Pivoting to Virtual Team-Based Care

June 11, 2020 Kathleen Harmon

Kathleen Harmon, MS, RN, CENP, Chief Clinical Officer PatientSafe Solutions

The New Requirements for Clinical Communication and Collaboration Platforms

Kathleen Harmon, MS, RN, CENP, Chief Clinical Officer PatientSafe Solutions

Recently, we announced the addition of video integration capabilities as part of our comprehensive PatientTouch platform. This new capability is our rapid response to supporting a strategic, enterprise-wide approach for virtual team-based care that health systems are challenged to efficiently, cost-effectively design and implement. PatientSafe’s perspective, and our current pursuit, is that clinical communication and collaboration (CC&C) platform vendors must stretch and expand to address three key areas of need that will persist in the new normal:

  1. Dynamic structural and capacity management
  2. Dynamic workflow and hand-off management
  3. Transitioning to enterprise-wide virtual care

Dynamic Structural and Capacity Management

Closely partnering with our healthcare clients during the COVID response period, we saw that technology must be nimble and flexible to support the evolving care delivery system. Health systems were challenged to rapidly stand up isolation units, convert non-care delivery areas (i.e. offices, parking lots) to triage and care delivery areas, and remote screening became an instant necessity. Literally, for caregivers, their work environment completely changed overnight. 

Throughout this period, our customers were relabeling their units, creating new roles and groups, reassigning staff, and creating new communication and clinical workflows to accommodate the pandemic’s care delivery demands. Staff leveraged PatientTouch for up-to-date care team context, patient assignment, on-call schedules, and unit and role information, so they could reliably and efficiently respond to care needs. We found customers leaning on our system’s assignment engine to build virtual units including new PPE supply runner units to make sure that caregivers had what they needed, when they needed it.  Our platform’s flexible, dynamic directory ensured the right roles were notified to address needs in a timely, safe, and efficient manner.  

Dynamic Workflow and Hand-Off Management

Our foundational belief is that technology must support best practice workflow and hand-off processes. COVID’s changing care environment generated requests from our clients for adaptations to their PatientTouch configuration to accommodate those changes. An example of this was the need to conserve and preserve PPE. At one health system, a streamlined workflow for a new PPE Runner role was defined, created, and configured in PatientTouch. Functionality and workflow were deployed to support the new role, and the outcome of optimized use of resources (people and PPE) was successfully achieved. 

In a second example we helped a health system build a smartphone-based COVID screening tool for the ED.  Screening results generated in PatientTouch triggered a set of notifications to the appropriate care teams responsible for transfer, coordination of resources, and updates to patient data. The ability to build dynamic workflows based on need, with constant vigilance toward designing for hand-off consistency, is going to be of great importance in the on-going new normal our health systems are dealing with. 

Critical to enabling dynamic hand-offs is ensuring the appropriate clinical and patient context, including the accuracy and volume of alarm, alert, and notifications per clinical role are well managed. To address these challenges, clients used PatientTouch for documenting and sharing patient interactions and interventions during and at shift change. Further, adding technical capability at the point of care, while mobile, contributed to nursing efficiency and satisfaction. 

Transitioning to Enterprise-Wide Virtual Care

Taking what we have learned during COVID and realizing the explosive impacts of the removal of regulatory barriers, it is critical now to ensure mobile-enabled closed-loop workflows are the standard as health systems expand their use of video-based interactions. How do we enable HIPAA-compliant video in the context of care team workflow? How do we enable virtual team-based care consults, visits, and workflows without fragmentating the experience of care? Our customers are now rethinking the clinical video model by asking for a consolidated approach to video CC&C that 1) integrates with their current solution(s) of choice and, 2) removes additional burden from their care team. And of course, key to deploying a strategic, enterprise-wide solution includes the ability to extend workflows beyond geographic boundaries.

PatientSafe always uses an outcomes-first, use case-based implementation approach to support clinical best practice. This methodology describes the desired outcome, the caregiver workflow, and the required technology to support workflow in order to successfully achieve the outcome. Critical to this approach is highlighting workflow by role. Often, heavy lifting falls on nursing and nursing support staff to enable video collaboration. By following an outcomes-first approach, health systems can load-level and prioritize prior to implementation, minimizing risk of low adoption or project failure. COVID has challenged CC&C vendors to deliver a unified experience across multiple settings, disparate locations, new physical and virtual roles, and new clinical workflows. To provide that for caregivers, patients and their families, we must seamlessly integrate with video solutions of choice to reduce fragmentation and provide a simple, effective end user experience. PatientSafe is collaborating with our health system partners to address the new realities of care delivery, support rapid recapture of patient volume and enable more efficient sustainable operations.

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