A Salute to Nurses

As we celebrate National Nurses Week from May 6th to 12th, let’s reflect on how we can empower the untold heroes of hospitals to deliver excellent patient care. On the frontlines every day, as Dr. William Osler, the founder of Johns Hopkins University aptly summarized it, “the trained nurse has become one of the great blessings of humanity, taking a place beside the physician…” Despite the key role they play, more needs to be done to empower them to do the best work they can.

Nurse Educator and Author Sharon Hudacek hit the nail on the head, highlighting how “bound by paperwork, short on hands, sleep and energy… nurses are rarely short on caring.” The main touchpoint between patients, their loved ones and the medical system, too often nurses are compelled to step away from caring, supporting and helping patients to fill out forms and file reports.

In too many hospitals, nurses spend hours away from patients manually completing reports chasing down colleagues for information and tackling reams of past paperwork whenever information is needed. Outdated and antiquated systems like this do a disservice to the noble profession of nursing, to hospitals and ultimately to patients.

At Prista Corp., we know there’s a better way.

Nurses need a system that allows them to quickly and easily report on incidents, a system that allows seamless collaboration across the hospital, and most importantly, a system that allows everyone to use data to drive their decision-making. It’s this vision of an innovative, collaborative system that minimizes busy work that motivates our team of experienced clinical professionals when developing and optimizing ActionCue.

Ahead of her 204th birthday, we hope to continue embracing Florence Nightingale’s advice that we must “never consider ourselves finished, nurses. We must be learning all our lives.”

This article first appeared in the May 2024 edition of Marketplace, the monthly newsletter of TORCH Management Services, Inc.

How Excellent Patient Care Saves Costs

Patient Safety is defined as “the absence of preventable harm to a patient and reduction of risk of unnecessary harm associated with health care to an acceptable minimum.”  Every hospital in America has a stated mission to prioritize Patient Safety above all else.  “First, do no harm” is the most fundamental principle of any health care service.  Every healthcare organization says it, but are they really doing everything they can to prioritize patient safety?

The first step to solving a problem is admitting that you have one.  But what if you aren’t aware that you have a problem?  Especially in the Critical Access and Community Hospital space, where staff is stretched to non-optimal lengths, how can a facility, not only stay on top of patient safety, but take the time necessary to rigorously evaluate processes and policies to improve their quality of care?

Beyond the moral and ethical obligation to provide the best health care possible, there are clear financial benefits, although often unrecognized, unknown, or undervalued, to doing no harm.  When was the last time you truly evaluated your facilities process of minimizing risk events, and optimizing quality outcomes? Could it be improved upon? Can it make your facility more profitable? The answer is a resounding yes.

Look at your patient fall data to see how much you’ve paid for Cost of Harm falls last year – what else could your hospital have used that money for? Next time you need to tighten your budget, remember cost cuts don’t just come from lowering staffing or standards. You can also save by minimizing how much quality and risk incidents are costing your hospital.

We’ve found this is true amongst our customers. Using ActionCue© CI’s Performance Improvement Plans and the guidance of our Implementation & Support team, one of our customer hospitals reduced falls at their facility by 25% over three years. Based on the Center of Disease Dynamic’s Cost of Harm figures, this saved them almost a million dollars in additional costs.

Another hospital saved more than a million dollars over three years as their CLASBI cases reduced by almost 47%. A third hospital saved more than $80,000 by cutting their rate of VAP cases by 66% in three years of using ActionCue CI.

Improving the quality of care, through proactively tracking and tackling risk and quality incidents can lead to significant savings from the cost of harm avoided – money that can fund additional staff, equipment upgrades and other improvements.

This positive cycle can multiply – every dollar saved by avoiding a Cost of Harm event can be spent on further eliminating Cost of Harm events, leading to more savings from the cost of harm avoided. As the cycle continues, avoidable costs decrease while the quality of care – and your reputation – increases.

This article first appeared in the March 2024 edition of Marketplace, the monthly newsletter of TORCH Management Services, Inc.

Prista Corporation and Idaho Hospital Association Partner to Promote Advanced Clinical Intelligence Software in Idaho

Why the Healthcare Quadruple Aim Hasn’t (Yet) Hit the Bullseye

In 2014, the Triple Aim proposed by IHI in 2007 became the Quadruple Aim. This transition occurred because the objectives of the Triple Aim – better patient experiences, better population health, and lower costs – had been pursued mainly with what may have been an ill-conceived and dangerous assumption. Specifically, the dedication of clinicians and providers was assumed to be an inexhaustible resource of human initiative, technical expertise, and plain old labor.

This assumption was dangerous because significant driving forces in healthcare, such as administrators, investors, regulators, and vendors within the industry, held this assumption to be true. This view led to initiatives, compliance requirements, and work demands that frequently did not align strongly with those dedicated healthcare professionals’ motivations and goals yet asked more and more of them.

Finally, healthcare team well-being was added to create the vital concept of the Quadruple Aim. How much progress has been made in the eight years since?

Many have reported real progress on parts of the Quadruple Aim. Still, several things stand out. First, gains in one of the Aims sometimes come at a cost, even to the point of backsliding, in others. If the true goal is to optimize for all four Aims, why is this acceptable? Second, some efforts become parochial and limited in focus as though they are driven by more competitive or “better” thinking than the unified way of thinking that is required to serve the four aims. Third, some analysts consider operational efficiency a frequent enabler of competing goals, but honestly, efficiency has never been a core strength or serious pursuit in healthcare. While efficiency is usually the key to serving these competing goals, it may address the fourth Aim, the team’s well-being, the most. And that is why it becomes such a breakthrough for the Quadruple Aim because, with significant weakness in the fourth Aim, the other three are rarely, if ever, met.

Here is a simple but essential chain of thought. Performance Improvement, as the critical path toward the Quadruple Aim, needs to be deftly integrated into all the processes used to manage clinical care. Endless speeches, white papers, classes, and slogans are not enough to accomplish this. Instead, genuinely re-engineering the workflows and tools used is required. Contrary to this requirement, the typical approach to PI is to approach it as a distinct function governed by conceptual methodologies, which are only blueprints for manual human work. Any means of technical facilitation is usually homegrown, lacking standardization and any real efficiency, and so are pinpoint solutions serving only separate tasks in the process chain without real integration or collective advantage. In Enhancing healthcare efficiency to achieve the Quadruple Aim: an exploratory study published in BMC Research Notes, Bengt B. Arnetz et al. said, “To our knowledge, no previous intervention has primarily targeted efficiency for quality improvement.”

An advanced PI software workbench designed with the real goals in mind, not just the separate objectives’ tasks, and strong UI/UX (user interface and user experience) that is directly connected to the processes for tracking, analyzing, and investigating quality metrics and safety event reports, represents a significant and vital innovation that can have tremendous impacts on efficiency for the overall effort. It is certainly worth an exploratory look and, frankly, serious consideration, but many will not take that next step because it is very different from what they have “always done.” So maybe it’s time for a real break out to get to the Quadruple Aim.

CIHQ Interviews Prista Founders