Memphis nurses deliver better care through better technology

The nurse and patient relationship is a sacred one in healthcare--their interactions are the foundation of good communication, trust and high-quality care. And while good bedside manner hasn't traditionally been seen as a high-tech engagement, area healthcare institutions are incorporating revolutionary technologies to improve the patient experience, from check-in to check-out, and beyond.

Baptist Memorial Health Care is piloting a new program that features large touch screens with patient vitals and medical team information in each room paired with smart tablets and a mobile phone app for patient and family use, while Regional One Health is using new UV equipment to sanitize patient rooms, creating new nursing programs to retain staff, and using new protocols on the nursing floor to maximize patient care.

Baptist introduced its Baptist OneCare electronic health record system on January 1 at Baptist's four Minor Medical Centers and Baptist Medical Group clinics located throughout the metro-Memphis area, West Tennessee and Mississippi. The MyChart portal allows patients to schedule appointments, refill prescriptions, and send direct messages, photos and lab results to their care providers from their iPhone or smart phone.
 
"The MyChart patient portal application is for those that are outside of the hospital, and it is really a communication tool with your physician. It allows patients to set up appointments, get information on test results and keep track of things like allergies, medications or other pieces of health," says Chris Altendorf, Director of Baptist OneCare at Baptist-Memphis.
 
She explains that parents can also now easily keep track of vaccinations and print out the necessary letters for schools right at home.
 
The Baptist OneCare software, developed by Verona, Wisconsin-based Epic Systems, creates a single (security-protected) patient record that caregivers and patients are able to access. The goal is to improve efficiency by reducing the need for duplicate medical tests and patients having to provide the same information to multiple caregivers.
 
In July Baptist launched the MyChart Bedside pilot program for long-term patients at its Baptist-East transplant unit, which includes roughly 60 Baptist employees.
 
"MyChart Bedside is focused towards each inpatient to help improve communication and to give that patient a better feeling that they know what is going on with their health care," Altendorf says.
 
From a ten-inch Samsung Galaxy tablet provided by the hospital, patients can see daily treatment schedules, information on their diagnosis or medication, vital signs, test results, photos of (and details about the specialties of) their care team and direct communication via text message, and can even play fun games like Candy Crush.
 
"With the transplant world, some of our patients are here for a long time as they are awaiting a suitable donor, so the tablet also provides some diversional activities and games," says Renee Hatcher, Nurse Manager of the transplant unit at Baptist-Memphis.
 
She feels MyChart Bedside helps the nurses to provide more patient-centered care.
 
"So far we've gotten very positive feedback from the four patients that have used MyChart Bedside," Hatcher says. "Patients like having access to their health care. With their [medical] information right in front of them, it helps them to understand what they are taking and to think of questions to ask their physicians."
 
The tablets represent the second piece of the Smart Room technology, which syncs up with Epic Monitors installed in each room. The large touch screens give the hospital staff instant access to a variety of important information on each patient. The next piece of the Smart Room project will be getting IV pumps integrated into the medical record system.
 
The successful pilot program is likely to be used throughout the 14-hospital Baptist system (including 14,000 employees and 4,000 affiliated physicians) in future years. Baptist treats approximately 85,000 admissions annually.
 
Regional One is implementing a new technology to help fight against infections, using ultraviolet (UV) disinfection devices to thoroughly clean the rooms after a patient is discharged or any time a patient is moved from a room for an extended period. The mobile device eliminates some of the harsh chemicals found in sanicloth wipes.
 
"We have focused on many initiatives for reducing blood stream infections, catheter-related infections and wound infections," says Regional One Chief Nursing Officer Pam Castleman, who oversees the hospital’s 862 nurses.
 
Teaching for the future
In July, Regional One kicked off a partnership with the University of Memphis on a new nurse residency program, as the first cohort of 19 nurse graduates began the one-year program.
 
"New nurses in most programs are now calling and asking at the hospitals they are applying for to see if they have nurse residency programs. It is very desirable because they know the benefits," Castleman says.
 
The idea to implement the new residency program came about as a way to improve the hospital's first-year retention rate of 90 percent and its overall employee turnover rate. Castleman expects to have two to three cohorts per year in the program, with the overall result being better care for patients.
 
"Our goal is to decrease the number of inpatients and take care of our patients on an outpatient basis as much as possible, and to keep them out of the hospital," explains Castleman, who estimates the cost of orienting a new nurse is between $25,000 and $40,000.
 
The new UHC/AACN residency program meets national accreditation standards and helps new graduates as they transition into their first professional positions. The program is funded through a donation from Ann and John Stokes, the Community Foundation of Greater Memphis, and Regional One Health Foundation in honor of Dr. Teresa Richardson.
 
Program Director Olivia Johnson is also managing the program right now, but Castleman expects to hire a new dedicated manager in the near future.
 
The RN workforce is expected to be one of the top occupations for job growth through 2020, according to a 2012 study from the Bureau of Labor Statistics. Projections call for a 26 percent increase in the number of employed nurses from 2010 to 2020 (jumping from 2.74 million in 2010 to 3.45 million in 2020).
 
Nurses are accepting new roles like nurse navigators, physician practice managers and care coordinators--some of which are being implanted at Regional One later this year.
 
"We will be hiring nurse care coordinators on one of our trauma units. It will be a pilot and if successful will be spread throughout the hospital," Castleman says. "We are trying to maximize everything that is done to the patient while they are in the hospital, and make sure that is done in a timely fashion, so we can discharge the patient and have a smooth transition to their next level of care."
 
Regional One is also one of the first in the local community to employ a perinatal patient safety nurse, and it is also in the process of filling a position for a patient safety nurse in its trauma center. On the floor, procedural innovations like hourly rounding, snap huddles and safety huddles keep communication flowing between staff and patients.