These days, there are few things that get me angry. Life is going well - Voalté continues to flourish, I have great family and friends, and I get to wear the coolest outfit in the industry everyday to work. Let me tell you, these pink pants are comfortable! With the exception of my Florida Gators struggling in football, life is good!

However, on January 9, 2012 Eric Wicklund published the following quote in an mHIMSS article about the SpectraLink 8452:

"Emerson says nurses are often left in the background when hospitals develop communication strategies…the 8452 is ideal for providers who have followed a "just good enough" policy for their nurses".

I don't normally call-out other vendors, but this article INFURIATED me.

"Just good enough" policy for their nurses???

I couldn't believe what I was reading.

Beyond claiming this device was "setting the bar" in any category (this phone probably has the tech spec's of a 1990's cellular phone), this company has the audacity to infer that hospitals should undertake a "just good enough" strategy for their nurses. This is contradictory to everything we stand for at Voalté and we aren't going to let this slide without calling it out.

I know if my friends or family are in the hospital, I don't want a nurse with "just good enough" technology taking care of them. I want a nurse that has the best tools and technology possible to take care of my loved ones. Our nurses have extremely demanding jobs and deserve the best - especially when the cost of the best is about the same as "just good enough".

Settling for "just good enough" isn't going to cut it anymore.

So as we kick off the New Year, I have one simple question for you and your administrative team: Is 2012 another year your hospital settles for "just good enough" or is 2012 the year your hospital steps up and makes sure caregivers have the best tools possible to do their job?

There is no time like the present to make the change… and we at Voalté are ready to help every step of the way.

Cheers to a great 2012!

No matter where I go when donning the Voalté scrubs, people stare, and often times (while smiling) ask, "What's with the pink pants?"

This is especially true when attending events such as trade shows, networking meetings, conferences, or even vendor fairs. Curious parties from both IT and clinical pass by to see, use, and demo our unique clinical communication tool – Voalté One.

In addition to Voalté, other vendors are in attendance as well, however, the usual suspects are typically in suit and tie, and as always, my colleagues and I stick out like a horse in a herd of ponies in our pink pants.

So, what's with the pink pants you ask?

It’s not only an expression of our quirky personality and the spunk that we bring to the healthcare industry, but also an external view to what differentiates us as a Company. When we first set-off to start Voalté, we turned to our development partners for some guidance. One of the overlying themes was that there wasn’t a Company that provided exceptional customer service. What we quickly recognized was that there was no Disney, Starbucks or Zappos in terms of the service experience provided by traditional healthcare vendors, and knew that this would be Voalte's opportunity to clearly differentiate itself – which we have.

Our mission is to set a new standard in point-of-care communications, and a key component of this mission, if not THE key component, is the user experience. Part of this experience is our company uniform (i.e. the pink pants and black scrub top) so that besides being memorable in events such as the ones above...we’re also easily identifiable and accessible when we’re out at your hospital during each phase of go live, clinical training and support, or when your Voalté Care Specialist comes back in each and every week to make his or her rounds. It’s part of our promise to make sure that your Voalté experience is nothing short than exceptional. 

Why telephones are the wrong solution for hospital communication.

When you’ve been in the computer software business for as long as I have, some themes tend to come back over and over again. During a recent presentation at a prominent hospital, I was asked, “With what wireless telephones do you compete?” Before I knew it, I time warped back to the 80’s to my Apple days.

I was in charge of Application Software at the time and in talks with a large corporation about the benefits of using an Apple II. The COO, leaned back in his chair and asked,“So Rob, tell me what this Apple II can do that I can’t already do on my Wang Word Processor or my IBM Selectric typewriter.” 

Looking back, I now see that he was asking the wrong question. Apple II computers were not some glorified word processor. They were multi-purpose productivity systems that could type letters, keep the books, prepare proposals and analyze financial statements. He should have asked, “How were desktop computers going to transform my business?”

