When disruption affects an industry, we feel beholden to our choices. We either take a leap of faith and adopt whatever shiny, new technology promises to solve all of our problems, or we turn in fear, afraid of what implications we may fall victim to. It’s hard to see that we have a third choice, because it is one that requires discipline—discipline of relationship. Discipline of relationship means defining the challenges and problems of our current situation while also exploring what is an acceptable solution to our problem. If the acceptable solution is innovation, despite known issues, we can lower our risk with the knowledge that it is solving a larger issue.
With this liberation, we can open doors for new solutions with a foundation in technology, ready to meet the demands of the informed and enabled. Such technologies offer benefits with irrefutable productivity and performance improvements. These benefits are being echoed by the customer experience in improved Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey scores, coordination of care, staff efficiency, attraction of talent, reduction in length of stay, readmission and other measures.
Those committed to innovating are joining an ever growing group. But being a pioneer in any arena doesn’t come without its own responsibilities and fear. Ignoring the movement will be detrimental to an organization’s vitality. Leaders who can quickly move beyond the disruption and embrace innovation are paving new paths, building new systems and providing a continuum of care with a heightened focus on the patient’s needs.
The Importance of Transitioning from Reactive to Proactive
It’s easy to get into the habit of constantly reacting to issues as they surface. Focusing on everyday challenges becomes a distraction and damages productivity. Organizations stuck in these patterns risk losing sight of the bigger picture and the future of the organization. Just like doctors tell their patients to exercise and eat right in order to prevent future health issues, organizations need to take the appropriate steps today to help secure their future tomorrow.
Many examples of disruption in the healthcare sector involve replacing existing technology that simply cannot keep up with the technological efficiencies of newer and more robust solutions.
Embracing certain disruptive innovations is a key component in pursuing a proactive position. Many examples of disruption in the healthcare sector involve replacing existing technology that simply cannot keep up with the technological efficiencies of newer and more robust solutions. Champions of innovation programs aimed at improving the customer experience do not dwell on obsolete technology; instead they focus on the improvements made possible by new technology regarding patient care and cost. Senior executives need to define a clear vision of the future of their organization to ensure all responses are strategically aligned with that vision.
An organization’s strategic response correlates in part to the components that are adopted. It means embracing technology that will transform the efficiency of care as well as increase productivity. Moreover, patient care is ultimately enhanced on top of promoting an environment where employees can thrive.
Take for example patient room dry-erase boards. They have been widely adopted for a major reason—the healthcare industry realized that a patient who understands their care, is a patient that will have a better experience. They also improve the coordination of care across staff, including physicians, nurses, CNAs, case managers and others on their care team. When accurately completed, “…whiteboards have been shown to provide as much as a 50 percent reduction in errors, and a 73 percent increase in patient and family understanding of the treatment being given.*” However, whiteboards have proven not to be the silver bullet that providers have been hoping for. The challenges include the whiteboards not being filled out in their entirety or at all, illegible handwriting, using acronyms only the nursing staff understands and even missing dry-erase markers.
With so many challenges, why do providers keep the boards? Clinical studies show properly and fully filled out whiteboards improve the experience of the patient, thereby improving the bottom line for the hospital. These improvements though, are only seen during initiatives directed toward having the boards filled out in their entirety. Failure to update information or fill out the information completely, directly correlates to time management practices among the “owners,” namely nurses and CNAs. Rightly so, because their primary responsibility is the patients and their care. In turn, this results in more impactful sentinel events and errors resulting in harm to the patient. As a consequence, patient room whiteboards have become a reactive medium in which the only time they are used as intended is when the nurses have the time to add information to them. This is a scenario in which healthcare leadership needs to shift from a reactive paradigm to a proactive one. By using discipline of relationship, certain disruptive solutions can be identified and explored. These disruptive solutions would take on the same or similar form of what was known to work, but in a more domesticated fashion that would solve the presented challenge while minimizing the risk presented by other potential solutions.
Understand the Disruptor’s Objective
The key to navigating innovative disruptors and employing them to their fullest capacity is first having full knowledge of the issues the disruptor intends to solve and being aware of both its applications and implications. This will lead to a more comprehensive understanding of the disruptor’s place within your organization and its daily impact on your patients and staff.
Think for a moment about your introduction to the healthcare field. Things probably look remarkably different today. This is because the healthcare field has experienced significant disruptions. One of the most prevalent examples is the introduction of electronic health records (EHR).
Prior to the implementation of EHR, all patient files were filled out by hand. Practitioners would spend hours upon hours handwriting all the notes pertaining to the patient’s visit. Files were not easily accessible and required a lot of storage space. Errors arose in patient care due to poor handwriting or filing mistakes. But even the EHR had a rocky start. Health facilitators imagined drawbacks that were both technical and financial in nature, while health practitioners thought, among other concerns, errors in data entry could even lead to higher patient mortality. The fear led to stagnation, but technological improvements have significantly improved and stabilized EHR systems. The book The Digital Doctor – Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age, points out that system developers have learned a lot and are making improvements every day. “In fact, many doctors and patients have forged a cranky truce with their systems, and it is nearly unheard of for a clinician or hospital that has made the switch to digital to return to pen and paper.” The result? One recent study, “…found that there was no difference in the rates of inpatient mortality, adverse safety events and readmissions in hospitals implementing EHR systems ….*”
… those embracing disruption through the discipline of relationship, are seeing improved HCAHPS scores, coordination of care, population safety, cost savings and brand image, and are growing their talent pool exponentially.
