Vituity's innovative acute care solutions are improving life for patients across the country. Watch the video or read the transcript below for three stories of healthcare innovation in action.
1. Vituity's Collaboratives: National, Cross-Functional Innovation
Location: Swedish Edmonds Emergency Department (Wash.)
- Gregg Miller, MD, Chief Medical Officer, Vituity
- Brian Mitchell, RN, Emergency Nurse, Swedish Edmonds
- Jeremy Hammel, MD, Emergency Department Medical Director, Vituity
- Devin Ball, RN, Emergency Department Supervisor, Swedish Edmonds
- Mike Hastings, RN, Emergency Department Manager, Swedish Edmonds
- Jean Doerge, RN, MBA, Nurse Executive, Swedish Edmonds
Gregg Miller: Vituity's culture is all about innovation and collaboration, and we use that to really transform the care that we deliver across the United States. One way we innovate is through our collaborative model, which is a great opportunity for all types of providers from the healthcare environment to get together in a room. We involve doctors, we get nurses, advanced providers, healthcare administrators, lab personnel, registration, radiology, whoever is important.
Brian Mitchell: We [at Swedish Edmonds] have a new [ED] building that's approximately two-and-a-half years old now. There were a lot of growing pains that came along with this building, which was bigger and a different design, different efficiency.
Jeremy Hammel: There were changes in the layout out of the emergency department. Things didn't flow quite the same way as they did before.
Devin Ball: We wanted to come up with a way to improve the throughput of our department to get our patients seen much quicker and get their treatment started so that we could have better outcomes and decrease length of stay as much as possible.
Mike Hastings: It's always a stressful time on your staff when you have higher volumes than you typically see. We were seeing about 30 to 40 patients a day additionally beyond our historical baseline.
Jean Doerge: The Vituity [ED Throughout] Collaborative presented an opportunity for us to learn how to do our work differently. It created a chance for people to work together and do some design work, which is sometimes hard to do in the midst of the busy, day-to-day responsibilities that we have.
Jeremy Hammel: Even though all the sites [participating in the collaborative] were different with different volumes and challenges, there were also common threads. Sometimes a team would get up and present the ideas they'd come up with, and all of us around the table would look at each other like, "Hey, we could use that," or "We could implement something similar at our site."
Jean Doerge: The results are exciting. We know that for the more than 50,000 patients served [during the collaborative], we've reduced their wait time and their throughput time significantly. And that's what it's all about: great customer service.
In January 2017, volumes were up 5 percent. However, turnaround time to discharge was down 27 minutes (12.5 percent).
Gregg Miller: We've seen significant improvements in productivity. We've seen improvements in throughput. We've seen improvements in patient experience. We've seen improvement in readmissions. We know that this is a model that works, and that's why we're continuing to invest in this.
Brian Mitchell: The Vituity partners provide a lot of support for us, but they don't micromanage. They offer support where it's needed, but they also know that you [the nurses] know your facility best. I've heard many of them say that.
Jeremy Hammel: It's so helpful to have the specialized personnel that Vituity made available to us: the practice management consultants and some of the data people who helped us actually put together the sheets to track what we were doing. Those are not always the sort of skill sets that we would have at the local level.
Gregg Miller: We save lives. That's our job, right? We don't know how to actually manage a program or manage a project, and so a collaborative really brings that skill set and a real sense of organization. And that increases the ability of these sites to really implement change and hard-wire that change once the initiative's over.
Brian Mitchell: With Vituity putting in as much effort as they have to back this, between their time and their resource investments, just shows me that they're in this as well.
Mike Hastings: They've been a phenomenal group to work with, and I'm glad that I'm here and that they're here with me.
Devin Ball: Having the support and strength of Vituity behind me makes my job easier. They help me to support my staff and patients.
Jean Doerge: Solutions come from the frontline, and solutions come from people that know their work and know what's needed. The collaborative helps us put together frontline thinking and solutions and do some rapid redesign and measure our results. I think that's the essence of how we change, how we transform, and how we improve.
