Smartphone platform speeds up hospital's nurse-doctor communications
New Hampshire-based Frisbie hospital has reduced communication lag time between nurses and doctors from 29 minutes to under 5 using a smartphone-based digital health platform. The system allows users to text and make direct calls to doctors depending on their urgency, reducing communication transaction time by 82%. 

Communication can be one of the most gratifying or frustrating processes that we experience every day—and typically fluctuate between one or the other at most hospitals.

Caregivers and support staff rarely sit by the phone, but instead, stay constantly on the move as they coordinate and deliver care to patients. Until recently, their means of communicating with each other moved at a considerably slower pace. Picture, for example, a nurse in such an environment who needs to update a physician on changes in lab values or vital signs. A call goes out to page the physician overhead and through the paging system. Minutes pass; sometimes many minutes. When the doctor calls back, the nurse is in a patient room. The doctor is put on hold, and if unable to wait, the nurse is asked to call back again, creating a cyclical process of inefficiency.

At Frisbie Memorial Hospital, we timed how long various communication transactions between a nurse and physician took using traditional pagers, telephones or cell phones. Results ranged from six minutes as the most efficient, to as long as 28 minutes. By using mobile smartphones, powered by a robust mobile healthcare communication platform, Frisbie replaced these sometimes lengthy communication processes with instant, direct and highly secure messaging between care members. To say this has made a difference is a significant understatement. Communication transactions between caregivers is now typically between 20 seconds and five minutes, which has had the cumulative effect of reducing all communication time between caregivers by 82 percent.

How secure messaging speeds up care

Here is a scenario that likely unfolds in hospitals everywhere, every day. A patient is scheduled for same day surgery, and as the appointed time approaches, the calls and pages begin to notify all appropriate staff. With traditional hospital communications, this is a process that must be repeated on an individual basis. Delays inevitably ensue and the patient may be left waiting. This in turn can touch off a series of delayed starts for the rest of the day in the OR, culminating in lost time and substantial costs. What if, instead, the entire team could be texted at once—and most importantly, given the capability to text or call back?

Frisbie Memorial has equipped caregivers and providers with secure smartphones to enable such direct and efficient communication. The change to care coordination is substantial. What was previously a multi-step process that had to be repeated with each caregiver is now replaced by a single group message to all care team members. From there, it is just a matter of receiving confirmation texts, which usually arrive within seconds.

Caregivers also have the option to communicate via voice calls; however, text messaging is by far the dominant form of communication in the hospital environment where people want to ask questions, and give or receive answers fast. At Frisbie, a protocol has been established whereby phone calls are considered urgent and require immediate response, and texts are considered less urgent and can be responded to within three to five minutes.

The actual technology Frisbie uses is a healthcare communications platform from Voalte, a comprehensive software and hardware infrastructure that enables secure voice and text communications between caregivers within and outside a healthcare organization's facilities. For internal communications, Frisbie utilizes Voalte's shared-device model, where smartphones are owned by the hospital and run the Voalte software solution that includes a directory, messaging by group, unit or individual employee; and an individualized text library. Frisbie's focus has been to implement Voalte smartphone communication around care coordination.

You can see how secure text messaging would speed up the original communication transaction described between a nurse and physician. In many instances secure text messaging completely cuts out the "middleman," such as the Unit Coordinator or other staff who would pick up a phone call at the main desk. It has most certainly transformed communication inside and outside the hospital, including communication between ambulances and hospital staff. The system also enables emergency responders to speak directly to a charge nurse in the Emergency Department, and access their role-specific medical text libraries to better inform the hospital about incoming emergency cases.

Mobile communications: a modern care coordination tool for the hospital

Over the years, healthcare has experienced many changes, especially in this current decade of healthcare reform and major leaps in technology. But certain truths remain timeless. One of the most fundamental is that hospitals must provide caregivers with the right tools to do their jobs. And that is what Frisbie's use of secure mobile communication is really about—equipping nurses and physicians and support staff with what they need to quickly communicate and coordinate care of the highest quality. Mobile communication provides a direct connection to effectively and efficiently relay information, ask questions and receive answers, whether a caregiver is physically on premises or not. As a result, everyone is informed and remains an active part of the care team.

Frisbie has had such success with a mobile communication platform, plans are in place to incorporate barcode scanning of patients and medications. This will reduce or even eliminate much of the current manual work required to verify patient identification, medication administration and other routine but essential patient care tasks. Frisbie also plans to extend the use of Voalte to providers' smartphones. This will further enable communication outside the hospital walls. Given that Frisbie has already made a substantial reduction in communication time—a full 82 percent decrease—expectations are high that these new features will likewise enhance collaboration and coordination between caregivers dedicated to swiftly meeting patient needs.

Sally Gallot-Reeves, MSM, CPM, CCM, RN, is Healthcare Project Director at Frisbie Memorial Hospital in Rochester, New Hampshire, and principal of Connect the Dots, www.ctdnow.com, a consulting company specializing in project management and change management.