When the Innovators Award was in the planning stages, the hope was that there would be broad interest across all hospitals and facilities. There was no magic number, but if there were, say, a dozen entries in each category, then the program would be a success.
Jump forward four years, and it’s easy to see how the Innovators Award, thanks to robust and growing input every year from all across HCA, has trounced expectations. More than 1,500 entries were received in the three categories, and now winners are chosen at the facility, division and national levels.
National winners receive $10,000 and the “Tommy” award, named for company founder Dr. Thomas Frist, Jr., who has long championed innovative thinking within HCA. Their stories are here, and this year’s division winners and their projects follow.
Improving Asset Allocation
Network revamps robotics inventory management system between divisions
There’s often a strong connection between early learning and lifelong success.
“I was raised by entrepreneurial parents,” says Sarah Dhane, Director of Robotic Surgery Operations at the Texas Institute for Robotic Surgery (TIRS) at St. David’s North Austin Medical Center. “Innovation and hard work were instilled in me from a young age.”
Dhane’s position involves operational development and oversight for the robotic surgery programs at 15 HCA-affiliated hospitals, including the Institute’s founding location at St. David’s North Austin Medical Center. Understanding the need to achieve greater efficiency, she developed the Robotic Inventory Exchange Network as a means to manage inventory reallocation between two Texas HCA divisions: Central & West Texas and Gulf Coast.
“Prior to the creation of the network, no process existed to coordinate the exchange of robotic supplies among HCA facilities based on need,” she says. “This resulted in overstocked products lying idle – or worse, expiring – at one hospital while another hospital was spending money to purchase those very same items from an outside vendor.”
Finding a solution
With the support of Dr. Randy Fagin, VP of Robotics for HCA, Dhane initiated the pilot for the network by establishing a communication framework around inventory visibility and exchange.
Hospitals with excess supplies posted them to a secure online portal, and hospitals that needed those supplies went to the portal to order them. This allowed the transfer of materials and funds to occur between HCA hospitals rather than between a hospital and a vendor.
In the first six months, more than $225,000 worth of supplies and funds were kept within HCA by transferring them among HCA facilities.
“We’re excited about the value this network brought to these two divisions in Texas and we are currently working with Parallon and IT&S to expand this capability across all of HCA,” she says. “As we work to scale this nationwide, we are also making significant improvements to the web-based application. I am just excited to see the value this brings to HCA by collaborating on a large scale.”
Dhane says that her new initiative would not have achieved immediate success without the support of the entire HCA community.
“From Parallon to robotic surgery coordinators, Amy DeCosmo at St. David’s Institute for Learning and the local team at TIRS and North Austin Medical Center – everyone played an active role in getting this project off the ground,” she says. “St. David’s is a collaborative and innovative organization. What I enjoy most about St. David’s is the people I get to work with every day. We have such a collegial crew here and we want to work together to implement innovative processes. It doesn’t matter what your role is, the benefit is ultimately to the patients we serve.”
Quality & Patient Safety:
Hopscotch program promotes collaboration
New tool for improved emergency care takes cues from a children’s game
Hopscotch isn’t just a playground pastime anymore – it’s helping hospitals improve communication among doctors and nurses so that they can make informed decisions about patient care.
Using the familiar grid, members of HCA’s Far West Division and others throughout the HCA community have developed a new tool for emergency room employees.
Hopscotch was created as a family of interconnected web pages that provides patient data, including labs, orders and vital signs – all displayed on one screen. The design features a series of squares that presents information in an accessible and easy-to-read format.
The IT&S team worked to create a graphic interface that would be visually appealing while still offering the necessary information.
“The most important goal is patient safety,” says Katie Bruels, Director of the Clinical Decision Unit at MountainView Hospital, Las Vegas. “We wanted it to become a very intuitive tool. The other tracking board we had been using was not feasible.”
More data, fewer clicks
Hopscotch is a customizable tool that offers more functionality while encouraging greater collaboration among physicians, nurses, facility executives and administrative department members. The tool also offers great convenience, providing appropriate patient data in as few clicks as possible.
“We sat down with our physicians and nurses and really drilled down what they liked and what they didn’t like about it,” says Dan Neuman, Manager of Application Services of the IT&S team. “You can basically see the whole department on this tool. You get more information on CTs and lab results. Before that level of detail was not quickly available. We can pull data from different areas and recompile it so that it re-displays as information that doctors and nurses can use.”