Gregg Miller: Vituity's culture really is a collaborative culture. It's a culture of partnership. And so I think that's our DNA. We want a partner, we want to work with everybody on the team.
When we give the teams these tools, it's amazing what'll happen. You just step back and let people loose. Beautiful things happen at our sites when they engage with the collaborative.
2. Vituity's Innovation Grant: Driving Local Results
Location: Arroyo Grande Community Hospital Emergency Department (Calif.)
- Juan Reynoso, Jr., MD, Regional Director, Vituity
- David Griffith, MD, Emergency Physician, Vituity
- Janet Young, MD; Vice President of Operations, Emergency Medicine; Vituity
- Rick Newell, MD, Chief Transformation Officer, Vituity
- Margaux Snider, MD, Emergency Department Medical Director, Vituity
- Dan Culhane, MD; Vice President of Operations, Emergency Medicine; Vituity
- Matthew Scales, MD, Emergency Physician, Vituity
- Villa Infanto, RN, MBA; Vice President, Patient Care; Arroyo Grande
Juan Reynoso Jr: I'm very grateful for our Innovation Grant that we have within the organization.
David Griffith: The Innovation Grant first and foremost gave me financial support in order to take time away from my clinical shifts to be able to dedicate time to this project. When I took over the job of doing the cultures for our group, it was fairly tedious, cumbersome, and flawed.
Juan Reynoso Jr: I think our microbiology culture management process that Dr. Griffith has been able to explore is a perfect example of who we are.
Janet Young: He identified a systematic problem, and even better, he came up with a solution.
Rick Newell: This is what led us to develop the Innovation Grant three years ago to build out and roll out frontline-driven solutions that aim to improve the patient experience, enhance clinical integration and care coordination, and further transform care delivery.
Juan Reynoso Jr: All hospital-based physicians are now heavily reliant on the electronic medical records system. Those systems are not without their own faults and problems. In the past, pending lab test results such as blood cultures that were drawn in the emergency department were falling off the list. This happens not just here but in every EMR in every healthcare system.
We are not afraid of taking ideas from any of our partners or advanced providers and sharing them with our hospital partners.
David Griffith: [Sitting at a desk with two computer monitors.] Welcome to the old system. When I was tasked with this job four years ago, this is what I was faced with every day. [Points to one monitor.] This is everybody who's had a lab test sent from our ED. This patient here has a normal urine culture, but this patient here has a positive urine culture, and there's absolutely no way for me to know that without opening their charts. [Clicks the mouse and waits. Chart loads on the second monitor.]
I have to wait for it to load. It loads up on the wrong screen. I have to change to the results screen, and then I have to go to the right tab to find out what the result is, and then I have to open the result. And then finally, I see that it doesn't matter. The patient's test is negative.
Margaux Snider: If you can think about how practical that is for your daily life, it's ridiculous. I mean, you would be opening sometimes a hundred charts a day. That's very time consuming.
David Griffith: The new way is called "the pool." [Refreshes the computer screen.] You can see that there are five people on the list now. And I can see whether the results are finished or whether they're still in progress, meaning there's no reason to open them up. I can see what kind of test was sent. So if there's a blood culture that's positive, I can see it right away. Boom. That's a blood culture, I need to check that out.
Dan Culhane: This takes a process that was very labor-intensive and paper-intensive and focuses it in a very concise way. It makes the practice better. It makes this a better place to work, and that's really important.
David Griffith: Right off the bat, I sit down to do my work every morning, and I can immediately see the [cases] that are most important for me to work on. I'll get right on those, as opposed to wading through what would have been 90 charts for both of my hospitals combined.
Matthew Scales: A lot of the burden, a lot of the risk has been taken away. Bad outcomes around culture results have plummeted. We hardly ever have any issues.
Villa Infanto: A lot of innovation comes up because there was some type of frustration at the beginning. We say, how can we do this better? And we were supported in this effort by Vituity, Dignity Health, and also the hospital in general. They said, "Yes, you need to move forward, because this is a process that we all are faced with. What can you do to help make it better?"
