Put Everyone on the Same Page to Improve Care and Flow By Billie Whitehurst, RN, MS Chief Nursing Officer McKesson Provider Technologies Playing Your A-Game with an At-a-Glance Enterprise-Wide View Football season is the favorite part of the year for many of us. Take a moment to think about the wonders of the football scoreboard. With a quick glance, anyone familiar with the game's fundamentals can come in during the third quarter and instantly be on the same page as everyone else in the stadium. Now imagine if each time someone completed a first down or kicked a field goal, everyone in the stadium had to be called or paged. Sounds ridiculous — yet that's how most hospitals are run today. In healthcare, the football scoreboard's equivalent is the enterprise tracking board. Instead of a tracking board for one department, this emerging technology provides patient visibility across the hospital or a multi-hospital enterprise. McKesson's solution, Horizon Enterprise Visibility™, uses visual controls to broadcast real-time, at-a-glance information about patient status against the hospital's floor plan. Information aggregated from clinical, ADT, housekeeping, transport, location and other systems is displayed on large, electronic whiteboards throughout the hospital, which helps:       Drive organizational alignment by putting          everyone on the same page       Ensure process compliance by increasing          transparency and accountability       Promote proactive behavior by enabling people          to anticipate what they need to do next What's Your Perspective on the "Goal" of New Technology? An enterprise tracking board addresses organizational challenges from multiple perspectives — the C-Suite, chief nursing officer (CNO) and chief information officer (CIO). The CEO, COO and CFO's Perspective When deciding whether to approve a new technology investment, CEOs, COOs and CFOs want solutions to the issues that keep them up at night, such as patient flow. The plight of hospitals experiencing ED overcrowding has been making headlines for years, but the real cause of ED challenges is usually "downstream" capacity issues in areas such as the ICU and surgery. Giving the people who make care decisions visibility into what's going on in the ED as well as the rest of the hospital is critical to understanding where bottlenecks occur and fixing them. An enterprise tracking board also helps prevent diversions by speeding bed turnarounds by up to 20 minutes so patients can be placed in the right bed more quickly. The CNO's Perspective CNOs want their managers to be able to walk onto a unit and immediately know what's happening, where any special patient populations are and who might need help. Amidst an ongoing nursing shortage and aging workforce, they also want to minimize agency costs by keeping frontline nurses happy. An enterprise tracking board helps make nurses' lives easier by saving them one hour per shift per day, by eliminating up to 7-10 phone calls and 3-4 wasted logins. Instead, nurses can instantly see:       Where their patients are and how long they've been there       Whether they have any new orders or results       Whether a patient is being transferred off the unit       Whether they are getting any new patients that shift While visibility doesn't replace interdepartmental communication, it reduces many of the inefficiencies that can mark the difference between a smooth shift and a hectic one. The CIO's Perspective CIOs are under constant pressure to maximize adoption of existing technology and ensure that incremental investments provide a quantifiable ROI and leverage what is already in place. McKesson's enterprise tracking board installs in less than 100 days and typically returns a full ROI in less than 2 years based on uncovering 5-10 "hidden" beds per day. By broadcasting information from source systems for everyone to see and use, it leverages the value of those systems and increases the accuracy of the information they contain because it is visible to all staff to question. The Playbook for this Emerging Technology Patient flow is an urgent, costly challenge that is addressed most effectively with an enterprise tracking board. But the solid ROI provided by uncovering hidden beds and uncorking bottlenecks is just the beginning. Imagine how you could enhance revenue, care continuity and patient satisfaction by alerting central supply, financial counselors, outpatient treatment centers and other stakeholders of all pending discharges? Oakwood Hospital and Medical Center in Dearborn, Mich., is doing this today and reaping the benefits, simply by listening to employees who came forward with good suggestions about how to leverage their enterprise tracking board. And we are just beginning to tap the potential to help customers improve compliance with timed core measures and other care protocols. Knowing the "score" every minute for every patient across your enterprise gives your organization the chance not only to achieve its clinical and patient flow "goals" but to change the game entirely.		Horizon Enterprise Visibility™ Horizon Emergency Care™ Horizon Surgical Manager™ Horizon Real-Time Location System™ Enterprise Scheduling McKesson Performance Analytics™ A solution designed to smooth daily patient flow proves invaluable during recent capacity surges during disaster responses at Providence Holy Cross. A centralized operations center manages bed availability enterprisewide, reducing patient wait times and improving satisfaction. Oakwood increases compliance with core measures while improving patient flow using an enterprisewide view of patient status. A Joint Commission expert recommends measuring "head to bed, foot to door" to establish goals and eliminate the bottlenecks that threaten patient safety. 5995 Windward Parkway Alpharetta, GA 30005
Billie Whitehurst, BC, RN, MS, is vice president and chief nursing officer for McKesson. Prior to that she was the general manager for McKesson's medication safety solutions, coordinating and developing McKesson's unified strategy for safe medication administration and patient safety. She has also served as vice president and solution line manager for the company's physician and nursing solutions. In 2008, St. Rose Dominican Hospitals (featured in this issue of Performance Strategies) received grants of $100,000 each for its three campuses to improve disaster preparedness. The grants were awarded by the Department of Homeland Security's Federal Emergency Management Association (FEMA) under its Urban Areas Security Initiative: Nonprofit Security Grant Program. The program awarded 309 grants in 2008 to nonprofit organizations within eligible urban areas in 29 states considered to be at high risk of terrorist attack. In November 2008, FEMA released FY2009 application guidance for 14 federal grant programs. The grants total more than $3 billion available in federal funding to assist state and local governments in strengthening community preparedness. For more information, visit the FEMA Web site.