That’s where the difference between telephones and smartphones come into play. Telephones only do one thing and are slowly becoming a thing of the past. Smart phones are like desktop computers that fit into your pocket. And when you think about it, legacy telephones require that both parties (caller and recipient) be available at the same moment to properly communicate. 

In busy hospitals, this is seldom the case. Caregivers are busy with patients, or family members, or physicians, or pharmacists, or phlebotomists or…a million other things. No one is sitting at a desk waiting for the phone to ring. So buying a telephone, even a wireless telephone, is like buying a Selectric typewriter in 1980 at the dawn of the computer revolution. Do you want to be on the wrong side of the tipping point? Do you think that hot new EMR application is going to run on a telephone?

Popular Mechanics just named the smart phone the number one gadget that changed the world - ahead of television and the bicycle. Smart phones didn’t achieve this because they are better telephones, but because they are changing the meaning of computers…and communication…and business…and education...and…you get my drift. 

Learn to ask the right questions. How are we going to change the meaning of communications among care teams? What amazing things can we expect these highly mobile pocket-sized computers to do and how will it change the patient experience?

Recently, I was privileged to be part of a workflow redesign team for a 75-bed ECC at one of our hospitals. The department had assembled a 20-person cross-functional team to streamline the ECC intake process. Their goal was to improve patient satisfaction scores by improving the time from patient arrival to head-in-bed, with a target goal of 30 minutes.

Because Voalté was being introduced into the department around the same time, we were invited to observe and provide insight into how our communication flow could assist with the project. One specific conversation caught my attention. One of the participants asked “Well, couldn’t we just Voalté them for that?” The others nodded slowly as they turned to me for assurance. “Voalté them?” I was surprised by the choice of words. Before I could answer, another person interjected “Oh yeah. We have Voalté on our floor and we Voalté them every time we have an XYZ problem.” 

What caught me off guard wasn’t the use-model or the problem they were trying to solve with Voalté - it was their use of “Voalté” as a verb. After this encounter, I felt like I heard the same thing at every hospital I visited. I took part in a go-live recently, and within days of using the system, staff members were saying things like “Don’t worry, I’ll Voalté you” and “Please hold while I Voalté that nurse.” How does such a term enter the nurse’s lexicon so quickly?

The only reasonable explanation is that this solution quickly becomes the default form of communication within the hospital almost in the same way that “Google” has come to mean “to search for something on a search engine.” By no means am I trying to compare Voalté to the size or success of Google, but like Google, we’ve chosen a niche problem (Google with search, Voalté with communication) and spent countless hours making it very simple to use. The result is a tool that becomes invaluable to the caregiver’s daily workflow. The fact that Voalté - the noun - enabled that workflow then becomes an afterthought.

Unlike Google, I think everyone at Voalté welcomes this phenomenon. For us, the transformation of the word implies widespread value within the hospital and therefore marks a milestone. It’s another sign that we’re accomplishing the goal set forth in our mission statement: 

BETTER COMMUNICATION MEANS BETTER CAREGIVERS

I love teaching and presenting to groups because I always learn something valuable.

I recently presented at the Florida Sterling Conference for Performance Excellence in Orlando, FL and I was able to share best practices and network with top executives from world-class companies. The annual conference focuses on business excellence and process improvement using the Malcolm Baldrige National Quality Award framework. The week of concurrent workshops culminates with companies being honored by the Governor of Florida for attaining world-class status by aligning themselves with the Malcolm Baldrige National Quality Award business model.

The presentation I delivered was entitled “Redefining the Customer Experience”. I have presented at this conference many times before while working as Director of Organizational Effectiveness for The Ritz-Carlton Hotel Company. This year I had the honor of presenting on behalf of my new organization, Voalté. I was pleased to find that although I was representing a different company, many individuals who had attended my workshops in the past were able to find me and participate in the session.

