Based in Sioux Falls, South Dakota, Avera Health serves a population of almost 1 million through 36 hospitals and almost 300 other clinics and care facilities across a huge, largely rural geographic area: 72,000 square miles in South Dakota and four neighboring states. This makes for some unique challenges, and communication is a big one, as it is for many health care systems.
Up until 2014, Avera providers, nurses and other staff relied on the usual assortment of legacy communication tools to keep in touch. Supervising nurses, for example, carried three pagers and a clunky mobile phone, a situation that made them feel like Tim “The Tool Man” from the show Home Improvement, says Candice Friestad, Avera’s Director of Informatics, and a former critical care nurse herself. “They came to us and said, stop this,” she continues.
A multidisciplinary team that included providers and caregivers, as well as administration and IT, considered the various options, ultimately choosing to pilot Voalte Platform™ for alarms, voice calls and secure text messaging. Since the pilot, the platform has been rolled out at multiple Avera hospitals, and plans are to implement it systemwide by 2020.
Solving problems near and far
Due to the large area Avera serves, physician specialists, such as cardiologists, nephrologists, psychiatrists and others, may need to visit up to 55 sites. And, of course, they sometimes need to consult with other physicians. The Voalte Me™ app has proven invaluable for this, as it allows them to use a single smartphone – their own – and still securely share text messages and images with other members of the care team. Almost 1,000 Avera providers are using Voalte Me right now.
Avera also operates a telemedicine center to better serve its remote patient population, and the Voalte Messenger™ desktop application is in use there. Other desk-bound staff also use it, including those at nursing stations and in Avera’s many ambulatory clinics and long-term care facilities.
Floor nurses and other mobile staff use the Voalte One™ app on shared smartphones. Thanks in part to the integration of Voalte Platform with other systems, including the Meditech EHR, Connexall middleware and Rauland nurse call, Avera has seen some striking results. For example, once a discharge order is entered into the EHR, Voalte Platform leverages the middleware to simultaneously send it to the unit, charge and bedside nurses, pharmacist and pharmacy tech, respiratory therapy, case management, and social workers. One hospital in the system has seen average discharge time drop by 25 minutes.
Another statistic Friestad and her team looked at was missed orders. A survey done before the Voalte Platform implementation showed that 100 percent of the respiratory therapists were missing at least one therapy or medication order per day by at least 30 minutes. The system in place at the time required them to check the printer or EHR for orders every few minutes, but competing demands often made that difficult. Now, with Voalte One, those orders go directly to the therapist’s assigned smartphone. The post-implementation result? Only 11 percent of therapists reported missing an order by 30 minutes.
Planning is key
Friestad maintains the Voalte Directory’s capabilities are equally important to efficient operations. For example, she says, “The role assignment function is particularly helpful in our many smaller facilities, where caregivers typically rotate among multiple functions.” This capability ensures all roles are covered and makes it clear who is filling each role on the current shift.
“Similarly,” she continues, “the room assignment function allows physicians to immediately identify and communicate directly with the bedside care team. And because physicians can assign themselves to patients, or roles or teams, anyone on the care team can quickly and efficiently reach the proper physician.”
To enable Voalte Platform to reach its full potential in a given setting, Friestad stresses, it is vital to observe a few guidelines in the planning stages:
- Work with clinicians and IT to be sure you have a wireless and security infrastructure that is robust enough to ensure reliability.
- Involve your bedside caregivers and other users when planning their new workflows.
- Make sure the Voalte Directory is easy to use, supports clinical workflows and helps standardize communication across disciplines – and, if necessary, among facilities or even across state lines.
- Set up appropriate pathways for communication handoffs and alarm filtering to avoid miscommunication, expedite responses and avoid alarm fatigue.
Scott Bettner is Area Sales Manager at Voalte.
Photo: Loren Townsley / Argus Leader