David Griffith: It was really only the freedom that Vituity gave my site over our own resources that allowed them to task me with this and make it happen.
Dan Culhane: There's no doubt that Dr. Griffith's use of this tool and the way he, as a doctor, uses it with patients has saved lives.
Villa Infanto: This is an innovation that is very unique to the Central Coast, and it should be spread out through the hospitals at Dignity Health and other emergency rooms that utilize Vituity.
3. Vituity Resources: Level-Up Technology
Location: Redlands Community Hospital Emergency Department (Calif.)
- Seth Thomas, MD; Director of Quality and Performance, Emergency Medicine; Vituity
- Brian Stinnett, PA-C, Advanced Provider Lead, Vituity
- Josh Tamayo-Sarver, MD, PhD, Vice President of Informatics, Vituity
- Pam Allen, RN, Director of Emergency Services, Redlands Community Hospital
- Charmaine-Mariz Mislang, Redlands resident
Seth Thomas: The challenge with Redlands Community was with their patient experience scores. They were really trying to innovate and come up with a way of improving their scores, and they felt that making patient callbacks was going to help them do that.
Brian Stinnett: We made multiple attempts to do callbacks in the past, and a lot of it centered around using paper lists and keeping stickers with medical record numbers and phone numbers and chief complaints on paper. But how do we keep track of those papers without losing them? How do you do callbacks from home? It became such a cumbersome administrative process that we wanted to do something different.
Using Google Docs and Google Forms, we were able to get away from the hard paper lists and make the info we needed accessible online. Providers could log in from anywhere to see it.
Seth Thomas: When they demoed it for me, I was blown away. I thought, This is really innovative. This is a really neat tech solution to try to help our providers make callbacks in an easy and convenient fashion.
Brian Stinnett: We needed something to further close the loop that was also able to access the medical record and be part of the medical record, in a sense.
Seth Thomas: So I went to the data team, our own in-house Vituity data team, and asked them to get involved.
Josh Tamayo-Sarver: The [Redlands ED] team was already trying to leverage technology. So clearly they'd identified a process that could — or even should — be better. They just needed the support, the infrastructure, and the expertise to make it better.
Brian Stinnett: The data team members were very excited to take what we were doing and transition that to other hospitals. They thought our idea could help other sites work more effectively with patient experience.
Seth Thomas: What the data team created is an app that sits on your phone and allows you to see the patients that you treated the day before or the week before. You're able to connect with them at just the touch of a finger. You make a call, and you can document that call right on the app itself, so compliance is automatically tracked for you. It's super easy, and it really allows our providers to do a great job without having to worry about the hassle of tracking callbacks.
Josh Tamayo-Sarver: The app is the right tool for Vituity providers, because it is born out of Vituity providers. Providers have a need, and they say this is the process I want. And then you create technology like this app that enables that process.
Pam Allen: Our CEO received a letter from a patient talking about her positive experience in the emergency department. What cinched it and just really brought it home was a callback that she received from the physician checking in to see how she was.
Charmaine-Mariz Mislang: I get this phone call, and the number looks familiar. It was the physician who saw me that evening. He just wanted to check up and make sure that everything was still going well. He said if there was anything else that I needed, I was more than welcome to call or come back [to the ED], and he was going to see me himself. And that was just really refreshing.
Seth Thomas: We do have evidence that the use of the callback app when targeting our high-risk populations can actually reduce ED revisits. That's incredible to me. And what that tells me is that we're able to continue the care of the patient outside of the walls of the hospital. It's an amazing thing for our physician to be able to say.
Brian Stinnett: One of the things that a lot of us did not expect was the positive effect it would have on me when I would reconnect with patients later on.
Seth Thomas: Making callbacks for me really speaks to the joy of medicine and allows me to appreciate the human aspect of my practice.
Josh Tamayo-Sarver: The reason that Vituity invests in technology and solutions is because by making providers better, more efficient, and happier, we can effect the lives of millions of people.
To learn more about Vituity's data solutions and capabilities, visit our website.
Originally published Dec. 6, 2018.