Keeping staff in contact with each other had become a real challenge at Reading Health System. Even if they were in the same facility, doctors and nurses struggled to communicate with each other using landlines and overhead paging systems.
Reading Health System in Pennsylvania includes not only Reading Hospital, a 647-bed acute-care hospital, but also Reading Health Rehabilitation Hospital, which features a 50-bed skilled nursing unit and a 62-bed inpatient rehabilitation unit. The system also provides office-based primary and specialty care through Reading Health Physician Network, in-home nursing care through Reading Health Home Care, and retirement living through The Highlands at Wyomissing.
The solution to the health system’s problems was a secure mobile connection that could be easily transported and provide staff with an instant connection to their coworkers. Vocera Communications’ suite of secure mobile technology was chosen as the solution to the health system’s problems.
By Katie Wike, Contributing Writer
Thanks to quick and quiet mobile apps and devices, doctors and nurses are now in constant contact without interfering with patient care.
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Keeping staff in contact with each other had become a real challenge at Reading Health System. Even if they were in the same facility, doctors and nurses struggled to communicate with each other using landlines and overhead paging systems.
Reading Health System in Pennsylvania includes not only Reading Hospital, a 647-bed acute-care hospital, but also Reading Health Rehabilitation Hospital, which features a 50-bed skilled nursing unit and a 62-bed inpatient rehabilitation unit. The system also provides office-based primary and specialty care through Reading Health Physician Network, in-home nursing care through Reading Health Home Care, and retirement living through The Highlands at Wyomissing.
The solution to the health system’s problems was a secure mobile connection that could be easily transported and provide staff with an instant connection to their coworkers. Vocera Communications’ suite of secure mobile technology was chosen as the solution to the health system’s problems.
Overhead Paging Woefully Outdated
To communicate with one another, staff at the Reading facilities largely used overhead paging systems that required repeating messages throughout the entire hospital. “Overhead paging was disruptive and disrespectful of patients. It contributed to making the Reading Hospital a much noisier place than it needed to be,” says Jorge Scheirer, M.D., VP, and CMIO of Reading Health System. “It was woefully outdated.”
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Oftentimes a patient’s condition or needs drive the necessity for immediate communication. In a pager environment, this means the nurse goes to a landline and pages the doctor to that phone or to the unit secretary. Rarely is the nurse able to stand and wait for the physician to call back to a line.
Many times, by the time the doctor can respond, the nurse is needed for another task, whether it’s a procedure or delivering medication to a patient’s room. When the physician calls back, someone has to locate the nurse. According to Scheirer, this “page-and-wait” scenario is not productive for anyone on the care team.
Another hazard of paging is that the person using the overhead system has no way of knowing whether the person they were trying to contact is actually in the hospital. Not only that, but Scheirer explains it was not always possible to hear the overhead pages everywhere in the hospital. “You often heard ‘Repeat the page for Dr. X’ immediately following the original overhead page,” he says.
In 2005, Reading Health System opened a new emergency room building. The new facility was designed with four pods arranged in such a way that it was not possible to see and communicate directly with all members of the care team. The design of this new emergency department was the last straw for the health system, which was already aware of the problems associated with its current communication system.
Direct Mobile Communication Is The Answer
Vocera’s secure mobile connection devices provided the emergency department staff the ability to communicate directly with one another without pagers and without the disruption of noisy and ineffective overhead paging.
Primarily, Reading Health System uses the Vocera B3000 Communication Badge, which is a lightweight, wearable, voice-controlled device that enables instant two-way or oneto- many communication using voice commands.
“Hands-free critical communications are important, for example, when the neonatal intensive-care unit nurse resuscitating a newborn using both hands covered in thick gloves needs to call the code team. Or, in the behavioral health unit when an orderly needs to call for help when the patient suddenly becomes unstable or violent,” explains Scheirer. A voice-activated communications badge — or one with a quick button push — can more quickly (as compared to an overhead page) alert team members to a situation where immediate assistance is needed.
Currently, the health system is testing the Vocera Collaboration Suite (CS), which is a smartphone app that integrates existing Vocera functionality with the power and mobility of mobile devices. The suite combines the calling, texting, alerting, and content distribution capabilities of Vocera into one, secure, smartphone application. The software platform contains user profiles, groups, call management, and call connections, as well as the ability to interface to existing telephony. It also includes clinical alarm/alert systems to expedite communication of critical data.
“One of the most important facets in the mobile communications buying decision is that ePHI [electronic protected health information] remains secure,” says Scheirer. Under the HIPAA Privacy Rule, PHI refers to individually identifiable health information, that which can be linked to a particular person. Vocera provides the ability to passwordprotect devices and deactivate those that have been lost.
Doctors Connected Anywhere
With Vocera, the page-and-wait scenario is eliminated. A nurse can immediately contact a physician on a hands-free wireless badge or smartphone, even from the patient’s room. If doctors are not available, they can connect directly back to the nurse when they are free.
Another useful feature is the option to send HIPAA-secure text messages that can be answered efficiently within seconds. These text messages are a quick form of communication, and as Scheirer says, “This helps us provide a positive patient experience and drive quality of care as patient requests are answered quickly and efficiently.”
In addition to speed and efficiency, the Vocera CS is more secure than sending an alphanumeric page to a pager. If a pager becomes lost, anyone can scroll through the list of pages received and read any PHI it may contain. “We require that a smartphone using the Vocera CS have a password,” explains Scheirer. “If the phone is lost, the password should prevent access to any PHI on the phone.” Furthermore, messages are actually stored on a Vocera server and displayed on the phone. If the phone with Vocera CS is lost, the system can remove the device from the Reading network.
Another helpful feature is that staff no longer needs to know the extension of the person they are trying to contact. They can, for example, simply say, “Call Dr. Jones.” They don’t even have to know who the person is in each department. They can say, for example, “Call respiratory therapy.” The system will then send the call to the next available respiratory therapist for that unit.
Physicians don’t need to be aware of who is currently on shift caring for their patient — they can simply say “call Room 414’s nurse” and instantly be connected. “We also can set up groups so that multiple people can be connected at the same time, and if a person in that group isn’t available, the system automatically escalates to the next available person covering that role,” says Scheirer. “This functionality happens seamlessly and intuitively on our mobile device of choice [Vocera badge or smartphone], whether we are inside or outside the hospital.”
Now that Reading Health System has integrated its EMR system with the Vocera system, it can update appointments as well. For example, when a physician enters an inpatient consult, it sends a message to the provider on-call based on a schedule maintained by Vocera.
According to Scheirer, the hospital staff sends approximately 80,000 voice messages a week. “I can say that our hospital staff — including ED, laboratory, radiology, physical and occupational therapy, patient transport, dietary, anesthesia, nursing units — relies on Vocera as the method of communicating with one another.”
Keeping staff in contact with each other had become a real challenge at Reading Health System. Even if they were in the same facility, doctors and nurses struggled to communicate with each other using landlines and overhead paging systems.
Oftentimes a patient’s condition or needs drive the necessity for immediate communication. In a pager environment, this means the nurse goes to a landline and pages the doctor to that phone or to the unit secretary. Rarely is the nurse able to stand and wait for the physician to call back to a line.
