Time-Saving Technology Enables Staff to Devote More Time to Care
PointClickCare
Technology is exciting, but sometimes learning new technology can feel like it's taking time away from the task at hand, and when it comes to nursing, there isn't any time to spare.
But the reverse is often true. Technology offers us the ability to give time back to people and lighten their burden. In this industry, adopting new technology, when all the pieces fall into place, can make a world of difference.
My experience at Resthaven, a non-profit, community-owned faith-based organization for long-term care has taught me this first-hand. For more than 75 years, Resthaven's mission has been to serve our senior neighbors in Holland, Michigan, through a continuum of care. We have over 400 employees serving our community, which includes a 145-bed skilled nursing facility, licensed assisted living with 117 beds, and two independent-living buildings.
I've been at Resthaven for 15 years, starting as a CNA, then a floor nurse, and later, a night shift supervisor. While a night supervisor, I attended the PointClickCare Summit and discovered the importance of clinical informatics, which involves using information technology to improve patient care. Resthaven wanted to incorporate that role into their strategy, and the company created a Clinical Informatics position that I accepted in January 2020.
Getting Through Crisis Mode
My initial focus was to standardize usage and improve the consistency of technology across all our buildings and continuum of care. We'd had PointClickCare since 2015 but primarily used the platform at our skilled nursing facility, which was the top priority at the time.
In January 2020, I began to audit, build, and manage our various clinical technologies. But a few months later, the pandemic threw everything into disarray. The expectations around my role shifted dramatically as we continued accepting and caring for patients during the crisis.
I joke that for the first year and a half in this role, I was the unofficial COVID Coordinator. Everything I thought I would be doing as Clinical Informatics Coordinator was on hold so I could reallocate my time to COVID-related activities such as testing, communication, and immunizations.
In the summer of 2021 Resthaven and I spent time reassessing the goals and priorities for this position. COVID wasn't going anywhere, so we had to think differently. What would the new normal look like for us from a technology standpoint? How could we make things easier for nurses and other clinical staff? How could we help managers and social workers stay on top of the many conflicting priorities? We needed to move out of crisis mode and determine how to move forward by standardizing our processes.
We reevaluated our tech stack and eliminated anything that wasn't necessary. During that process, we realized that some solutions we had once considered out of our price range were worth it for the long-term benefits. That's why, in addition to enforcing a more uniform use of PointClickCare, we also decided to adopt Automated Care Messaging (ACM), PointClickCare Connect and maximize our use of Secure Messaging. Combining these solutions has made a major difference in our workflow.
Secure Conversations: A HIPAA-compliant Fast Track to Treatment
Our previous process for non-urgent collaboration and communication with physicians required nurses to put a request on a clipboard and wait a day or two for a response. Because of the lag in response time, the nurse replying to follow-up questions would likely be a different nurse than the one who made the initial request. Clarifying details would sometimes require additional back and forth. Meanwhile, the patient is dealing with an ailment. Just because it's not "urgent" doesn't mean it's not irritating, uncomfortable, or negatively impacting their quality of life, and this process prevented us from addressing it quickly.
With Secure Conversations, we receive physician responses within a single shift. The message goes directly to the nurse who made the request, and they can immediately complete the request or quickly answer any follow-up questions. This real-time exchange leads to better, faster care for the patient, and it saves valuable time for nurses. And with the click of a button, the conversation can be documented in the patient's chart. Secure Conversations is also HIPAA compliant, which addresses a major concern. Instead of risking fines for having patient-centered conversations over unsecured platforms, all parties have peace of mind that all sent and received messages are secure.
Once we made an effort to have this feature used for 99% of our skilled nursing residents, we saw that Secure Conversations made nurse-physician communication incredibly efficient. Our re-hospitalization rate consistently trends downward, indicating a cost-effective and outcomes driven response to better collaboration of care.
Automated Care Messaging: An Effective Way to Communicate Notifications
Another big time-saver is Automated Care Messaging (ACM), which in hindsight, would have been a big help at the beginning of the pandemic. We are required to notify families when we have a positive COVID case and a weekly family update. We used to update families via email, but not every contact has an email address, so we had to make phone calls to many families.
Given the subject matter, these calls could turn into tough conversations. Tensions were high, especially when visitation wasn't allowed. Nurses easily spent upward of 10 minutes per call talking to families. It was also difficult to document these conversations—especially when everyone was in crisis mode.
We adopted ACM and gained the ability to set up voice, text, and email notifications. We have message templates, so it only takes a couple of minutes for the Nursing Director or I to review the communication and select the recipients. ACM sends the email, and if no email address exists for that contact, it automatically moves to SMS or phone call. ACM then documents the communication in the patient's chart.
Pandemic aside, ACM integrates with our resident event calendar and automatically notifies families of upcoming events, such as family care conferences. ACM is also useful for notifications around other infectious outbreaks or severe weather. Thankfully we have never had to evacuate, but if we had to leave the building during an emergency, I could alert families from my mobile phone. We have established set hours for messaging, so we don't disturb people in the middle of the night, but we also have an override feature in case we need to assure families that their loved one is safe, regardless of the time.
Nursing is a hands-on profession, and interaction with patients and families is critical to patient wellbeing and quality of care. But it's important to balance that with healthcare technology. Today, people are used to—and even prefer—receiving notifications electronically rather than receiving a phone call. Automating notifications through ACM isn't a significant connection loss; by changing that workflow process, we can reallocate time back to care.
PointClickCare Connect: Efficient, Accurate Transition of Care
PointClickCare Connect surfaced during our reevaluation process. It was available at no extra charge, but we hadn't yet maximized its potential. So, we doubled down on using the platform, which facilitates easier collaboration between hospitals and post-acute providers as patients transition into and out of facilities.
PointClickCare Connect allows our clinical managers and supervisors to admit patients much faster. A process that used to take between 20 and 30 minutes for managers to sift through hospital documents now takes them less than 5 minutes! With the click of a button, we can import all the information, including allergies, diagnoses, and medications, directly onto the patient chart rather than manually searching and inputting patient data.
The process isn't only more efficient, but it's more accurate. The information is less prone to human error, so we get it right the first time.
Staff Retention Amid Industry-wide Burnout
One way we can lower the burden of technological change is by identifying who needs what training for specific platforms. For example, Secure Conversations is user-friendly, but there's still an education element. It's not Facebook Messenger—it's a legal chart, and we have to remind all parties to communicate as such. With the proper education and more consistent usage, our nurses adapted well.
Meanwhile, only managers use ACM. It's easy to use and requires minimal training for this much smaller group of people.
Whether through ACM or PointClickCare Connect, time saved for managers also translates to more time for meeting with patient families and helping on the floor. Every efficiency we can find to support nurses means better patient care. That's more important than ever, given the burnout and labor shortages plaguing the healthcare industry.
Resthaven has done well to retain and recruit staff during the past couple years, with less than 20% RN turnover this past quarter according to Medicare.gov. I'm proud that we are a 5-star in staffing and that our team continued to put one foot ahead of the other to care for residents in our community. The best way to keep that momentum is to find ways to make work easier for our floor staff on and off the clock. With a tool like ACM, we don't have to call patient families during our personal family time, which is precious.
Little things can be a huge relief to floor staff. Using PointClickCare solutions more consistently has led to increased efficiencies, not to mention lower stress and staff retention. We expect PointClickCare will continue to be our partner of choice on the path to better patient care.