Category Archives for General Interest

Nurse with patiens

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 Outdated and antiquated systems like this do a disservice to the noble profession of nursing, to hospitals and ultimately to patients.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.

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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.

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Nurses Week Thank You

National Nursing Week 2020

As we prepare to celebrate National Nurses Week during the Covid-19 pandemic, it’s difficult to find words that adequately express the thanks and gratitude that each of us feels for America’s brave, dedicated, and heroic nurses during this crisis. And the truth is that even a week of honoring our nurses simply doesn’t cut it, because they deserve our respect, thanks, and admiration every day of the year.

For many folks, it’s hard to understand why anyone would want to work in such a physically and emotionally demanding profession, but the truth is that many nurses don’t think of it as a profession, but rather as a calling. That was certainly the case for Florence Nightingale, the British nurse whose experiences on the frontlines and advocacy work back home helped reform medical care and established nursing as an essential position in society.

Each year, National Nurses Week begins on May 6th to celebrate America’s nursing professionals and concludes on May 12th–a date that was symbolically chosen because it is also Florence Nightingale’s birthdate. To celebrate the 200th anniversary of Nightingale’s birth, the World Health Organization declared 2020 the year of the nurse, which is especially appropriate in this time of global health crisis.

Nursing in the modern era

While supportive care roles have always existed in some form throughout recorded history, nursing as we know it today only came into existence in the second half of the 19th century, as Nightingale and others began to recognize the dire need for skilled healthcare providers, both on the war front and at home.

Nightingale, who cared for wounded British soldiers during the Crimean War, witnessed firsthand the pain and suffering her patients experienced due to a lack of proper medical care and trained nurses. Upon returning to Britain, Nightingale embarked on a campaign of reform, publishing training manuals for nurses and advocating for the establishment of nursing schools and standardized care. In 1860, Nightingale and a group of influential benefactors established a nursing school at St. Thomas’ Hospital, where they began training future generations of nurses to implement their vision of increased care, better patient outcomes, and less global suffering.

Through tireless advocacy work, Nightingale and her supporters revolutionized nursing and helped establish the modern system of care. Politicians and citizens alike began to see that nurses are essential to a functional healthcare system. Working in warzones, hospitals, rural clinics, and family offices around the world, nurses provide critically needed care to patients day in and day out.

Today, Covid-19 provides a somber reminder of how crucial nurses and other frontline workers really are.

Ways to show your support

During the Covid-19 Pandemic, there are many ways that you can show your support–not only during National Nurses Week but also year-round.

  • Show you care and are thinking of them – As natural caretakers, many nurses and providers feel pressure to shield their friends and families from the stress and trauma that accompanies their work, shouldering the burden alone. During this crisis, reach out to the nurse in your life to let them know you’re thinking of them. Offer to make yourself available if they need someone to listen, and check-in with them weekly or bi-weekly. If they do want to talk about their experiences, remember to listen actively and show them you’re there, especially during hard times.
  • Donate PPE – If you or your business have a stockpile of personal protective equipment (PPE) such as N-95 masks, respirators, or face shields, consider donating it to a local hospital or through an online donation portal. By helping provide essential PPE, we can help keep our nurses and other frontline workers healthy.
  • FLATTEN THE CURVE! – One of the biggest ways we can thank our nurses is by following the guidance of trusted public health officials. Social distancing, frequent hand washing, and minimizing unnecessary trips outside of your home will help slow the spread of the virus and prevent the healthcare system from becoming overwhelmed. By abiding by the CDC-recommended best practices, every one of us can help save the lives of patients as well as healthcare workers.
  • Donate to the American Nurses Foundation Coronavirus Response Fund– If you would like to give a financial gift, considering donating to the Covid Response Fund for Nurses, which is run by the American Nurses Foundation, an official partner of the American Nurses Association. This fund benefits nurses in a variety of ways, from offering direct financial relief to funding access to mental health care professionals during this time of crisis.

Today, nurses and other healthcare workers are more united than ever in the face of Covid-19. Simply put, never in our lifetime has there been a greater unified effort to confront an illness on frontlines around the world. Together, let’s thank our nursing professionals and continue the crucial advocacy work needed to ensure that our frontline workers have the resources they need to stay safe.

 

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ActionCue Clinical Intelligence Software

3 Reasons Why “Designed by Clinicians” is Not Going to Save Healthcare IT

A recent article in Medical Economics, “The Promise of Next Generation EHRs” was an interesting read.  It got me thinking, and there were a few parts of the article that left me uneasy, given the challenges in healthcare today.

