CASE STUDY
Customer: Guthrie County Hospital
Solution: Ascom Telligence Nurse Call and Wireless
Handsets
GUTHRIE COUNTY HOSPITAL
CLINICAL STAFF IMPROVE WORKFLOW AND
REDUCE PATIENT CALL RESPONSE TIMES
“We are always looking
for ways to streamline
efficiencies. As a Critical
Access Hospital, we often
have to do more with fewer
resources. Having the right
support tools is crucial to
efficiently managing our
workflow.”
INTRODUCTION
_ Danielle Navarro, RN
Chief Nursing Officer
Guthrie County Hospital
Situation Analysis
Staff at Guthrie County Hospital struggled with an unreliable
communications system that required staff to return to the nurses’ station
to answer patient calls. This was problematic with the potential of
affecting safety, efficiencies and satisfaction. When calls were answered,
it was often difficult to clearly hear the patients or respond adequately
without sending staff to the patient rooms to determine needs.
Additionally, it was impossible for staff to directly communicate with one
another, resulting in delayed information exchange and slowed responses
for staff assistance.
Pictured above, Becky Benton-Kaldenberg, RN,
shares patient updates with clinical staff. Ascom
Telligence Nurse Call and Wireless Handsets
allow efficient staff-to-staff communications.
Like many Chief Nursing Officers, Danielle Navarro is all too familiar with the
challenges of stretching resources in the delivery of exceptional
patient care. Navarro is the CNO of Guthrie County Hospital, a 25-bed
Critical Access Hospital in one of Iowa’s most underserved regions. Located
30 miles from Des Moines, Guthrie County Hospital must balance
a lean budget while offering an expansive range of services to meet
the varying needs of the local community. With enhanced communications
tools and workflow solutions available through the Ascom Telligence
Nurse Call system, clinical staff are improving efficiencies and measuring
positive results.
CASE STUDY
In an effort to manage staff communications, the Unit Secretary served as
the hub for calls. If a clinician, such as a Certified Nursing Assistant (CNA),
was working in a patient room, it was her responsibility to let the Unit
Secretary know her location. Once her tasks were completed, she would
contact the Unit Secretary once again. These added steps increased workload
and delayed information exchange between care givers.
Ultimately, the legacy communications system was making it difficult
for staff to locate one another quickly or easily. In critical situations, the lack
of direct staff-to-staff communication caused heightened anxiety.
“When a care giver needs support in a patient room,” Navarro says,
“he or she needs to be able to find assistance quickly and easily, without
shouting into the hallway or spending extra time looking for available staff.”
Clinicians at Guthrie County Hospital were also conducting regular
rounds to assess patient status and anticipate needs before they escalated
to patient calls. Because the legacy nurse call system did not have a
mechanism to extract call data, clinicians conducted a manual study of their
rounding initiatives to measure effectiveness and impact on patient care and
satisfaction. According to Navarro, the manual data was time consuming to
collect and inconsistent, only giving clinical leadership a gauge of
effectiveness. They wanted a solution that would allow them to collect the
data with more precise metrics to improve performance and outcomes.
They also sought a better means of communicating with housekeeping
regarding bed turnaround. Previously, housekeeping staff would review the
daily discharge list posted at the nurses’ station. This manual list review
increased potential failure-points as patient status could be changed after
the housekeeping list review, causing delayed room readiness.
Chelsie Kopaska, CNA, CST responds to a patient call.
Timely responsiveness has been one of the recurring
comments on patient satisfaction surveys this year,
with patients reporting 100% satisfaction for the first
and second quarters of 2012.
Solution Delivery
Guthrie County Hospital selected Ascom Telligence Nurse Call and Wireless
Handsets to improve clarity and efficiency of patient-to-staff and staff-tostaff communications. The nurse call solution was integrated with Ascom
wireless handset to enable care givers to assist patients more
effectively and reduce delays in information exchange.
Communications Engineering Company, an Ascom partner based in
Hiawatha, Iowa, worked closely with the staff at Guthrie County Hospital to
configure the nurse call system and wireless handsets to support patient
care and quality initiatives.
At the beginning of each shift, the Unit Secretary assigns the wireless
handset and enters staff room assignments into the software component.
With the goal to improve responses to patients’ needs, the clinicians decided
that when a patient presses the call button, the call should ring
directly to the Certified Nursing Assistant’s (CNA) wireless handset. If the
CNA does not respond in a preset amount of time by answering the phone
or going to the patient’s bedside, the call escalates to the assigned
Registered Nurse (RN). Likewise, if the RN is unable to respond, the call
escalates again and rings to the House Supervisor.
