API for Staff Assignments – A New Paradigm in Clinical Staff Assignment Workflow

Efficiently managing staff assignments is essential for effective hospital operation and responsive patient care.

Staff assignments list the caregivers available for each shift and who is responsible for each bed location at a given escalation level. Hospital systems rely on accurate assignment data for everything from administration to critical patient care.

How many applications in your hospital depend on this information?  How is it accurately maintained across systems?  How many hours are wasted manually entering the same data into multiple systems?  Is out-of-date and inconsistent data across your systems the inevitable result?

Frustrating, isn’t it?

Common issues:

  • Wasted hours manually entering the same data into multiple systems, each with its own UI
  • Increased opportunities for data entry errors and inconsistencies
  • Delays until data is the same across all systems, if ever
  • Ad-hoc assignment updates can be inconvenient to make

It is a miracle that staff assignment data gets distributed properly, and let’s be honest, it probably doesn’t.

There must be a solution.

What if you could enter and update staff assignments in one system and have the data automatically flow to all your systems in real time?  And what if these changes could be made on the application most convenient at that moment, not the one and only master system at the other end of the facility?  Does it sound too good to be true?  It isn’t, and it’s real.

How do Staff Assignment API’s work?   Typically one system is designated the master system.  The majority of data entry/editing is done here.  This system provides a formal Staff Assignment API specification using industry standard technologies.  All other systems in the hospital implement this API to receive staff assignment updates in real time.

Use case #1:  Staff assignments for the following week are entered into the master system.  The new assignments are immediately published to all other subscribing systems in the hospital.

Use case #2:  Nurse ‘Nancy’ becomes unavailable for the rest of her shift.  Nurse ‘Bob’ is chosen to cover her assignments and all subscribing systems are immediately updated.

Use case #3:  Nurse ‘Nancy’ is going on break and Nurse ‘Laura’ agrees to cover.  Instead of wasting time going to the administrative station to update her assignments, she makes a few quick selections on her smart phone.  The phone app makes an API call to the master system to report the change, which is immediately published to all subscribing systems.

The Results

A system that uses a staff assignment API along with a smartphone application that automatically publishes the up to the minute assignments to every device can provide the following benefits:

  • Enter staff assignments in one system and they quickly and accurately propagate to all systems in the hospital.
  • No need to re-enter the same data in multiple applications.
  • Immediate and accurate data synchronization between systems.
  • Ability for assignment data to be updated by the application that makes sense for each use-case.

Staff Assignment API’s. What are you waiting for? Your staff and patients will thank you!

From 15 Minutes to 15 Seconds

A friend of mine is an expert on “lean thinking”. This is where processes are evaluated as a whole and then changes are made to streamline the steps and reduce any waiting times. Lean thinking originated with the automobile manufacturers but is being increasingly applied to healthcare. My friend has conducted a number of healthcare lean projects primarily around patient flows, emergency departments and operating theaters.

I was explaining to him how mobility was being used in a healthcare environment and I was walking him through a use case that we did not expect to see. The before and after scenarios follow:

USE CASE: An out-of-the hospital physician would like to check on the pain level of a patient who had a procedure completed earlier in the day.

BEFORE:

The physician’s first step would be to try and locate who is currently responsible for the patient’s care in the med/surg unit. The physician would need to pinpoint the patient’s unit via either the main switchboard or an educated guess. Once the patient was located, a call would be placed to the charge nurse for that unit who would then look up the patient and determine which nurse on the care team was currently responsible for the patient. Here is where the process gets tricky (or in “lean thinking” where the value stream can be improved) – the nurse would need to be contacted to answer the physician’s question so the charge nurse would:

  1. End the current call and let the physician know that the patient’s nurse would call back as soon as possible.
  2. Go on a hunt for the patient’s nurse.
  3. Once contacted, interrupt the nurse’s current duties in order to call back the physician.

So finally the communication can be completed – but wait – there’s more complexity. If the nurse calls the physician back and the immediate conversation is unsuccessful (i.e. the nurse has to leave a message for the physician), this “phone tag” starts all over again. One physician stated, “It takes me 15 minutes on average to check on the pain level or condition of a patient”.

AFTER:

Now consider a mobility deployment where the nurses within the hospital are utilizing hospital-supplied smartphones running a clinical communications application and the physicians, who have their own smartphones, are running the personal device (BYOD) version of the app.

The scenario changes are dramatic, namely:

  • The physician no longer needs to locate the patient. The patient and all pertinent information is assigned to the physician within the app. More importantly, the physician can view all patients under their care across multiple facilities.
  • Instead of the charge nurse determining who is responsible for the patient and tracking that nurse down, the physician can see the patient’s care team and their real time status.
  • The physician no longer interrupts the nurse’s work. The physician now sends the question via a secure text message and the nurse can then respond at the first free moment.

This same physician, when asked how long this patient inquiry and answer now takes responded, “As little as 15 seconds.”

So when my friend looked at the before and after through his “lean thinking” lens, he had the following breakthrough analysis:

“By deploying smartphones and clinical communications software throughout the hospital, this facility has taken lean thinking all the way into the hands of the clinicians. There are not many opportunities to take a 15-minute process and reduce it to 15-seconds; but mobility, applied to the entire care team can do this repeatedly.”

Now his mind was racing to find other use cases and I leave you with a similar challenge: in your hospital where will better clinical communications take a critical process from 15-minutes to 15-seconds?

Clinical Communication – What is it? Why is it?

Welcome to the Mobile Heartbeat blog! Our staff will be blogging on a number of topics related to clinical communication but to get us started, some Q&A is in order:

Q: What exactly is “Clinical Communications”?

A: It’s much more than secure text messaging. True clinical communications provides the integrated ability to:

  • Conduct a voice call with another staff member
  • View pertinent patient information that is complementary to the hospital’s EHR
  • Receive alerts, alarms and other broadcast messages
  • And of course – send and receive secure text messages

This needs be done via two important criteria – clinical communication should be patient-specific and it should enable the clinician to see EXACTLY who is on each patient’s care team at all times.

Q: So what do I get from putting a clinical communications system in place? What are the benefits?

A: Consider all of the clinical touch points in your organization – from looking at patient lab results to finding a colleague for a consultation. Now remove all of the friction associated with these everyday actions. Clinicians can reach each other seamlessly and patient lab results are available on the user’s smartphone via a single click. Clinicians can now better focus on their patients and the practice of medicine.

Q: What does Mobile Heartbeat have to do with all of this?

A: We built out clinical communications software around the following premises:

  • Instead of the clinician having to find information, the information should find the clinician. This means that “push” technology is used whenever possible. For example, Critical Lab Results are “pushed” out to the care team’s smartphones as soon as the results are available.
  • No proprietary hardware. We believe that every hardware item should be commercially available from numerous sources. From smartphones to charging racks, they should all be available “off-the-shelf”.
  • It’s all about each patient and their care team. The notion of patient-centric is overused. All clinical software should be patient-centric otherwise why would it exist? However, we believe that a clinical communications system should be patient-specific. Each patient’s care team is unique and this combination of care team members should be recognized and kept up-to-date in real time.

Q: Who is Mobile Heartbeat? I’ve never heard of you until now!

A: Until recently, we’ve kept a fairly low profile. Our first hospital to use our software was installed in September 2011 and has been utilizing our product for almost 3 years. We have successful installations ranging from community hospitals to large teaching hospitals and even the largest for profit hospital operator in the world.

We’ve chosen to focus our efforts on our product and its benefits to clinicians and patients – we look forward to hearing from you to see how we can help solve you clinical communications challenges.