Surgical precision

When Elmhurst Memorial Healthcare began planning for its new 886,000-square-foot main campus, improving the patient experience was a top priority. Specifically, the hospital — located in the Chicago suburb of Elmhurst, Ill. — had a goal to create a less intimidating and more comforting healthcare experience for patients and their families. A key element in meeting this goal would be a nurse call system that enables staff to quickly and effectively respond to patient requests, for both medical and non-medical needs.

At the time, the hospital was operating multiple nurse call systems — also referred to as “call light” systems — throughout its original facility, which had been established in 1926. Over time, the various systems became a challenge to maintain and provided little flexibility for integration. A goal for the new campus was to install a single system that could provide a superior patient experience while also meeting the needs of diverse internal stakeholders.

To that end, the hospital wanted to be able to mine call light system data to support its focus on continual improvement. It hoped to find a system that could provide relevant data to both administration and finance staff, as well as to its nursing and medical teams. And, it had to meet the requirements of the hospital’s IT and facilities departments.

The first step was to assemble a multidisciplinary team, which ultimately was comprised of nurses, nursing-unit clerks, patient-care technicians, hospital administrators, IT specialists and facilities managers. Site visits were a critical assessment tool for the team, because they allowed members to see nurse call systems in action and talk to peers about their system’s benefits and limitations.

A visit to a hospital that was using Intego’s centralized CommonPath nurse call system made an immediate and long-term impression on the team. The first thing that resonated was how quiet it was on the floor. The centralized system virtually had eliminated the alarms, buzzers and overhead paging associated with most call-light systems. Patient requests quickly were answered and triaged by dedicated operators. Those same operators were able to send requests directly to the appropriate caregiver’s communications device, and to monitor request fulfillment.

The assessment team recognized the powerful improvements in patient satisfaction that were possible using a centralized approach. In addition to a more peaceful environment and faster, more efficient responses to patient requests, the system offered dynamic reporting capabilities. Conversations with current customers also highlighted the reliability and scalability of the system.

The hospital’s new campus has 259 private inpatient suites that are organized in 12-bed pods designed to bring the caregiver closer to the patient. The facility also has private recovery rooms for endoscopy, ambulatory surgery, the cardiac catheterization lab and the emergency department. In all, that represents 450 nurse call patient stations feeding into a centralized remote operator center that triages patient requests.

Outpatient services never had used a call light system before, as those patient-recovery areas did not include private rooms. By taking patients out of immediate eyesight of the staff, we wanted to make sure that any potential safety issues in the new facility would be fully mitigated by the new nurse call system.

The hospital team worked closely with Intego to customize patient request palettes according to nursing unit, and to create specific workflows tailored to individual patient requests. Each unit also was able to define response parameters and escalation protocols that were suited to unique patient needs. Because this system is a software-driven approach to nurse call, the hospital even was able to integrate with patient beds, providing an alarm system for patient bed exits and fall risks.

The new centralized nurse call system also has had a profound impact on the way code- and rapid-response teams respond to calls in the new facility. Previously, only one code-response team was in place and overhead paging was used extensively when calling a code. In the new campus, the goal was to eliminate overhead paging. The larger facility and layout made this a challenge — especially with three code-response teams operating in the building.

Integral to the workflow management and reporting capabilities was the installation of a real-time locating system in patient-care areas. Staff badges are read automatically by the system, and identify the individual caregiver when that person enters the patient room to fulfill a request. This simple approach requires no additional action by staff and creates an accurate and detailed log of response times and staff utilization.

The hospital opened the doors to its new campus on June 25, 2011. Staff immediately noticed how quiet it was on the floors and in the patient pods. The centralized system eliminated all the alarms and overhead paging associated with the old nurse call systems. Staff also appreciated that they could now be proactive in meeting a patient’s needs, as the centralized system allowed them to walk into the room with a solution rather than a question.

The patient experience has improved thanks to faster responses to patient requests. Data from the system’s first nine months of operation tell a compelling story:

• Patients receive a personal response from the dedicated nurse call operator within 5 to 6 seconds of activating a request.
• The centralized nurse call operators triage an average of 26,000 patient calls each month.
• Bathroom requests are being fulfilled within 2.9 minutes.
• Pain medication request fulfillment occurs within 5.9 minutes.
• Program directors receive a monthly “Top 10” patient requests for their nursing units.
• The system identifies the busiest times of day for patient requests on a unit-by-unit basis

The hospital also has seen significant increases in several patient-satisfaction metrics. In the first nine months at the new campus, average overall patient satisfaction scores increased from 66.7 to 79.3. In addition, the average score that indicates the likelihood that a patient will recommend the hospital increased from 74.1 to 84. And patient scores for the new outpatient surgery units soared to new levels, with satisfaction levels ranging from 90 to 100.*

Patients, staff and administrators all have benefited from the hospital’s new centralized nurse call system. Satisfaction increases and anxiety is reduced when patients know that their requests are being answered quickly. For staff, the immediacy and efficiency of the system in responding to patient requests means better patient care. And, administrators have found that the reporting capabilities inherent to the system provide a level of detail that helps staff meet its commitment to continual improvement.

* Results based on HealthStream telephone interviews with patients conducting the HCAHPS survey.

Jean Lydon is the associate vice president of patient care services at Elmhurst Memorial Hospital.