Aone Day 2 Time Saving Medical Device Interoperability

I moved to the country....farther into the country than I already lived in my small rural town….I moved to “county”.  Outside the city limits, on acreage with a pond full of fish, land full of trees, and plenty of space to attempt to grow something larger than marble sized tomatoes.    We have learned about several things since we moved – most of which will turn into blog posts (bet you all are really excited for me to compare something to living on septic….and how much I miss the Pizza Hut delivery guy).   The biggest change for us has been time – it’s a drive to the nearest grocery, a couple acres to the next neighbor, etc.    I have started thinking – well that will take me an extra 30 minutes so I need to make this trip to “town” count.  I get very frusterated when I execute my shopping list incorrectly…I actually tried to make shrimp cocktail the other night because I forgot to pick it up – which didn’t work so I made a remoulade.     Time is our most valuable asset and we start to make decisions on what we will or won’t do based on how much time we have.

Yesterday, I posted about acuity management based on the diagnosis of the patient, and how it could be augmented by adding more information about the need that the patient is generating.   The time that you would save only happens if you balance the need index and the task list associated with caring for a patient.   Then clinicians can spend more time doing patient care and less time being interrupted. 

Today, I am posting about ways to use technology to save time.    There was a study released yesterday by West Wireless on the value of interoperability. http://www.westhealth.org/institute/interoperability  (if you go to this website you can download the full report in a PDF)  

Here is what I like about the report – it’s not written by a vendor…… West has nothing to gain by telling hospitals to invest in technology that makes medical devices interoperable with the EMR.  Second, it speaks to nursing workflow and the value of the nurses.  Did you know that nurses salaries account for $173 billion of heath care spending per year?   The report cites the 36 hospital time and motion study (It’s amazing how prolific that study has been in defining how nurses spend their time.) that indicates 35% of time is spent on documentation. (They uses a lower figure for their findings)   If I am making the correct assumption – 20% of a 10 hour work day is 2 hours per day per shift….that’s real savings.  It’s not 2 minutes or 10 minutes (always question when vendors give you savings of 10 minutes or less for a value add) The 20% they are referencing would allow for better patient care – more time at the bedside however they link it to a potential savings of  $12.3 billion dollars…..that’s where I have a slight issue.

Here is what I don’t like about the report – if I run a company that has people that I can save 2 hours per day doing a task that can be automated….the only way to “save” those dollars is to eliminate staff.  If you shift the tasks (remember yesterday’s blog – tasks associated with timeframes) then you can potentially have fewer people do the same “care.”  So, for example, to save money we would need to reduce staff by 1 which would equate to 8 hours of work tasks that need to be distributed throughout the workforce in some way.   Maybe I am looking at this wrong….but dollars and sense would say I have to reduce staff to gain the savings.

Reducing workload by 2 hours per day not only saves time but it also allows for a more time to engage with patients, do rounding, and patient centric care.   It allows nurses to engage in better patient care, more time at the bedside, and (as the study goes on to site) improve quality and safety.    The study sites a $36 billion dollar savings - $12 billion is nursing salaries.

Since it’s AONE and a number of nurse leaders have the ability to seek out new technologies that can aide in the automation of work flow of their nurses.   There are two that come to mind as industry leaders in the medical device interoperability (namely documentation)  Isirona (www.isirona.com/for-clinicians) and Capsule (www.capsuletech.com/our-solution-clinicians) . 

Isirona is three spots down from Sphere3 (we are in booth 727) stop by and chat with them.

We hope to see you today at AONE we are at Booth 727 and would like to introduce you to Aperum a mobile dashboard that allows you to identify not only the need generated by the patient but their current perception of their care.

AONE 2013 Patient Need Based Acuity

My husband ran a distribution center  for 13 years.  When we met had around 150+ employees and through automation, software, and workflow modification was able to reduce the employee count to less than 10% of that number.  His guiding principal was to break tasks down and manage the individuals according to the time it took an average person to accomplish the task.   He and his team could watch a process and identify skills sets and aptitudes that allowed them to manage the team to accomplish the goal in a timely way with a low error rate.

As I have researched acuity it seems to be a similar structure.  The DRG defines a grouping of tasks and the tasks have an associated average time of completion (geeks call this a weight) and the assignment is made based on how many “tasks” can be completed within a shift.  Then the patients are assigned to the caregivers based on the workload associated.  That’s when I started to ask questions….are we treating nurses like assembly line workers?   How does this affect how we assign them to a patient – does our technology really support the mindset?

I have watched this process at a number of hospitals, interviewed a number of managers and I do believe that it’s much more of an art than a science.    In the last few years I have also observed several production facilities - from a Milk Farm to a Coffee Roasterie to Electronics manufacture.  The thing that jumped out at me……the product or coffee bean or electronic doesn’t drive any additional demand or strain on an assembly workers day.  There are outliers where a piece of material is bad but for the most part it’s pick up the widget, put it in a box, etc.   The point is – the widget doesn’t ask for ice chips when you are trying to complete other assigned tasks....the widget dosen't code.   

I get it – there has to be a way to balance the workload of the caregiver and acuity (aka task management) seems to be the best method.  I am not trying to disregard the years of research and work done in creating the tasks associated with diagnosis, etc  but there is more here than just a task list.  We at Sphere3 believe there is a way to capture additional information to make assignment of patients easier and managing the workload more effective.  Stop by and check it out.

I am eager to see at AONE this week how many vendors try to tout their technology as a way to reduce staff….be careful with those statements…..technology should be an enabling tool the data should give the ability to manage the workload more effectively.  Patients aren't Widgets – Caregivers aren’t assembly line workers.   

If you would like to see how Aperum® can help your facility better manage workload of your caregivers stop by BOOTH 727 this week at AONE.