Integrating On-Call Scheduling Software to Improve Patient Care by Monitoring Pain Pathways
Valley Health is a not-for-profit organization serving the healthcare needs of residents in Virginia, West Virginia, and Maryland. Valley Health provides outstanding care to their patients through a system of six hospitals and related facilities, offering patients convenient care that is close to home. One of the Valley Health locations is Winchester Medical Center, located in Winchester, Virginia. Winchester Medical Center is a 455-bed Level II Trauma Center, Level III Neonatal Intensive Care Unit (NICU), Level 4 Epilepsy Center, Chest Pain Center, Advanced Primary Stroke Center, and a Magnet Designated Hospital. Winchester Medical Center is a resource for more than 500,000 residents, offering diagnostic, medical, surgical, and rehabilitative care, along with advanced critical care services in heart, neurosurgery, oncology, trauma and neonatal care.
A Unique Approach to Managing Patient Pain
Helping patients manage their pain is important to every healthcare facility. Being able to monitor and record each patient’s pain level on an ongoing basis can be challenging, as it takes a large amount of a nurse’s time.
According to Lorraine Leake, Corporate Director of Communications at Valley Health, the ongoing charting “takes away time from the patient, so anything we can do to help the nurse, so they are doing more bedside. That is our goal.”
Integrating 1Call’s On-Call Scheduling Software and the GetWellNetwork System
Lorraine looked at the various systems available in their facility, trying to find a way to make it easier for the nurses to monitor pain levels. Knowing that they had 1Call’s call center system that streamlines enterprise-wide communications by providing patient room information and on-call scheduling information, along with the GetWellNetwork, which allows patients to enter their pain level with a remote control, Lorraine began working on a plan to get the two systems to work together.
Lorraine presented her ideas on merging the data in these systems to both 1Call and GetWellNetwork. The two companies then worked together to integrate the two systems.
How the Pain Pathway Process Works
To start the pain pathway process, a nurse scans a medication given to a patient. Fifty minutes later, the patient is asked, using the GetWellNetwork on their television, to rate their current pain level on a scale of 0 (low) to 10 (high). The result is sent through the GetWellNetwork to 1Call’s On-Call Scheduling module, which keeps track of the nurse responsible for that patient’s room, and messages the appropriate nurse with the result.
Early results showed a 48% average response rate from patients. “It is used in every inpatient area, except for the critical care area.” Lorraine stated.
A time study revealed that checking on a patient takes a nurse 9 minutes. Susan Clark, RN Clinical Manager for the Float Pool at Valley Health, commented, “For a pain scale of 0 to 3, when the nurse doesn’t have to do anything since the patient’s pain is being controlled, it saved 69,066 minutes in a two-month period, which turns out to be 1,151 hours. For a pain scale rating from 4 to 10, where the nurse would have to do something, it saved 74,988 minutes; basically 1,249 hours within a two-month period.”
Meeting Joint Commission Standards
The Joint Commission staff was impressed with how the pain pathway was set up at Valley Health. Joint Commission would like all healthcare facilities to have 100% documentation of pain scores. Valley Health’s scores were “originally around 59%, and went up to 89% in documentation with the pain pathway. The scores have gone up to 92% with this system in place,” according to Lorraine.
Valley Health quickly found out what an effective process this was. When the schedules for the nurses covering the patient rooms weren’t copied by several departments, the scores went down, giving them a way to prove that the pain pathway process is working.
Even though the process is automated, Valley Health still knows when something isn’t functioning exactly as they would expect. If a patient doesn’t respond to the GetWellNetwork pain level request, perhaps because their television is off, or the patient was asleep, the nurse receives a message that the patient did not respond so the nurse can check on that patient.
Although there were mixed reactions to this new process among the nurses, with some of them loving it, and some not liking the many messages that they receive, the benefits for the nurses make it a very worthwhile process. “They don’t have to go to the patient’s room, then get the medications, and then go back again. They are there one time, and that saves them a lot of steps,” said Lorraine.
Fine-Tuning the Process
At first, Valley Health wasn’t planning to use this system in the Pediatrics department, because they were worried the kids wouldn’t understand it, or think it was a game. The Pediatric nurses, on the other hand, wanted to have this available for their patients. When it was implemented, it worked very well.
Red Alert Integration
Valley Health also uses the 1Call Red Alert notification system. “We are sending reminders out through Red Alert, reminding the nurses ‘to chart your medications,’” Lorraine said. Susan added, “That has brought up scores on some of the floors that are very busy and always turning over beds and patients.”