University of Medical Center DigitalCommons@UNMC

Posters and Presentations: State of the Art Nursing Conference

3-26-2019

Embracing Technology as the Extension of Nursing Practice to Enhance the Patient Experience

Liz Raabe Nebraska Medicine, [email protected]

Brandon Fleharty Nebraska Medicine, [email protected]

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Part of the Nursing Commons

Recommended Citation Raabe, Liz and Fleharty, Brandon, "Embracing Technology as the Extension of Nursing Practice to Enhance the Patient Experience" (2019). Posters and Presentations: State of the Art Nursing Conference. 1. https://digitalcommons.unmc.edu/state_pres/1

This Presentation is brought to you for free and open access by the Nebraska Medicine at DigitalCommons@UNMC. It has been accepted for inclusion in Posters and Presentations: State of the Art Nursing Conference by an authorized administrator of DigitalCommons@UNMC. For more information, please contact [email protected]. Embracing Technology as the Extension of Nursing Practice to Enhance the Patient Experience

Liz Raabe Brandon Fleharty

1 Frequently asked patient questions

Asking for a dining menu, or waiting on the phone to place the order When their last pain medication(or any other PRN) was given? What were my lab results? Who is my doctor, nurse, case manager, respiratory therapist? When is my MRI? Why am I taking that medication? What is my diagnosis or reason What was my blood pressure this morning? When do I get to go home?

How often are patients just bored......

How long does it take you ask patients screening questions on admission?

2 Quote from Study

In one study, 71% of patients felt the application provided useful information and 76% used it at least once a day. A larger percentage of patients were able to identify at least one physician on the team (56% vs 29%) and identify their role correctly (47% vs 16%). The effect of tablet computers with mobile patient portal application on hospitalized patients’ knowledge and activation. JAMIA, 2015

• 90% of patients reported that it helped them understand their medications better

Inpatient Experiences with MyChart Bedside. Telemed J E Health, 2017

3 Why Bedside?

Patient value Organizational value • Labs • Promote patient and family engagement • Vitals • Strengthen the patient-provider • Medications relationship & improve communication • Allow for a more enjoyable stay • Diagnostic procedures (entertainment) • Improve patient satisfaction scores • Scheduled Appointments • Meaningful Use • Care Team Members • Core Measures • Education topic • Reduce readmissions

4 What is Bedside? Home Screen

Reason for Admission • Info button linking • Medication List • Info button linking

5 Happening Soon - Schedule

Happening Soon • Schedule of events(Past and Future) • Visualization of medications given (Scheduled & PRN)

6 Taking Care of Me Care Team • Photos and Bio

7 One Chart| Patient Sign Up

Patient Portal Sign up

8 My Health

Vital Signs & Results • Trending

9 Dining Menu

Dining Menu

10 To Learn Interactive Patient Education •Content, Video, Teaching Sheets

11 Entertainment Applications

Entertainment Applications

Healing Arts Games News Sports Pinterest Candy Crush Omaha World Herald Fox Sports Go The CW Sudoku Fox News BTN2Go Kids Draw and Solitaire CNN ESPN Coloring Angry Birds WOWT NFL HGTV Mahjong NY Times MLB At Bat Infinite Painter The Weather Channel NBA Spotify Huffington Post PGA KETV KMTV

13 Implementation Timeline

2016 2017 2018 2019

Scoping/Pilot Cancer Hospital Evaluation & House-wide Go Live Re-engineering roll out Reference calls Specialty care Metrics Community Project plan Medical-surgical Workflow hospital Funding/approval Intensive care Technology Pilot on OHSCU Acute care hospital • LDRP • NICU • Pediatrics • ICU

14 How champions are made

COMFORT The more interactions with Bedside, the more comfortable nurses KNOWLEDGE become. EFFICIENCY • Provide resources to # of tablets More interactions over understand the why distributed time produces • and what of Bedside. # interactions with efficiency and • Tip sheets Bedside patient confidence. #1 • Training courses • # questions answered • Research articles by team CHAMPION The unique combination of knowledge, comfort, & efficiency helps create strong nurse champions.

15 Tablet Distribution Workflow

16 Tablet & Cleaning Distribution Workflow

Red light = not ready for patient use. Data wipe in progress

Green light = ready for patient use. Data wipe complete

Patient Joyfully Uses Tablet

17 Process Metrics

18 Outcome Metrics - HCAHPS Werner Hospital Patient Satisfaction Scores (Bedside Users vs Non-Bedside Users)*

100% 120

90% 100

80%

80 70%

Top % Score Top Box 60% 60

50% 40

40%

20 30%

20% 0 Info About Nurses Treat With Likelihood to Rate Hospital Overall Nurses Listen Staff Worked Nurses Explain Med Purpose Staff Took Med Side Effects Symptoms Courtesy/Respect Recommend Carefully Together Preferences Into Account

Bedside (n=300) Non-Bedside (n=1020) *Based on Discharges from 1/1/18 - 1/31/19 (Data as of 2/28/19) Bedside Percentile Rank Non-Bedside Percentile Rank

19 Outcome Metrics – Patient Portal

90 TOTAL PATIENT ACTIVATIONS IN ONE CHART PATIENT!!!

20 Outcome Metrics – Patient Engagement Activity usage (most to least) Hours of engagement My Health (Jan 2018 – February 2019) Happening Soon

Taking Care of Me 1,219

To Learn Patients

Notes 9,686 total hours of Let’s Eat engagement (average 9 hours/patient/encounter) Other Welcome Video 9,902 My Chart 16% Bedside Logins

21 Lessons Learned

People are resourceful

22 Motivation – Provider Feedback

23 Frequently asked patient questions Asking for a menu When their last pain medication(or any other PRN) was given? What were my lab results? Who is my doctor, nurse, case manager, respiratory therapist? When is my MRI? Why am I taking that medication? What is my diagnosis or reason What was my blood pressure this morning? When do I get to go home?

How often are patients just bored......

24 Motivation – Patient/Family Feedback

25 Motivation – Patient/Family Feedback

26 Questions?

27 Contact Information Liz Raabe Brandon Fleharty [email protected] [email protected]

28