan recruitment strategies to reach and engage the intended participant groups effectively.
9. Data Collection and Analysis Plan
Data Collection: Implement methods for data gathering, ensuring consistency and validity.
Analysis Techniques: Decide on analytical approaches (e.g., statistical
2024 Media Preferences of Older Adults: Consumer Survey and Marketing Implica...Media Logic
When it comes to creating marketing strategies that target older adults, it is crucial to have insight into their media habits and preferences. Understanding how older adults consume and use media is key to creating acquisition and retention strategies. We recently conducted our seventh annual survey to gain insight into the media preferences of older adults in 2024. Here are the survey responses and marketing implications that stood out to us.
Nursing management of the patient with Tonsillitis PPTblessyjannu21
Prepared by Prof. Blessy Thomas MSc Nursing, FNCON, SPN. The tonsils are two small glands that sit on either side of the throat.
In young children, they help to fight germs and act as a barrier against infection.
Tonsils act as filters, trapping germs that could otherwise enter the airways and cause infection.
They also make antibodies to fight infection.
But sometimes, they get overwhelmed by bacteria or viruses.
This can make them swollen and inflamed.
Tonsillitis is an infection of the tonsils, two masses of tissue at the back of the throat.
Tonsillitis is inflammation of the tonsils, two oval-shaped pads of tissue at the back of the throat — one tonsil on each side.
Tonsillitis is common, especially in children.
It can happen once in a while or come back again and again in a short period.Nursing management of Tonsillitis is important.
A comprehensive understanding of the operations for management of Tonsillitis and areas requiring special attention would be important.
Cancer treatment has advanced significantly over the years, offering patients various options tailored to their specific type of cancer and stage of disease. Understanding the different types of cancer treatments can help patients make informed decisions about their care. In this ppt, we have listed most common forms of cancer treatment available today.
2. Overview
The “Care Communication Gaps in U.S. Hospital Emergency Departments” research was conducted in
December 2016. The goal of this research was to understand the common communication challenges
which exist in U.S. Emergency Departments (ED) today and the impact of those changes on patient care
and care team performance. The survey also sought to understand the processes and technologies ED
care teams have used to improve those communication challenges and the effectiveness of those
improvement initiatives.
A total of 158 emergency department leaders replied to the survey. These included primarily Directors
of the Emergency Department and Directors of Clinical Quality (a complete breakdown can be seen
below).
Emergency Departments that participated in the survey included academic medical centers, private,
nonprofit hospitals, publicly owned hospitals and for profit systems in short term stay acute care
hospitals with at least 200 beds.
Primary Insights
Emergency Departments are complex communication areas – 59% report more hand offs than
the rest of the hospital.
Communication errors are relatively common – More than half of Emergency Departments
report more than 10% of hand offs have a communication error.
Real-time communications are the most effective – face-to-face, secure messaging and mobile
phones are reported as the most effective forms of care team communications (79-82%).
3. Many hand offs are complex, requiring multiple communication methods – between 3.3 and 4.9
channels are used at each hand off point.
Front-end processes are the most inaccurate communication points – intake and triage report
the least accurate communications.
Communications across remote individuals raise the most communication challenges, including
waiting for physician responses (23 – 32%) and incomplete or delayed information (19-21%).
New workflows have an impact, but don’t solve the entire problem – 34% of hospitals using Fast
Track for low-acuity patients still report ED wait times to first see a doctor at over 30 minutes.
Emerging remote team technologies and workflows show promise for impacting care team
collaboration – over 80% report tele-consult and tele-stroke are the most effective workflows,
with secure messaging being listed as the 2nd
most effective communication technology (just
after face-to-face).
ED Coordination is More Complex Than the Rest of the Hospital
Emergency Departments have more communication complexity than the rest of the hospital. 61% of
departments report that they have more staff involved in a patient’s care than throughout the rest of
the hospital. This aligns with the complexity of care in an Emergency Department. For example, in order
to manage a stroke patient, an average care team might involve 12-15 doctors/nurses and staff
members spread out across the hospital. ED care team members (59%) also reported an increased need
for a doctor/nurse/practitioner updating another doctor/nurse/practitioner in the facility about a
current patient’s care or recommended care (hand offs) and the use of more specialized terminology
(55%) in order to treat patients.
