Author: SuperScoutTrooper

After an energizing first day, we’re back with another afternoon of fantastic content to share with you. As Gerry Lewis said during our closing fireside chat, in today’s environment clinicians and IT teams have a responsibility to work together to, “Create an end-to-end ecosystem that leverages enhanced clinical process and integrations, so we aren’t overburdening our clinical staff from a cognitive and burnout standpoint – otherwise, we are going to be challenged to take care of those in need in our communities.” Our role in helping to provide elevated patient care while liberating the bedside nurse has never been more important than in the midst of current staffing crisis.  

Today, we focused on Change Agents: Creating Awareness, Confidence and Excitement when rolling out a new care model inclusive of AvaSure TeleSitter and TeleNurse programs. We discussed obstacles to overcome, best practices for implementation and keys ways to share results with leadership. Then, we spoke with systems that have scaled to hub and spoke model systems – increasing their coverage through a centralized monitoring model. Ending the day, AvaSure CEO Adam McMullin sat down with Gerry Lewis, former CIO/EVP of Ascension to discuss the role of technology in the future of healthcare – exploring how to drive change at a health system, advice for expanding your virtual care program and how clinical leaders can best partner with their IT teams.   

Let’s look at some of the key findings from today: 

Change Agents: Creating Awareness, Confidence and Excitement

Presenters:

• Shannon Robertson, BSN, RN, Unit Director, Virtual Care Operations, Carilion Clinic Park View
• Jason Crouch, Virtual Care Operations Manager, Carilion Clinic Park View
• Meg Alexander-Patton, RN, BSN, Carilion Clinic Park View
  • No one is going to be a bigger advocate for your program than you are! You need to sell the value of your program – to leadership, to staff – for it to be successful. Meet with teams at all levels, explain the service and benefits to drive utilization. 
  • Change doesn’t end – it’s constant. If you don’t keep yourself on the front of people’s mind, they may forget you. Keep pushing to find new and innovative ways for devices to be used to continue pushing value of the program higher. 
  • Trust is the biggest key to success. Leadership and bedside staff need to trust that the monitor staff isn’t just “watching a camera” but adding value. You can demonstrate this with great catches, with shadowing programs and with communication.  
  • Listen to your staff – try to understand potential pain points, make them feel heard and important. Also make sure stakeholders have skin in the game, including these stakeholders in the process helps drive the best outcomes ensuring they have reasons to help drive the program forward. 
  • Best practice: do shadowing as part of interview process so that monitor techs can truly get a feel for what their job will be like before accepting the role, this helps them grasp the reality of the role and drive retention 

Centralized Monitoring: Optimizing Labor Across an Entire Health System 

Presenters:

• Mark Quirin, MSN, RN, Regional Manager for Virtual Monitoring Loyola Medicine
• Katherine Mitchell, BS, BSN, RN, CMU/VMU Nurse Manager, Baptist Health Medicine
• Kahlia King, CARE, Assistant Nurse Manager, Cox Health
  • Think about time zones being served and having an adequate hiring pool when picking a hub location.
  • As best you can, standardize data collection and routines across spokes being served by your hub to ensure consistency 
  • Involve more stakeholders up front – think beyond just clinical teams when starting your program and include case management, social work, security, financial leadership and more 
  • Consider a steering committee to help drive policy and procedure implementation but also to have people not in the “day to day” provide a wide-angle lens on your program 

Best practices for creating an engaged and effective monitor staff: 

• Consider flexibility in scheduling – 12-hour shifts may make sense for nursing but not for monitor techs sitting at a desk, consider breaking them down or allowing for regular breaks to ensure they’re engaged when monitoring 
• Use sit-to-stand desks to give monitors a way to change up their workspace. Want to take it one step further? One panelist has treadmill desks, stationary bikes and more! 
• If you’re in an office environment, consider ‘theme days’ – like potlucks, pajama days, karaoke parties and more! 
• Focus on recognition: use a ‘wow wall’, kudos system, newsletters, or emails to share great catches and recognize your monitor staff 

Fireside Chat with Gerry Lewis, Former CIO/EVP of Ascension and Adam McMullin, CEO AvaSure: How Technology Plays a Role in the Future of Healthcare 

• Three things to consider when trying to drive change at a health system (if you can meet 2-3 of these, we should be taking next steps in how we operationalize this):
  • Does this differentiate the patient or clinical experience? 
  • Does this help us improve the value of the services we provide? Can we provide better services and be more efficient in how we deploy them? 
  • Is there an opportunity to bend the cost curve? 
• The key to project success: clinically led but technically enabled – if that partnership isn’t there it’s very difficult
  • When working together with clinicians and IT teams – the more we create relationship and trust, break big complex processes down and continuously iterate we will be more successful. We like to go after these big bang projects where we expect everything to be perfect instead of starting with the first 20% and iterating until we feel like we’ve met all the clinical needs
• We are at an inflection point; skilled care labor shortages have put us there. We need to look at how we apply labor and technology differently. We need to look at models, processes, technology and people in a very different way because the fundamentals are going to be challenged. 

Thank you to all who joined us for an exciting two days of sharing stories, learnings and experiences together.  