CASE STUDY
The Ascom Telligence Nurse Call solution enables
staff to improve workflow efficiencies with a touch
of a button, while its configurability safely ensures
that familiar terms are incorporated into care giver
routines. Guthrie County Hospital integrated a
3-button nurse call peripheral station (above) in
each patient room to automate steps in routine
care processes.
Q2 2012
Q1 2012
Q4 2011
Q3 2011
Q2 2011
Q1 2011
0%
20%
40%
60%
80%
100%
Average inpatient satisfaction scores 2011-12
(Ascom Telligence Nurse Call and Wireless
Handsets implemented mid-Q3 2011)
As part of the strategy to improve workflow efficiency, Guthrie County
Hospital integrated a nurse call peripheral station in each patient room that
staff members use to automate steps in routine processes, signal staff
presence and alert each other of needs. Each peripheral station includes
a button for the primary nurse, one for the nurse assistant and one for
housekeeping. The RN and CNA buttons signal when a particular staff
member is present in the room, eliminating the necessity to notify the Unit
Secretary each time a care giver is in a patient room. As the appropriate
button is pushed, whether it is the nurse or assistant, a light illuminates in
the hall and an icon populates on the user interface.The clinician is easily
located and can be called directly, saving time and enhancing care delivery.
Similarly, when the housekeeping button is pushed, the corresponding
light is illuminated in the hallway and a message is sent to the housekeeping
staff member’s wireless phone indicating a need.
With the reporting component, the Telligence nurse call system delivers
immediate access to patient call statistics and response times to support
quality and process improvement opportunities.
Results
Since the implementation of the Ascom Telligence Nurse Call and
Wireless Handset solution, the overall quality of communications has
improved dramatically, enabling care givers to respond faster to patient
needs. Calls are answered from almost any location without staff returning
to the nurses’ station.
“Once we integrated the nurse call and wireless handset solution into
our care plan, our target was to respond to every patient call within seven
minutes,” says Navarro. “We could hear the patients clearly, easily connect
with staff on the floor and speed service delivery. We dropped our target
response time to five minutes and we’re still meeting it 99% of the time.”
“The phones also enhance communication within our organization,”
says Navarro. “Staff can call for a consult or additional assistance without
leaving the patient’s bedside. And we’ve reduced the number of overhead
pages for a quieter environment for patients.”
With a Critical Access designation, Guthrie staff must often accomplish
more with fewer resources, forcing everyone to wear many hats to get the
job done. Streamlining workflow enables staff to manage patient throughput
more efficiently, equating to smarter allocation of staff and resources.
With the integration of reporting features, nursing leadership and staff
seamlessly access documentation to assess call response times, evaluate staff
efficiencies and adjust accordingly. This timely data enhances care delivery
and lends support to quality and safety initiatives and patient satisfaction.
The “housekeeping” button on the patient-room peripheral station
allows clinicians to easily alert the housekeeping staff when a patient is ready
for discharge. This speeds room readiness for incoming patients and takes
the guesswork out of room status.
CASE STUDY
_ Danielle Navarro, RN
Chief Nursing Officer
Ascom Patient Systems
9024 Town Center Parkway, Suite 100
Lakewood Ranch, FL 34202 USA
Toll Free: 800-385-2639
www.ascom.us/ascom-telligence
Future Plans
Guthrie County Hospital is looking to incorporate the nurse call peripheral
stations into their care process to formally capture rounding initiatives and
document efficiencies. They are also considering using peripheral stations to
alert the hospital’s Rapid Response Team (RRT), which would eliminate
overhead paging to alert team members and speed response times.
About Ascom Telligence Nurse Call Workflow Solutions
The Ascom Telligence Staff Station is a wall-mounted touchscreen device
for the patient room (below) that promotes clinical workflow and
communication across the hospital enterprise.
The Staff Station is fully configurable to support the care processes
crucial to any healthcare facility. Solutions may include rounding, falls or
pressure ulcer prevention, medication reminders, precautions, room readiness
alerts, rapid response team alerts and other clinical initiatives.
MSC-00203 Rev 2 ©Ascom (US) Inc
“We hear patient comments
almost daily as to the
wonderful care we deliver
and the prompt attention
to the call lights.”