Care Coordination Complexity
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
Many Fewer Somewhat
Fewer
About the Same Somewhat More Many More
Care Coordination Complexity
More People More Jargon More HandoffsMore People More Jargon More Hand Offs
4. Communication Errors Happen During Hand Offs
Over half of respondents reported that communication errors occur in more than 10% of Emergency
Department hand offs. The Joint Commission has previously reported that 37% of unexpected events
causing injury or death in the hospital (sentinel events) are due to communication and assessment
errors, highlighting the impact of communication on patient care. With the large number of hand offs
and communication methods used in Emergency Departments, it is easy to see how inefficiencies could
affect patient care.
Communication Complexity and Challenges During Care Team Hand Offs
Emergency Departments use a myriad of communication technologies for each hand off, as care team
members need to discuss each patient case in real-time, notify team members when they are needed to
take action and document information for follow-up.
5. Along with the complexity of communication and methods used at each hand off, a number of common
challenges were highlighted which impact the effectiveness of those communications. Those challenges
included waiting for physicians and specialists to respond to requests, such as the need for a consult,
following up with patients and orders. The communication tools commonly used to notify physicians of
requests (e.g. pagers, voicemail, faxes and answering services) were rated among the least effective
communication methods by respondents.
Poor handwriting and incomplete information were also highlighted as common communication
challenges. Typically, this results in the need to follow up with other care team members for clarification
Highest No. Used
4.9
during treatment
discussions
Lowest No. Used
3.3
when discharging a
patient
Top Communication Challenges
6. and/or more information in order to be able to assess or treat patients. Delays in receiving information
such as lab and test results also were indicated as common challenges.
In addition to top communication challenges, respondents reported some issues with accuracy of
passing patient information and clinical instructions during specific hand off points in a patient’s care in
the Emergency Department. The least accurate communications were reported between in-bound
ambulance crews, triage nurses and charge nurse as care teams are managing the arrival of patients;
these hand offs require having the most accuracy – and staff face challenges in gathering information
about the patient. These hand offs were also reported as some of the quickest hand offs, which aligns
with the speed needed to handle inbound patients.
The most accurate hand offs reported were transfers to trauma or stroke centers where many hospitals
have dedicated individuals assigned to handle these communications. These were also reported as the
quickest hand offs. The majority of these hand offs are being managed via landline(s) for transfers or
face-to-face communication. For managing arriving patients, this often means that information is not
communicated until the patient arrives versus pre-hospital arrival.
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Transfer to
Stroke
Transfer to
Trauma
ED Physicians
to Specialists
EMS/
ambulance to
Triage
Registration to
Triage
Triage to
Charge Nurse
Communicating Patient Info & Clinical Instructions
During Hand Offs
Most Accurate Communication Most Inaccurate Communication
Most Accurate Communication Most Inaccurate Communication
7. Communication Methods and Workflows Have Had Mixed Results
In order to support real-time discussion of a patient’s case, the survey found a number of
technologies/methods are being used, with respondents reporting various levels of effectiveness:
Face-to-face discussion and the use of landlines are the most used forms of communication across
Emergency Departments (over 90%). It was noted, however, that landlines reported a lower level of
effectiveness than face-to-face discussions (69% vs. 82%). This may be due to the fact that landlines
require that care team members be at a fixed location – and they are frequently mobile within the
department, making it difficult to reach individuals.
The survey also noted the rising use of mobile phones within the Emergency Department (79%), which
respondents believed were nearly as effective as face-to-face discussions (79%). While not as prevalent
in Emergency Departments, with just under 50% indicating the use of secure messaging, many reported
that this newer technology was more effective than just mobile phones (80%). These newer solutions
are often mobile. Respondents reported walkie-talkies/radios are nearly as effective as landlines, but
the survey saw the use of these limited (32%). Often this technology is limited to communication with
in-bound ambulances or onsite security personnel.
Another emerging area of real-time communication is the use of video. Only 28% of respondents replied
that video was being used. Respondents were mixed on the effectiveness of video (close to 50% either
way). This is contrary to later questions about the effectiveness of tele-medicine programs (which
8. involve video) in improving communications. While the study did not explore the reason for this
discrepancy, the mixed response may be due to the mix of early generation tele-medicine technologies
and the emergence of newer smart phone/tablet-based solutions.