In the case of the EHR, getting out in front of the disruption is less about the Health Information Technology for Economic and Clinical Health (HITECH) Act mandate and more about having a team of leaders that understands the objectives of the disruption and successfully implements a forward-looking, proactive and preventive culture. Those entrenched in dated infrastructures and mired in the status quo are missing out on the positive impact new technologies are having and effectively passing up opportunities to attract the very best talent. On the other hand, those embracing disruption through the discipline of relationship, are seeing improved HCAHPS scores, coordination of care, population safety, cost savings and brand image, and are growing their talent pool exponentially.
The Benefits of LEAN Methodology
It is clear that disruption can be beneficial to your organization, but augmenting staff workflow, fearlessly adopting disruptions and connecting new technologies to current infrastructure isn’t always a feasible option. Embracing LEAN methods is one way to eradicate fears and instill confidence across hospital administrative, clinical and informatics teams. By establishing a small group of users and superusers to implement an initial phase of the disruptor, any potential errors or negative impacts can be minimized and contained. This method utilizes a small footprint, measuring results each step of the way and making appropriate adjustments as needed to ensure that site-wide adoption is supported. Throughout the process, periodic staff and patient feedback will confirm success or open discussions concerning better potential solutions, all while minimizing the risk that the organization assumes.
When introducing a disruptor into your organization, combining discipline of relationship and LEAN methodologies can minimize potential risk during both the decision-making process and implementation. This is evident when looking at the patient room whiteboard example.
MEDI+SIGN is a connected health platform that includes fully automated patient monitoring and digital whiteboard display solutions. When considering the benefits of the digital solution, many challenges of the traditional whiteboard are eradicated: digital boards are up-to-the-minute accurate and easy to read, take less time for nurses, improve coordination of care by using centralized data from the EHR, and the list goes on. However, there is a heightened level of fear associated with implementing the digital solution. Because the technology is new, questions may arise about the EHR integration, system support and cost, among other things. While these are all legitimate concerns, dwelling on your fears can freeze innovation and progress.
Hospital decision makers should consider adopting disruption using LEAN practices in order to improve efficiency, as St. Luke’s Hospital – Miners Campus in Coaldale, PA, has done. St. Luke’s has chosen to slowly introduce MEDI+SIGN to their hospital, replacing all existing traditional dry-erase whiteboards in just one of their many care units before a full deployment. MEDI+SIGN’s digital patient room whiteboards, along with a partner’s high-tech nurse call systems and Real-Time Location Systems (RTLS), address critical tasks relating to the care of each patient. It highlights data on patient’s fall risk, real-time mobility status, pain control and medication management plan. Furthermore, MEDI+SIGN is automatically updated by connecting to the hospital’s current electronic health records, eradicating all of the challenges of the dry-erase method, without having something new for the staff to learn. St. Luke’s hopes to improve patient safety and communication, and elevate care coordination, while alleviating the lengthy time, inaccuracies and costs associated with the manual whiteboards.
Throughout the implementation of MEDI+SIGN, St. Luke’s is collecting feedback from nursing staff, patients and other hospital administrators, as well as reviewing HCAHPS scores and other measures, to make necessary adjustments and ensure future success. By limiting the disruption to just one unit using the LEAN method, St. Luke’s Hospital is removing barriers and reducing their upfront costs and potential risk of failure.
Longtime Hospital and Healthsystem Association of Pennsylvania member and Vice President of Patient Care Services for St. Luke’s Hospital – Miners Campus, Kim Sargent, RN, had this to say about MEDI+SIGN: “For our staff, it is a time-saver; for our patients, it is a modern approach to the information they need. From patient stats to their nurse manager’s picture, patients and their caregivers have easy access to helpful information.”
Changes in healthcare are ongoing and evolving daily. Rather than resist, we must ask ourselves how we can improve patient care and provide a satisfying work environment for our staff. As Andy Carter, president and CEO of the Hospital and Healthsystem Association of Pennsylvania, noted, we must “… rise above the fray to ensure health care providers can meet new consumer demands, improve more lives, and continue to innovate ….”
See MEDI+SIGN Sponsors 2016 HAP Leadership Summit >
References:
- http://healthresearchfunding.org/whiteboards-improve-patient-communication/
- http://www.news-medical.net/news/20160729/Medical-professionals-express-fears-in-implementing-new-EHR-system-in-hospitals.aspx
- http://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/how-us-healthcare-companies-can-thrive-amid-disruption