The IT&S team provides additional resources to help physicians evaluate, negotiate and manage their usage of the tool. An online user guide includes screenshots and graphics that help inform users about all of the tool’s features.
“We are constantly in that educator mode, working with the ER staff to get their input and help them use all of the features,” says Daniel Sowell, FWD Education Specialist of the IT&S team. “We have to put ourselves in the shoes of our users. We took the time to walk around the ER and see what everyone was looking at on the boards, answered questions and documented their suggestions.”
“It allowed us to capture the entire department and figure out whether our front-end process was backed up, or we had a significant amount of activity in radiology and imaging,” adds Dr. Scott Scherr, ER physician at Sunrise Hospital, Las Vegas. “It’s nice to get feedback on things we can improve so that it’s more user-friendly.”
With the right data at their convenience, physicians are more empowered to adapt to patient needs. Hopscotch helps them move forward with confidence when taking actions that can improve the patient’s health.
“It was enlightening to see it put to use,” Bruels says. “It shows that everyone from the nurses to the physicians is addressing the same issues.”
Turning tablets into lifelines
Technology fills the gap for mothers separated from newborns
Delivering a baby long before its due date is a terrifying experience for any mother. The tiny newborn may spend weeks, even months, in a hospital NICU before he or she is strong enough to go home. Usually, however, the new mother can at least visit with her baby and begin to bond during that time.
But what if there are complications that mean the mother is unable to be with the baby? When that happens, the stress of an early delivery is compounded by a mother’s inability to see, touch or hold her baby.
The NICU staff at North Florida Regional Medical Center knew that somehow, some way, that had to change. And working with tech partners within the hospital and at the division level, they created a way to connect mother and baby.
Using iPads and Apple’s FaceTime technology, a nurse in the NICU initiates a call to the mother’s tablet. Then she is able to see, hear and talk to her baby for as long as she likes. It’s not the same as being there, but it’s a huge benefit to everyone involved, says Deborrah Furse, Director of the Critical Care NICU/Nursery.
“We had a mother who had to be flown to Texas for some surgery after delivery, and the baby had to stay here,” Furse says. “As a mother, I can’t imagine being separated by so many miles. We can use the iPads to let mothers see their babies, even if they are just in the ICU here in the hospital.“
Solution boosts staff morale
The NICU nursing team loves the project, because instead of having to tell a mother she can’t see her baby due to risk of infection or other medical issue, they can get the connection going between two iPads and let a visit unfold.“The joy a mother has, even with just that tablet, is awesome to behold,” Furse says. “It has been wonderful to be able to share in that.”
The project required serious IT expertise, because the devices had to be rendered HIPAA compliant to be used within the hospital. Furse partnered with Edrye Copti, Senior Technical Analyst, to make the back-end operations happen.
“We’d never done something like this within HCA, so there was a lot to look at it in terms of HCA standards for security and patent information, as well as all the protocols around safety and security for infants,” Copti says. “We wanted to use FaceTime, as well as Skype, so that parents in the hospital could use it as well as those who had been discharged.”
Everything from reconfiguring the devices themselves to writing new release forms was folded into the project. Copti brought in Gerrett Conover, who at the time was Division Systems Administrator for the North Florida Division, to explore existing tech infrastructure and see how the program, once launched, could be duplicated at other facilities. Division Information Security Officer Debbie Bush also joined in, identifying what parameters needed to be met so that the overall project would be in compliance with HCA’s patient data and security processes.
“We wanted to repeat it throughout the division,” says Conover, who now is a Manager of Technical Services for the division. “We had the capability to set up the iPads, but we needed to get the profiles set up and then locked down so that they would be safe and secure. But that’s done, and now at least one other hospital is ready to roll it out.”
The project took a lot of time and effort, but both Copti and Furse point to one instance they say made all the long hours worthwhile.
“One mother stayed up all night holding that iPad and watching her baby,” Copti says. “She got to interact with her child the only way she could, and she was so happy she cried the whole time. Now other divisions are taking it and making enhancements to it, seeing how this idea can do more to serve our patients. It’s huge, and there’s just no telling where it can go, and grow.”