Stormont Vail Health | Medical Services Innovation
Photo by THOMAS HALL
Like any other business, healthcare providers must stay on top of advances in the field, offer customers a better value for their money than their competitor, and continue to improve services. For Stormont Vail Health, the organization’s mission goes even further, aiming to positively impact the overall quality of life and health of the community that they serve. Stormont Vail’s leadership team is committed to empowering their workforce to continue to be viable and competitive, while also empowering patients to be active participants in their own care. It is no small feat, but CEO Robert Kenagy is proud of how well Stormont Vail is meeting its goals.
“Creating a sustainable care model relies on innovation,” Kenagy said. “Our investment in this innovation and new technology is an investment in our community. Not only are we investing in new technology to help our patients, such as the Virtual Nurse, we’re also working on a national level to develop and refine new medical treatments and therapies that can enhance patient care and well-being through our clinical research program.”
Looking toward the future, Stormont Vail Health is implementing new progra}ms and technology to offer cutting-edge patient care at the best value for the cost.
Quality service at a good value for the customer starts with contributions from everyone within an organization, which is why Stormont Vail Health has implemented Lean Six Sigma to improve performance. It is not only a set of improvement and innovation tools and strategies, but also a management system that leads to greater consistency and more reliable outcomes.
Chad Yeager, administrative director of performance, excellence and quality for Stormont Vail Hospital, said that leveraging Lean means empowering staff at every level of the organization to be a problem solver.
“With Lean we’ve developed improvement and innovation capabilities deep into the organization,” Yeager said. “This has led to breakthrough results that would have been challenging to achieve through traditional means.”
Stormont Vail Health has implemented Lean by flipping the leadership structure. Rather than all of the decisions and improvements coming from the top, leaders act as coaches and develop those skill sets deep within the organization.
“The goal is to create eyes for waste and encourage ideas for innovation at every level,” Yeager said. “We train staff to be efficient and flexible, able to adapt and act with agency. Lean gives the crew more buy-in, because everyone owns the improvements.”
One of the first tests of Lean was with the process by which Stormont Vail Health transports heart patients from home to the hospital’s cardiac catheterization lab, where treatment begins after a heart attack. The government sets a time benchmark of 90 minutes for this process to meet quality standards, and the top 90th percentile of hospitals consistently complete the process in 48 minutes. }Stormont Vail wants to be excellent in all that they do, so they used Lean to evaluate their process and dramatically improved their time, surpassing the 90th percentile goal.
But they did not stop there. They then applied Lean to inpatient length of stay to solve capacity issues and continue to look for ways to execute changes across all levels of the organization.
Stormont Vail’s commitment to systemic change has resulted in real stories of improvement in areas that had previously been challenging— allowing the organization to see movement in a positive direction with seemingly immovable problems.
Nurses are some of the hardest working people you’ll meet, doing some of the most important work necessary to keep people safe and well. They have a lot on their plates, which means that they might not always be available when a patient presses the call button. Stormont Vail Health’s Virtual Nurse platform is changing the traditional nursing model by giving patients access to a nurse via video and audio as needed.
A virtual nurse does not replace human nurses with computers. Tracy Duran, RN and Nurse Manager, is glad to say that no one is being taken out of the equation.
“Virtual nurse technology is about changing the workflow around nursing,” Duran said. “This is an addition, not a subtraction. You’ll still see the same bedside care, but with virtual nurse technology, you now have two nurses on the case.”
A virtual nurse looks like a 40-inch television and touchscreen computer in the room. If a patient calls for a nurse, or it is time to check in, a virtual nurse will ask for permission to turn on the camera, much like knocking
on a door. When permission is granted, the patient will then interact virtually with the nurse, much like having a conversation via Skype. The camera is only able to live stream a session, so nothing is ever recorded.
Virtual nurses are Stormont Vail employees committed to the organization’s values and mission. They help coordinate the care plan and perform electronic functions such as compiling a medication list or updating medical records. The virtual nurse can also be present when a physician visits, which allows for better coordination of care. The virtual nurse can bring up images such as x-rays and other medical information needed to make an informed plan.
The virtual nurse system, which was implemented in 32 rooms in the beginning, has resulted in a substantial decrease in length of stay in }those rooms where virtual nurses were put into action.
Duran credits the Virtual Nurse platform’s greater coordination of care with the results. Staff members are asking questions in a timely manner, which means setting up any consultations with other providers and services sooner, and that directly impacts the length of stay.