First, the article cited reports that point to software as the primary administrative burden to physicians’ productivity. The article notes that inefficiencies in software lead to click fatigue and multitasking, which ultimately lead to mistakes.

Indeed, mistakes are very serious problems in healthcare. However, it’s not only physicians who suffer from inadequate software - nurses, clinicians and a host of administrative staff are spending most of their day using various software systems and applications.

Second, and perhaps more importantly, while stressing the need for flexibility and usability in information technology for healthcare orgs, the author specifically advocates that the best software is “designed by clinicians”. Ironically, this “designed by clinicians” paradigm is a major contributor to the dissatisfaction many users have with healthcare software products – including EHRs.

Of course, healthcare application vendors would be silly not to include significant input from current and former clinicians. Clinicians’ hands-on experience is invaluable to clinical in the form of environmental background, workflows, user scenarios, use cases, specific requirements and other types of content.

The much greater concern over healthcare institutions jumping onto the “designed by clinicians” bandwagon is that it quickly leads to the idea that software must be designed, not by just any clinicians, but by their own in-house team of clinicians.

Thus, when considering new software products, healthcare leaders are quick to ask the vendor, “Can we customize it?” (meaning a unique instance of a product, custom-developed for an organization) before they have seen much of the existing product.  That question is where the real trouble begins. It is far from the end of the story, however.

Challenges in Healthcare Software Design

Improving software in healthcare is a noble - and very necessary – goal. But when the rubber meets the road, software designed exclusively by clinicians leads to three major pain points that are already widespread in healthcare organizations.

Problem #1 – Clinicians and Developers working together: mismatched skills match lead to less than optimal products

 The best software vendors use highly trained with a wide breadth of expertise in fields like information engineering, perceptive science, psychology, user interface (UI) and user experience (UX), for starters.

It takes all these skills and more to shape an optimal UX for a software product. Unfortunately, not every software developer is also gifted with design skills. Similarly, clinicians are untrained in the various disciplines of UX employed by a design expert during the product development process. As end-users, clinicians are often better at describing the problem rather then envisioning “clean slate” solutions that could drive the desired results.

In other words, both sides may be operating outside their area of expertise. Thus, having clinicians tell programmers what they want can lead to problems such as:

  • Communication breakdown over terminology
  • Conflicting approaches to both the problem(s) and potential solutions
  • Extra time spent in design and review processes to educate clinicians on UX and design principles
  • Important design features are diminished or omitted

To avoid this scenario, I feel that the best outcomes result from software designed not by, but with clinicians at multiple points during the design, development and maintenance phases of the software lifecycle.

Problem #2 – Customized product development “branches” leads to higher cost, but not necessarily higher performance

In recent years, custom development of healthcare management platforms has become ever more common. Vendors are eager to offer customization because they can charge more for the end product, while simply passing on the additional development costs directly to the customer. For some, in fact, it’s become a major part of their business model.

The more vendors provide custom development, the more customers ask for it, and so begins a vicious cycle. But the ugly truth is, while custom development or “customization” of healthcare IT products is lucrative for the manufacturer, it doesn’t necessarily benefit the customer. Much of customization work amounts to simple personal preferences which have no effect on patient care outcomes. Custom-developed products

Problem #3 - People tend to lean on (and thus design based on) what they know

One of the most important skills professional software designers have is the applied fundamental of design thinking. Design thinking uses a set of defined principles and constructs, combined with a very intentional process, to realize a desirable end product. Design thinking helps product designers fight the (very human) urge to “go with what you know”.

Most of us, when asked how a new system or product should look or work, will describe something very much like what we have used in the past – regardless of how well that product met our needs. People tend to lean on familiarity (often without even realizing it) which results in a “that’s the way we’ve always done it” attitude. It is this attitude that holds back much-needed progress in hospitals, clinics, and other healthcare organizations.

The unintended consequences of this perpetual cycle are:

  • Unintuitive platforms that are difficult to use
  • Software that feels just like a digital version of outdated paper forms
  • Expensive cycles of customization
  • Wariness at trying new products and systems

After a few years and many thousands of dollars, too many healthcare organizations find themselves still encountering the same problems.