Respondents were also asked about the negative impacts of using specific communication technologies
on the team (e.g. impact on efficiency or costs). Real-time communication methods received the lowest
reports of negative impact, with nearly half of respondents reporting no negative impact and the
remainder indicating scattered impact on provider and satisfaction for some of the newer technologies
(21-25%), likely indicating adoption challenges. Respondents reporting on face-to-face and landline did
indicate an impact on staff time (17%) and efficiency (21%).
Non real-time (or delayed) communications are used throughout the Emergency Department to notify
team members of the need to respond to a request from someone else on the team, a patient, or new
emergency. A number of these communications are also used to “leave a message” for a clinician for
follow-up later. Most of these methods were rated much less-effective than real-time communication
methods. Unlike real-time communications, several of these methods were reported with negative
effects for more than 25% of respondents.
In particular, respondents reported that voicemail, answering services and pagers negatively impacted
patient satisfaction. These communication methods are often used for contacting physicians to request
patient callbacks, complete orders, or consult with other physicians and clinical staff on patients. 32% of
respondents reported that getting a response from a physician is a communication challenge. Overhead
paging was also reported to have an impact on patient satisfaction. A number of studies have shown the
negative impact of noise levels in the hospital due to overhead paging systems, which impact patient
satisfaction during their stay.
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Pager Fax Voicemail Answering
Service
Overhead Email EMR Secure
Messaging
Non Real-time Communications
Prevelance Effectiveness
Non Real-Time Communications
9. Those reporting on the effectiveness of the EMR in communication (which is typically used throughout
the patient stay to document/communicate about the patient) found it slightly less effective than secure
messaging (88% vs. 77%). They also indicated that EMR usage has negative impact on the care team
including costs (staffing, resources, and other expenses) (49%), physician satisfaction (39%) and staff
time (35%).
Many Emergency Departments have implemented numerous workflows in order to improve patient
flow and care team communication. While most have shown to improve communication effectiveness,
those which require infrastructure changes such as embedding imaging or labs into the Emergency
Department are less frequent. Many hospitals (75%+) indicate they are implementing Fast Track for low-
acuity patients and pre-hospital assessment for high-acuity patients, while nearly 60% of hospitals
indicated the rising use of tele-medicine (using voice, video and image sharing to assess patients). These
programs were also rated as having the most effective impact outside of infrastructure changes within
the hospital.
Impact of ED Workflows
10. While many hospitals reported a positive impact of new workflows on care team communication, survey
results indicated continued room for improvement. For example, of the emergency departments
reporting the use of Fast Track (63%), 78% reported wait times for patients first seeing a physician at
over 30 minutes and 50% reported no improvement in that measurement in the last 12 months.
Use of Personal Mobile Communications Increasing
50%
28%
47%
Fast Track Impact on Wait Times
Over 30 minutes and Not
Improved
Over 30 minutes & Improved
Under 30 minutes
Over 30 Minutes
Unimproved in last 12 months
Improved in last 12 months
Under 30 Minutes
11. Survey respondents reported that the most effective forms of communication included face-to-face
(rated the most effective), secure messaging, mobile phones and the EMR. As noted earlier, many times
team members cannot have a face-to-face conversation and need to communicate more than the non-
real-time communication available via the EMR. The combination of mobile phones and secure
messaging (typically available via mobile devices) were the closest in effectiveness to face-to-face. This
combination supports both real-time, notify and non-real-time communication methods. Most
respondents indicated no negative impact of using those methods (nearly half of respondents). EMRs
were also indicated as an effective communication method, but with some drawbacks, with nearly half
of respondents indicating increased cost from staff time to use the EMR and 4 in 10 indicating that the
use of that method negatively impacted physician satisfaction.
Along with the rise in mobile devices, one of the challenges hospitals have had to face is whether to
allow and support physicians and clinical staff using their own mobile devices in managing patients.
Respondents indicated the increasing acceptance of physicians and clinical staff bringing their own
devices to work. In addition, over three quarters of respondents indicated that using personal devices
for communicating clinical information had a positive impact.