How Sharp Memorial Hospital modernized its ED workflows and communications

When inefficient workflows and antiquated communication tools are added to an already-stressful emergency department (ED) environment, physician burnout increases, and both staff and patient satisfaction plummets.

In a March Becker's Hospital Review webinar sponsored by TigerConnect, Jessica Carlson, MSN, RN, clinical nursing support manager at Sharp Memorial Hospital in San Diego, described her organization's workflow and communication challenges, how TigerConnect helped resolve these difficulties, and results Sharp Memorial has achieved. 

Four key takeaways were:

1. Sharp Memorial had unique ED complexities. Besides the typical complexities associated with an ED, Sharp Memorial also had a complicated call system involving three large medical groups,  antiquated communications pathways, and inefficient workflows. 
   
   According to Ms. Carlson, this 62-bed emergency department and Level II trauma center had not focused on physician-to-physician communication prior to initiating a project to modernize communication and workflows. "We believed this could be fairly straightforward and could potentially have significant impacts," she said. "We started by looking for opportunities to optimize efficiency."
   
   Carlson shared this ED to Inpatient workflow example to illustrate the previous communication process: Once a physician decides to admit a patient, the physician asks a clerk to page the hospitalist. The clerk reviews which hospitalist is on call and notifies the hospital operator, who sends a one-way pager notification with limited information to the hospitalist. The hospitalist calls the clerk back, who then puts the call on hold to find the ED physician. By this time, the physician may be pulled away to assist a different patient. "There were too many people involved, too many interruptions, and too much time spent waiting by all parties," she said. "We learned that at least 20 percent of the time, the hospitalist took 15 to 20 minutes to return a page to discuss an admission. This is zero-value-added time."
   
   
2. Sharp Memorial implemented TigerConnect to provide two-way, HIPAA-compliant communication, simplifying the existing workflow. "We needed to streamline and modernize the workflow by reducing the number of people involved and leveraging HIPAA-compliant technology,"  Carlson explained. TigerConnect provided a two-way closed-loop communication between physicians on their cell phones and an integration with the hospital’s physician scheduling tool to ensure the right doctors were getting notified at the right time. Widespread implementation and adoption took only two months.
   
   
3. TigerConnect has helped Sharp Memorial improve response time, decrease delays and streamline physician on-call assignments. "Since implementation, we have seen a 72 percent improvement in the average response time for all admissions; the average response time is now 3.2 minutes," Ms. Carlson said. "The solution automatically switches from the outgoing physician to the oncoming physician during on-call changes, requires a single sign-on, and allows for group messaging and forwarding. It has helped reduce physician burnout and improved patient satisfaction. The impact of TigerConnect has been dramatic."
   
   
4. Critical success factors included having executive support, forming a multidisciplinary team, and setting pre- and post-implementation metrics. "It was important that we had a commitment from leadership to seek out a solution to fix an age-old problem," Ms. Carlson said. "Collaborating with a multidisciplinary team and having shared decision-making contributed to the success of this project. Pre- and post-implementation metrics for response time helped secure physician buy-in and adoption. Finally, having ED leadership set clear expectations that TigerConnect will be the primary method of communication going forward was huge."

By implementing a HIPAA-compliant, clinical communication and collaboration platform like TigerConnect, hospitals can improve ED throughput and reduce ED overcrowding with a streamlined ED admissions process. Efficient ED workflows remove communication gaps – leading to an increase in ED capacity, reduced length of stay and improved provider and patient satisfaction. 

To register for upcoming webinars, click here.