As part of the workshop, we were discussing what makes service great. This quote always puts this into perspective for me. “Great service is only great if your customer thinks it is.” Many individuals in the workshop shared examples of how their organization brought this thought to life. I was particularly impressed with one individual’s comment. She described a scenario and went on to say that because she works for a governmental agency, she has many restrictions on what she can and cannot do for her customers legally. The part that really struck me was that her organization took a situation that was consistently perceived as a negative experience by the customer and turned it into customer delight. The example that she shared with me was about how they made the waiting room experience more comfortable. They provided shawls for women just in case they got cold and had extra pairs of glasses for those who weren’t able to read their paperwork.

Others went on to share similar incredible stories. I even learned that there is a city in Florida that has a car dealership with a nail salon and neck massage services inside. All of these ideas really reinforced what Voalté already knows - “Legendary service does not have to cost a lot of money!”  

What are some things your organization has done to improve customer service and enhance customer experience?

When I heard that the National Patient Safety Foundation was celebrating Patient Safety Awareness Week this week, my first thought was "Great. What about the other 51 weeks out of the year?" If there were ever a time to get really sick and get rushed to the hospital, this would be the week to do it!

But patient safety is no joking matter. When the New York Times wrote about patient safety in hospitals last November, I don't think anyone in the healthcare field was surprised with the study's findings. The general public, on the other hand, was shocked to read that medical mistakes cause as many as 98,000 preventable deaths and over one million injuries a year. An even more shocking way to look at it is the oft-repeated phrase: "Hospitals kill a jumbo jet full of patients every day due to medical errors."

Studies attribute a large portion of these errors to poor communication and The Joint Commission has even stated that inefficient communication is consistently the root cause of sentinel events. It's no surprise then that the goal for the patient safety campaign is to improve patient care through better communication.

This is something that has always been a core value for Voalte. In fact, improving communication and patient outcomes is part of our Mission Statement. However, regardless of whether it's through Voalté or another system, hospitals need to think about their communication strategy as it relates to patient safety. The technology afforded by smartphones and other mobile devices, while certainly cool, is merely the enabler to improved communication. Think of it as trying to lose weight by buying a workout video. The video is the tool for success, but it's up to the viewer to watch the video, follow the routines correctly, and supplement it with a healthy diet. With the right communication diet, perhaps we can turn that jumbo jet into a little Cesna.

Hospitals all over the country are thinking about patient safety this week and communication plays a big role in that. Below is a fun video from UMC on the subject. Sometimes humor gets the message across more than you think. 

What's your hospital doing for Patient Safety Awareness Week?

Every month or so, the Voalté staff gets together to review our most recent deployments and current implementation projects with the goal of taking away lessons learned. What worked? What didn’t work? What was overlooked? What was unnecessary? Did we overcomplicate any aspects? What areas did we underestimate? Mistakes are ok, provided that you learn from them. This is a great exercise that ensures just that.

During our last meeting, we decided to change things a bit. Coming off a very successful deployment, we instead asked ourselves “What did we do right?” Why did this deployment go so well? How can we replicate this go-live over and over again? We looked at it from every angle:

ü  Total buy-in from all stakeholders at all levels? Check.

ü  A clear project plan? Check.

ü  Meticulous attention to details? Check.

ü  Solid documentation of Current State / Future State workflow? Check.

Yet time and again, the discussion returned to the project manager assigned by the hospital. There was no denying that she played a big role in the success of the project. Sally Reeves was absolutely exceptional.

But what was it about her and how do we replicate that success? I recently came across an article by MIT Sloan Management Review titled “How to Prevent Your Customers From Failing” that answers that question much better than I could possibly attempt to. While it is a few years old, it is still just as relevant today and should be considered mandatory reading for all healthcare implementation projects. I was so inspired, in fact, I copied the title of the article for this blog post.

The premise is simple: Customers that are actively involved in the design and delivery of the goods and services that they purchase are considered “co-producers.” They impact the quality of their own experiences and influence the satisfaction of other customers. As a result, hospitals play a key role in the success of the systems and services they purchase.