“Virtual nurse makes sure that patient needs are met, and also helps balance nurse’s workloads,” Duran said. “It helps us meet our quality and regulation standards, and raises the bar for patient care.”
In healthcare, having an expanded network means the opportunity for a second set of eyes on a medical issue at the touch of a button. Instantaneous communication makes it possible for healthcare providers to work together in the moment, which is why Stormont Vail Health is a member of the Mayo Clinic Care Network. The Mayo Clinic Care Network uses technology and physician collaboration to deliver a full spectrum of medical expertise to communities across the country and throughout the world. Through the network, Mayo Clinic collaborates with local providers, complementing their expertise. So what does this mean for patients? Clifton Jones, M.D. and vice president of specialty services at Stormont Vail Health, notes that being part of the network means additional peace of mind and the best quality care close to home.
“We have the ability to transfer lab data, pathologic slides, imaging and hospital and clinic documentation along with specific consultation questions to any Mayo Clinic subspecialty, frequently answering diagnostic and therapeutic questions without the need for the patient to travel out of state,” Dr. Jones said. “These are specialist-to-specialist consultations and typically are for extraordinarily complicated illnesses or unusual manifestations of common problems.”
In other words, the Mayo Clinic Care Network is like bringing another expert or specialist to the table to collaborate on patient care, and it can make all the difference.
Dr. Jones said that Stormont Vail has had more than 1,000 e-Consults over the past five years. The Mayo Clinic Care Network models the possibilities of collaboration to expand the reach of services.
“We’ve established this relationship with an international leader in the delivery of healthcare in order to advance the care we provide to this community and this region,” Dr. Jones said. “We can model our delivery systems through consultations focused on many different services and health issues, based on Mayo’s experience and vast reach, even where our volumes and reach are limited by where we are geographically.”
CLINICAL RESEARCH PROGRAM
Stormont Vail is not just relying on doctors outside of the community to make advancements in patient care, they are also driving research and innovation through their clinical research program, working on a national level to develop and refine new medical treatments and therapies that can enhance patient care and well-being. Mary Martell, director of research services for Stormont Vail Health said a strong research program benefits the community in a number of ways. First, clinical research means that patients who are suffering without clear-cut treatment options are able to access other avenues with improved efficacy or safety. Clinical research also results in innovative approaches to care, often in collaboration with other organizations moving toward similar goals, such as the National Cancer Institute.
“We work in many different therapeutic areas across the organization,” Martell said, “so patients suffering from many different conditions and diseases can access the research process and potentially benefit from participation.”
Martell said research programs also influence the culture of an organization, encouraging a learning environment and innovative spirit, and elevating expected outcomes. Staff members who work on clinical research have access to the newest information and best technology and are given opportunities to learn complicated procedures while assessing the efficacy and safety of a new treatment or medication. A standard treatment setting does not always allow the time necessary to work in this way, so clinical research allows staff to gain experience with components that are not yet part of standard care.
“This means that our staff are ahead of the curve,” Martell said. “When those innovations become the standard, our health personnel are already trained and ready to put that innovation into practice.”
Stormont Vail’s clinical research program also makes the organization more appealing to physicians, so it improves recruitment and retention.
“We’re not an academic medical center,” Martell said, “so the scale of our program is bigger than expected,
and that is often of interest to physicians. Bringing those doctors to Topeka has a ripple effect, where we are providing the best possible care.”
Recruiting high-caliber physicians and specialists means that patients are more likely to be able to receive care right here in Kansas, rather than having to travel. The goal is to ensure that people in need are able to access research opportunities and care close to home, which means that they can keep the support of their communities. It can make all of the difference.
Clinical trials are heavily regulated, and all of the research that Stormont Vail Health participates in requires scientific approval and protections by an institutional review board. The study design must support an appropriate risk-benefit analysis, and patients must always be protected. Most importantly, patients must truly be a part of the process.
“Patients are active partners,” Martell said. “They are highly engaged and informed decision makers. We work closely with them to make their consent to participate an ongoing process, with real-time updates and analysis, not a one-time decision. We help the patient to stay connected to the process, and we work to ensure access to all community members for the potential benefits of our clinical research.”
Martell said Stormont Vail Health is doing more than just sharing information with patients: it is actively listening to the community that it serves.
“Our goal is to empower patients in all aspects of their own well-being,” Martell said, “and to make a positive impact on the health of our community. It sounds so simple, but that’s really what it’s all about.”