Rounding with IT staff has not only raised the IT skills of nurses, giving them a competitive advantage, it has also reduced the volume of help desk tickets and rewarded some IT staffers with a deeper level of purpose than ever before.
We hear about alert fatigue, but tech fatigue in general is also worthy of attention in healthcare.
As a way of combatting tech fatigue, the IT staff of HCA North Texas is making regular rounds of units, and in the process redefining how a healthcare IT department interacts with hospital and clinic staffs.
Miller told me how she partnered with HCA North Texas Chief Nursing Executive Carol Gregory to verify that the myriad of equipment in use by nurses at the division’s 13 hospitals was continuing to be in good working order to meet a variety of important objectives, including compliance with sepsis bundle initiatives to reduce mortality.
“What we realized is they don’t really have time to make the call to ensure their equipment is working, and [also] take care of our patients,” Miller says. “So we took some of the Studer Group nurse leader rounding principles, and we created tech rounding.”
Here is how it works. Once a week, an IT team from HCA walks through each unit. “You can think of them as operational blitzes, where every member of the IT staff, from our nurses, our clinical informaticists, to our technical folks, to our physician support folks, all round to a unit at once,” Miller says.
A More Proactive Service Team
The idea is to evolve from the traditional IT service desk model, where all too often, staff wait to get a call, then generate a trouble ticket, then resolve the problem, and then move on to the next call.
During IT rounding, IT staff does everything from updating tracking equipment, to clinician training on systems, to checking computers to make sure they are in good working order and running the latest updates.
By being proactive, HCA is avoiding IT troubles in the units later on. “Recently in our division, we proactively touched 4,000 scanners for exactly that reason,” Miller says. “We don’t want our nurses in front of our patients having problems scanning meds.”
In the last three months, HCA North Texas has seen an average reduction in total trouble ticket volume of 15% percent, which equates to approximately 7,000 tickets HCA clinicians did not have to call in.
HCA North Texas has seen an even greater reduction in high priority tickets, those that are urgent because they can directly impact or delay patient care. These high priority tickets have dropped by an average of 52%, or 787 fewer instances per month of issues delaying patient care.
As elsewhere, clinicians are literally surrounded by technology as they do their jobs. HCA North Texas has more than 700 different applications it uses to deliver care to patients and it is not uncommon for a nurse to interact with about 50 applications on a daily basis. So IT rounding is an effort to simplify clinicians’ lives.
As beneficial as IT rounding appears to be to HCA North Texas IT operations, its biggest benefit has been to improve job satisfaction of nursing and related staff, Miller says.
“What else can we provide nurses as a competitive advantage to recruit them? Traditionally, in the healthcare systems I’ve been in, we focus so much on the physicians, and sometimes our nurses get lost, so we’re really trying to change that.”
Additional Benefits to IT Rounding
IT rounding may also have other beneficial ripple effects. First, there’s the rest of HCA, a much larger national healthcare organization which could benefit from this practice and help it spread.
Second, this increased level of engagement between IT staff and clinical staff could definitely influence future technology acquisition decisions. As much as the healthcare industry likes to measure things, there is something about measuring the quality of a technology product or service by simply counting the number of trouble ticket it generates that fails to capture some essential properties of that technology.
Miller agrees, and says that the tech rounding notion was born in part at HCA North Texas’ quarterly governance committee. “We take a service line at a time and focus [in a] deep dive, look at what’s trending in the industry, where the pain points are for clinicians,” she says.
“Our senior leaders chose med/surg, which is how this all started. It brought a lot of good things to light, everything from what you say [to] how we approach RFPs for vendors to the new tech that we’re looking at.”
For instance, when HCA North Texas set a new standard for in-room computing, leadership took care to ensure it uses equipment that does not have our nurses’ back to the patients. “We changed some things up in the way they document and the way we communicate with them, education tools for the patients. I’m just talking about the blocking and tackling of rounding, but it has, there’s probably six initiatives just from this that have started because of this.”
Although IT staff was initially a bit hesitant to move away from its traditional role, it now means some IT staffers see the healthcare mission at a deeper level than some of them had before.
“One of our techs met a teenager who was suffering from cancer and not going to make it. [He was] just on palliative care, and all he wanted to do was play his Xbox, and so we were able to get an Xbox for him,” Miller says. “As each of these guys have this interaction at a deeper level, they are now believers. They realize it connects them to purpose, to why we’re here.”
Scott Mace is the former senior technology editor for HealthLeaders Media. He is now the senior editor, custom content at H3.Group.