“Wait. We’re paying you all of this money to install your solution and you’re telling me that if it fails it’s my fault?”

Well the short answer is maybe. Implementation projects need to be considered a partnership between the hospital and vendor (or maybe, in the spirit of Valentines Day, a romance). Stakeholders on both sides need to be fully committed and in sync with the same vision. Consider these all too common scenarios for a minute:

·      Project Manager goes to the Network Admin to get an IP Address created for new servers being installed. The Admin responds with “I just can’t right now. The XYZ project is my priority and I don’t have any bandwidth.”

·      Security changes need to be made to the firewall, which are sent to the Network Security guy. After 3 conference calls to understand why we’d dare question his security settings, he agrees to make the required changes. Three weeks later, he confirms he made all of the changes. Testing begins and you discover that not all of the changes were in fact made.

·      A decision is made at the top to pilot a new product in a specific unit. A week before go-live, the Manager and staff on that unit are brought into the project discussion for the first time.

·      Databases, workflows, and templates are created for clinical staff without any input from clinical.

Of course, the article does state several times that a clear difference exists in perceptions of the cause of failure. Customers often believe that the vendor could have done more to prevent them from failing. I’ve previously written that even when it’s not your fault, it’s still your problem and this is no different here. It’s why we put such an emphasis on identifying potential customer failures and understanding their root causes when they do happen—to put the project and customer in the best position for success.

A husband and wife bring their two kids to the Magic Kingdom and spend a day creating memories that will last a lifetime. As they leave, exhausted, with cranky tired kids in hand, they get to the parking lot. The husband asks the wife “where did we park?” to which she responds “I told you to write it down…” [Insert screaming kids and arguing adults here]

For most people, the idea of software development is somewhat of a black art.  So consider this: if you’ve ever experienced homeownership, you already have a sense of what it is like to manage software development. 

For starters, you’re familiar with a fixed deadline:

“You really need to get the plumbing sorted out by Sunday night.”

You know about changing requirements:

“I didn’t know it was the wrong color until you finished painting the house”. 

And you know that mistakes are expensive:

Cutting the new bathroom door too small = buying another bathroom door.

Given these challenges are taxing enough in the domestic realm, how does a company like Voalté manage these same challenges in the complex world of software development? And how do our developers keep it all straight when they are delivering code for three endpoints (iPhone, Blackberry, web client), and two servers (voice & data) in a mission critical environment such as a hospital?

The answer is through a process called Scrum. The idea behind Scrum is fairly simple: develop software incrementally in iterations that last two to four weeks.  These iterations, referred to as Sprints, allow the Team to add new features on a frequent basis, with each iteration resulting in a shippable release. Perhaps the greatest advantage of Scrum is to the business itself, through the ability to quickly adapt to changing requirements and customer preferences.

Compare Scrum to the traditional model of software development (Waterfall):

1. Spend six months conducting market research

2. Spend another three months writing the product specifications

3. Hand requirements over to the Engineering Team (with great ceremony)

4. Engineering Team develops the product for a year.

5. Software is passed to the Quality Assurance Team (more ceremony)

6. Then the long slog as the product is debugged, often with limited success.

7. Finally the product is launched (greater ceremony).

Here’s where the real heartbreak is.  By this time the product is launched, the customer’s needs have either changed, or the customer now realizes that with the product in hand, they really wanted something else in the first place (see “wrong color” above).  Compare this to Scrum -- a working product, although not fully featured, is released to the customer far sooner, when changes can be made more easily and less expensively (bathroom door).

There are three main roles in Scrum.  The most central role is held by the development Team (typically seven members).  The Team is self-organizing, meaning that Team members decide how the problem is to be solved, and who is to complete what tasks.  Scrum is a “pull” based process, meaning the Team commits to only as much work as it believes it can complete during the Sprint.

The Team pulls work from a list called the Backlog.  The Backlog is composed of several user stories, which are effectively new features to be added to the product.  An example user story follows:

As a clinician, I want an easy way to send my most commonly used text messages, so that I do not have to retype the same message over and over again.