Taking steps toward meaningful and effective change in healthcare Performance Improvement Software

So what should healthcare organizations do? It will require a major attitude shift to get out of the rut that’s been dug over decades of stagnation and frustration at ineffective systems. Meaningful change requires buy-in, starting with management on down through all levels of the organization.

Here are some starting principles for effective change:

  • Commit to innovation in selecting, acquiring and using healthcare management software
  • Accept the idea that progress comes with a certain amount of pain
  • Seriously consider newer, smaller vendors because they are the ones best positioned to truly innovate
  • When evaluating a product, focus more on organizational goals and actionable insights needed and less on tasks, processes and reports used in the past
  • Give turnkey products a chance to demonstrate their full functionality before asking about what can be built
  • Focus on whether a product is intuitive, easy-to-use and even exciting to think about using. If it’s not, keep looking

Developing New Approaches in Healthcare Performance Improvement Platform Software

The takeaway here is that optimal product design “takes a village” – a multi-disciplinary team that includes, but is not controlled by, end users (clinicians, physicians, administrative staff).

ActionCue CI is built upon this principle. Our innovative solution was developed in partnership with clinicians, as well as highly trained UX/UI product designers, to address known problems in ways that go beyond what myopic visions of what so-called ”new” solutions can lead to. The dashboard is configurable to meet the unique needs of risk managers, clinicians, and healthcare executives while avoiding the pitfalls of full customization, resulting in a more cost-effective and intuitive product that end users love.  By providing configurability without customization, ActionCue CI delivers an affordable solution that still meets specific users’ needs.

Would youlike to learn more about ActionCue CI and how it can benefit your organization?

 While there, be sure to check out the “Watch It Work!” video and sign-up for brief walk-through of the platform from a Product Specialist.

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The Equifax Data Breach – What You should do to Protect Yourself!

This advice is from Prista’s partner and advisor for HIPAA Compliance, Third Rock.  Considering the vast number of individuals impacted by this breach event, and the seriousness of the issue, we thought it would be good to share this.  Please consider these steps for your own effort.  You can also see this article from their current newsletter, find other resources and subscribe to their newsletter here.

If you would like more insight or help with your organization’s HIPAA Privacy and Security compliance, you can direct any questions or follow-up to Robert Felps at Third Rock, via email or call 512-310-0020.


Stealing headlines from Hurricane Irma was the revelation that Equifax experienced a major data breach during the summer.  Equifax is one of the “big three” credit monitoring services and therefore the data they collect on each of us is broad and deep.  They estimate that data for 143 million people –  nearly half the population of the United States – has been stolen!

What does this breach mean for you?  Your financial history and ability to buy a home, new car, or even get healthcare could be at stake.  Here are recommended steps to protect you and your family.

  1. Be skeptical! Equifax is looking out for itself, not you!  They will fight to survive this fiasco, spending the minimum required. Don’t give away your rights – read all documents carefully before signing. Don’t rush to sign any agreements. The aftermath of the breach will play out over months, not hours, and new information will emerge every week.
  2. Be cautious! This breach is so large, scammers will take advantage of it.  Be wary of offers to sign up for credit monitoring services and giving out any additional personal information!  Validate the authenticity of any such services. Research these services because many do not provide the protection you need or believe you will receive.
  3. Assume your data has been stolen, even if Equifax says your data has not been stolen! Breaches tend to grow over time because companies often under-report to minimize the bad publicity. As the company investigates the breach, they are also likely to uncover more theft that wasn’t obvious at the beginning of the investigation. For instance, on Tuesday of this week, it was publicized that EquiFax suffered additional breaches this year before this major breach.
  4. Check the Equifax website set up to inform people if their data was stolen. The link to the site is  equifaxsecurity2017.com.  Questions abound about whether the website provides accurate responses or not!  Remember, be skeptical!
  5. Keep all your records! Record all your interactions with Equifax. Ask for email confirmations after phone conversations. Save email as PDFs.  Any costs you incur, get receipts and put them in a specific location or folder.
  6. Check your credit report at; https://www.annualcreditreport.com/index.action. This is a free service and you can get one free report a year from each credit reporting service.  I recommend getting one report every 4 months from a different service so you can maintain a fairly regular status of your credit information.
  7. Freeze your Credit – this is your last option and prevents companies from checking your credit score in an effort to get additional credit. This is not something you should do without evaluating your circumstances.  If you are planning to purchase a new car, take out a loan, or get a new credit card, you should evaluate your options.

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