Improving Hospital Admission Wait Times with Social Media Solutions

Michelle    June 25, 2015

Organization(s): Chatham-Kent Health Alliance; Oculys Health Informatics

Websites: Chatham-Kent Health AllianceOculys Health Informatics

This week’s social media case study focuses on supply chain management. Supply chain management is, quite simply, the management of goods or services in order to fill (supply) a demand. For this week I’ve decided to look at a proprietary communication solution offered by Oculys Health Informatics and recently implemented at Chatham-Kent Health Alliance to manage the admission of patients into inpatient beds.

Chatham-Kent Health Alliance (CKHA) is a 200 bed community hospital system equipped with state-of-the-art facilities and technologies, serving the residents of Chatham-Kent, South Lambton, and Walpole Island, in the Erie St. Clair region of Southwestern Ontario.  CKHA sees over 65,000 emergency room visit per year.

CKHA was looking for a solution to provide better visibility for all staff into what was happening across the organization. “We would call admitting and be able to gather some information and then we’d be on the phone with the ER for other information. We would often be physically walking around to gather all of the information we needed to really understand what was happening in the hospital,” said Sarah Padfield, Chief Operating Officer at CKHA. “We were really good at knowing what happened yesterday, but were having a harder time predicting what today would be like.”

To solve this challenges, CKHA contracted Kitchener-based Oculys Health Informatics, a company which offers focused on delivering real-time, integrated support solutions designed for healthcare organizations.

CKHA deployed a software solution called Oculys Performance, which provides data from all hospital units and can be accessed by staff via a web-based platform. For example, “with one look, our staff can see the number of patients currently waiting in the ER and intensive care unit, compared to beds available,” Padfield said.

Following the implementation of Oculys Performance, CKHA approached Oculys to expand the tool to include housekeeping and portering. At that time, housekeeping was using Blackberry Messaging (BBM) groups to help coordinate work effort. CKHA wondered if it was possible to leverage the better visibility provided by Oculys Performance to enable this communication between housekeeping and clinical teams.

Why Hospital Housekeeping and Portering Matters to Patient Care

Reducing emergency room wait times for patients being admitted to hospital is important at any hospital, particularly because literature shows that the longer patients stay in emergency, the worse their outcomes will become.

Improving patient throughput is a complex issue that hinges on a number of different factors. In this podcast, Dr. Sachin Pendharkar explores overcrowded or access-limited healthcare systems and the variety of factors which influence them.

Although it’s simplistic to suggest wait times are only a matter of demand outpacing supply, it does contribute to delays in patient care. There is a finite availability of space available in an emergency room and the hospital as a whole. If there are no inpatient beds available, patients must wait in emergency room until they can be admitted. This holds up a bed in emergency and means that patients in the waiting room may not be able to see a care provider until space becomes available.

When a patient leaves a bed (for example: patient is discharged), the hospital’s housekeeping staff must do a thorough sanitization of the room in order to prepare it for the next patient. This cleaning is essential in controlling rates of healthcare-aquired infections, which affect nearly 200,000 patients a year in Canada (resulting in death for approximately 8,000 of these patients, who are often frail or elderly). Common healthcare-aquired infections include difficult-to-treat antibiotic-resistant infections such as Clostridium difficile, Methicillin-resistant Staphylococcus aureus (MRSA) or Vancomycin-resistant Enterococci (VRE).

Since cleaning is a critical step in preparing the environment for a new patient, housekeeping staff are at the leading edge of the hospital’s ‘inpatient bed supply chain’. Knowing when beds need to be cleaned and when they become available for new patients is critical to the flow of patients from the admitting source (emergency room or other) through the hospital.

hospital housekeeping workflow simplified

Simplifed workflow: Housekeeping in inpatient admissions from emergency

Communication “social media” solution for housekeeping to improve patient flow

Knowing this, CKHA wanted to identify potential challenges in housekeeping’s workflow and interactions with other parts of the hospital, in order to improve patient flow. One of these challenges was communication between housekeeping and clinicians.

To address the needs of housekeeping to communicate more effectively with clinical teams, CKHA implemented Oculys KeepNTouch on the Blackberry smartphones the housekeeping team were already using. Housekeepers can use KeepNTouch to view which beds were waiting for cleaning, and allowed individuals to indicate when they were cleaning a bed and when they had finished. Admitting is automatically notified through this tool when housekeeping finishes with a bed.

KeepNTouch has enabled housekeeping to communicate more effectively, which has increased efficiencies which impact patient care. Following the implementation of Oculys Performance and KeepNTouch, CKHA is now ranked 6th in the province for wait times for inpatient beds, rising 8 places from 14th prior to implementation.

“The Oculys housekeeping application on BlackBerry is helping our housekeeping staff to be more efficient and has streamlined their workflow. Our admitting department has a real-time notification that a bed is clean and ready for the next patient,” Padfield explained.

Lessons Learned for other organizations

When examining the CKHA case, there are several lessons that can be applied to other organizations looking to implement a social media solution for supply chain management, especially in a healthcare environment or a service-supply organization (considering the availability of an inpatient bed to be a hospital service, rather than a good like, say, syringes).

  1. Set aside pre-conceptions and evaluate and understand workflows to influence meaningful change. Like it or not, there is a hierarchy in healthcare and housekeeping isn’t at the top. Approaches to improve wait times could have started with higher prestige positions like physicians, however, in evaluating their workflow, CKHA identified housekeeping as a critical part of the admissions workflow, and enabled them to communicate better with the admitting department.
  2. Social media for supply chain management should be grounded in data. Housekeeping was already using a communication tool to coordinate their own activities (BBM), however, it wasn’t connected to the real-time information available in Oculys. Oculys KeepNTouch integrated this data to streamline the workflow process.
  3. Leverage and improve on existing social media solutions. Oculys KeepNTouch could be installed on mobile devices, which allowed CKHA to leverage the Blackberrys that housekeeping already had, and improved upon their pre-existing communication solution.
  4. Look for “outages” or communication gaps. There was a gap between housekeeping and admitting that caused patients to wait longer for service. By implementing Oculys, CKHA was able to eliminate this gap.

Submitted by: Michelle Maw

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