The backlog is created by the Product Owner, who is responsible for the commercial success of the product.  The Product Owner writes the user stories and prioritizes them by business value.  The Product Owner also has the responsibility of reviewing and accepting work completed by the Team.

The final role in Scrum is the Scrummaster.  The Scrummaster facilitates communication between Scrum participants, removes impediments, shields the Team from interruptions, and ensures the Team is on track to complete the work it has committed to. 

One of the most powerful elements of Scrum is the process of continuous improvement.  At the end of each Sprint, the Team reviews what went well and what didn’t, and then uses this feedback to improve the next Sprint.  This feedback loop is just one of the reasons highly effective Scrum teams see productivity levels at 5 to 10 times the industry average*.

Scrum, born from the shortcomings of the traditional Waterfall process, traces its roots a variety of influences, including lean manufacturing techniques, process engineering, and behavioral science.  Designed to be lightweight, easy and fun, Scrum is realistic enough to be adopted by even the most skeptical engineering team.

Now if I can just convince myself my next home improvement project will be lightweight, easy and fun…

* http://jeffsutherland.com/scrumpapers.pdf

My name is Caston Thomas and I am the North Central Sales Representative for Voalté; a job that I love. When was the last time you had one of those situations where the reaction you got from someone was mind-blowingly unexpected?  I was telling a friend of mine about what we were doing at Voalté  and about the problems we help solve with caregivers.  She started to sob.

Now, I’ve got a great circle of friends.  They’re a supportive and wonderful group of people.  So, when I’m on a roll, going so far as waving my arms with excitement as I talk about what I do, I don’t expect the reaction to be crying with obvious sadness.  These were not tears of joy.  But when you hear the rest of the story, you’ll understand, just as I did. 

You see, my friend is a respiratory therapist.  She works hard at her jobs.  She floats between two hospitals and works long hours but enjoys what she does so much that I don’t think I’ve heard her complain about her work even once.  She entered into the profession to touch peoples’ lives - to really make a difference.  It doesn’t take long when you meet her to know that she loves what she does.

That evening, “Ann” told me a story - the reason my excitement brought back a painful memory – the event that almost caused her to leave the profession and the one that caused her to struggle with “burn out” for a couple of years.  As best I can retell her story, “Ann” was in the ER one evening.  She had been called down to help an elderly gentleman that had been brought in by ambulance.  He was having serious problems breathing – complications from pneumonia, if I recall correctly.  It was late at night and his family had yet to arrive.  Well, the man entered a state of serious respiratory distress.  He was drowning on the bed and there was little she could do.

“Ann” told me there was one chance in a hundred that he would be alive if she left the room to find the people and equipment she needed to save the man’s life.  In one short moment that seems like a lifetime, “Ann” had to make a single, gut-wrenching decision.  “Do I leave this man alone, almost certain that he will be dead before I’m able to find what I need to save his life?  Or do I stay with him so he doesn’t die alone?”

“Ann” told me, just as I’m sure she’s told a hundred other people, about looking into this gentleman’s eyes as he died – the panic, the confusion, the desperation.  I don’t know this, but as she told me her story, I was imaging that the pain I saw in her eyes was a replay of what she saw that evening.

“Ann” said she still wakes up from time to time, this man’s eyes haunting her in a nightmare.  I must confess that I can’t even pretend to understand what she’s gone through.  That event happened many years ago and it still affects her tremendously.  I have never brought it up again.

As much as I don’t want to believe this, I’m afraid that just about every nurse that has been in the profession for a while has a similar story.  I admire every single person that has dedicated himself or herself to the nursing profession. 

Working at Voalte gives me the opportunity to impact people’s lives.  I know that I am improving the lives of the caregivers I serve.  Indirectly, I know that I’m helping to create an environment where every patient and every family member has a better experience, even if it is under very difficult circumstances.  Thank you.  It is a privilege to serve you.