Healthcare communication can be a complex process even at the smallest hospitals, where nurses and physicians may struggle to connect on important matters of patient care. Large, academic medical centers take that complexity to a whole new level, with intricate workflows involving nurses, therapists, support staff and a wide rotation of physicians who cover numerous roles on any given shift.
In October at VUE17, the Voalte User Experience conference, Whitney Chadwick, MD, Pediatric Hospitalist at Lucile Packard Children’s Hospital Stanford, shared her experience as chief resident during the transition from legacy phones to Voalte smartphones.
Every July, this prestigious teaching hospital sees an influx of hundreds of “housestaff,” new physicians who have recently completed medical school or residency but are not yet board certified in their specialty of choice. Interns, residents and fellows rotate through multiple clinical areas before moving on and making way for the next wave of recent graduates.
“New housestaff have limited clinical experience, and are entering a brand-new environment with a steep learning curve,” said Dr. Chadwick. “They are learning volumes of medical knowledge, the art of working with patients, how to lead a medical team – all while also trying to function in incredibly complex institutions. From memorizing the layouts of enormous hospitals to figuring out how to use a new electronic medical record – it’s overwhelming. And we ask them to do all of this while promptly answering pages, texts or phone calls every few minutes. Most communication involves minor events, such as a patient needing Tylenol, but about 10 percent can involve a clinically urgent or even life-threatening issue. Prioritizing communication with multiple other team members can be extremely stressful for trainees as they often have limited clinical experience and institutional knowledge to draw from, and they often must communicate up and down the chain of command before making a decision.”
When the hospital replaced legacy phones with Apple® iPhones running Voalte Platform, staff response was overwhelmingly positive. But there were some challenges, which Dr. Chadwick shared at VUE17, along with the solutions she recommends for other teaching hospitals:
- Implement smartphones in late winter or early spring. Due to the high volume of staff turnover at teaching hospitals every summer, Dr. Chadwick recommends introducing new technology at times of the year when housestaff are more settled and adapted to their surroundings, but still allowing time for existing housestaff to adapt to the new technology before having to orient the next batch of trainees arriving every July.
- Take time to set up the directory. Reaching the right physician or nurse quickly depends on being able to find them easily in the smartphone directory. Housestaff pose unique challenges because they assume many different roles, and each role has its own distinct phone number. By involving the chief residents and/or residency and fellowship program directors early in the process of planning a new communication platform implementation, you can build a directory that is effective for each clinical workflow.
- Build mass on-boarding and off-boarding systems. When housestaff arrive in July, they go through orientation and training, learn how to use the EMR, and get their white coat and identification badge. Dr. Chadwick recommends including smartphone procedures and protocols as part of that orientation, so housestaff can log in on their first day.
- Evaluate current communication standards and culture pre-implementation. Consider how physicians and nurses communicate using existing systems before introducing smartphones and creating new communication guidelines. The Lucile Packard team set clear rules dictating that secure text messaging should be used for brief, non-urgent, non-time-sensitive communication, while paging or phone calls are more appropriate for urgent situations.
“We are at an exciting point in time, uncharted territory in the world of healthcare communication. Voalte has harnessed smartphone technology to fundamentally change interdisciplinary communication. Our next task is to begin to study and understand the impacts of this tremendous technology on patient care and provider well-being. We look forward to continuing our partnership with Voalte in this effort,” said Dr. Chadwick.
We welcome the opportunity to work with customers such as Lucile Packard Children’s Hospital to evaluate their unique needs, accommodate their particular workflows, and connect care teams with the EMR to ensure those with patient permissions have access to the most up-to-date information. Whether a small community facility or major academic medical center, every hospital can benefit from those improvements.
Austin Paramore is Area Sales Manager for California and Hawaii at Voalte.