We had a fantastic first day of the AvaSure Virtual Symposium focused on Transforming the Industry. “This year, our customers are focused on protecting their patients, making things easier on their care teams and reducing cost”, per Adam McMullin, CEO of AvaSure. That’s why the theme of this year’s event is Transforming the Industry. We know that customers need to make changes to their care delivery model in light of macro factors and we are here to help.  

Day one’s discussion were focused on various aspects of this care model transition – starting with Virtual Nursing: It’s a Thing, But Where to Start? We then spoke with a customer panel on using the TeleSitter solution to monitor for suicidal patients – an important and underutilized form of virtual monitoring. We ended the day highlighting the superstars of monitor staff programs sharing their best practices on staffing a program.   

Let’s look at some of the key learnings from today: 

Virtual Nursing: It’s a Thing, but Where to Start?

Presenters:

• Sarah Brown MSN, RN, Chief Nursing Officer, UnityPoint Health
• Amy Hassell MSN, RN, Director of Patient Services, UCHealth Virtual Health Center 
  • 89% of hospital and nurse leaders are moderately to extremely interested in virtual nursing, but most are still in planning phases. From our customers on the panel who have implemented, they all say, “just do it”. As our one panelist said, “have courage to try something – create some buzz around it. There’s a lot of work in this, but it’s good work so give it a shot.”  

Early results from virtual nursing pilot panelists:

• Time savings for bedside staff using a TeleNurse for admission and discharge – reduce admission time by 12 minutes and discharge by 15-29 minutes 
• Saw increase in patient experience scores on HCAHPS – 7.6% increase in patient understanding of purpose of taking medication and 2.04% increase in top box score for transition in care 
• Critical care expert TeleNurse helped drive increase in rapid response calls and an unprecedented 25-70% reduction in code blues in combination with deterioration education 

Lesson learned for starting a virtual nursing program:

• Whatever process you’re designing needs to make sense for and solve a need at the bedside. It needs to be easy for the end user, needs to be seamlessly integrated and make sense in building a team effort.  
• Clarify what virtual nursing is – and importantly what it is not – to all team members 
• Need senior leadership buy in but nurse managers and front-line staff buy in is essential – start conversations on the issues they’re having and key pain points to address 
• Just jump in and be willing to iterate – you need to be flexible and be willing to adapt as you gain feedback. The hardest thing to do is just say go and start. 

Keeping Suicidal Patients Safe, Virtually

Panelists:

• Debbie Cronin, RN, Director of Patient Care Services, St.Peter’s Health 
• Kim Beckett, RN Manager – Clinical Surveillance, Ascension Michigan 
• Wesley Wingate, Director Cardiac Telemetry, HCA Methodist
  • You may have to address your hospital policy, but virtual monitoring of low and moderate risk suicide ideation patients is accepted by most governing bodies 
  • If you’re struggling to gain buy in or are skeptical, consider a pilot where a physical sitter is outside the room with a virtual monitor. This will allow a safety net while you gather outcomes of how verbal interventions help prevent adverse events. This can be presented, in addition to research and testimonials, to leadership in order to drive program acceptance. 
  • Device selection is key based on your anticipated use cases. When purchasing devices, if you anticipate using on SI patients make sure you consider ligature risks and buy appropriately, or this can be a challenge down the road. 
  • Training and education of monitor staff here is key – AvaSure provides a great module focused specifically on suicidal patients that can help educate both monitor and front-line staff 
  • Best practice: don’t think about limiting just SI patients in a ratio for your monitor techs, instead make sure they take note of all “busy” patients (could be falls risks, elopement risks, SI or other risk) and ensure they don’t have more than 2 per monitor tech 

Tips, Tricks & Tales from Monitor Staff Superstars

Panelists:

• Kearston Winder, Ascension Via Christi 
• Juliet Aninye, LVN, VA North Texas Health Care System
  • It’s all about communication – communication with the patient and communication with the bedside staff. Ensure you properly introduce yourself and your role to the patient to put them at ease but also ensure there is easy, routine communication between monitor staff and the bedside team for an effective TeleSitting program. 
  • Develop a handoff process – some panelists used a document where monitor techs would note any key interventions or patient/nurse preferences that could be given to the next tech, but whatever your process ensure information can flow from nurse shift to nurse shift and monitor tech to monitor tech 
  • Best practice for veteran facilities: Many of these patients may suffer from PTSD. Ensure your staff when introducing themselves coaches on what a verbal intervention and stat alarm will sound like so they are not startled – especially when sleeping 
  • Best practice: have an escalation pathway on both sides – so that monitor staff know who to escalate to when they can’t reach the nurse and so nurses know who to escalate to when they have feedback for the monitor staff. It all comes down to transparency and good communication. 
  • Build rapport with the patient through conversation, this will help them to respond more positively during intervention periods  

For those who joined us – we hope you enjoyed the first day as much as we did. If you missed it, all of the recorded sessions will be available for viewing next week. Make sure you tune in tomorrow as we have another great day of content including:  

• Change Agents: Creating Awareness, Confidence & Excitement! 
• Centralized Monitoring: Optimizing Labor Across and Entire Health System 
• Fireside Chat with Gerry Lewis

See you tomorrow! – AvaSure Team