Transforming Patient Flow at Trinity Health System

0:00:00.0 Matthew Colflesh: There’s been instances that trigger my mind all the time about, “We could have done this better or that better if somebody would’ve just gotten the communication directly to the providers, to the staff.”

0:00:19.7 Mary Ann Borer: Hi, I am Mary Ann Boer with HIMSS. And today I am joined by Dr. Matthew Colflesh, chief medical officer at Trinity Health System, and Dr. Will O’Connor, chief medical information officer at TigerConnect. And today our topic is Transforming Patient Flow, a conversation with Trinity Health’s Chief Medical Officer. And before we start, I want to say thank you to TigerConnect for sponsoring this podcast. Trinity Health System is part of CommonSpirit Health, one of the largest nonprofit health systems in the U.S. with more than 1000 care sites in 21 states, coast to coast, serving 20 million patients in big cities and small towns across America.

0:01:00.5 MB: TigerConnect transforms healthcare with the industry’s most widely adopted clinical collaboration platform, uniquely modernizing how doctors, nurses, care teams, patients, and data connect with a comprehensive range of solutions, including care, communication and patient engagement, scheduling, alarm notifications, nurse call, and more. TigerConnect enhances efficiency, lowers expenses, and ensures safe, reliable communication. Dr. Colflesh, Dr. O’Connor, thank you both for joining us today.

0:01:34.8 MC: Good morning. Thank you.

0:01:35.0 Will O’Connor: Thank you very much.

0:01:36.6 MB: Now we’ll start with you Dr. Colflesh. Could you please tell us about your role at Trinity Health, what type of patients you treat and how you support your community there?

0:01:47.9 MC: Sure. I have a privilege of actually serving in my community that I grew up in. So actually was cleaning floors in this hospital as a kid. So I had gone away. I’m an internist, so I had gone to residency in Pittsburgh, which is our closest tertiary care centers that we have here. And I came back 2003, and I’ve worked as a traditional internal medicine doctor through many different forms of medicine, whether it be in acute care, outpatient, long-term acute cares, hospice, many different areas of medicine. So eventually, I formed a hospitalist group in 2017 to meet some of the demands for the hospital. And I then went into leadership and ultimately became Chief Medical Officer as of last year, and I serve in that role. I oversee a number of operations in the hospital that involve really the clinical operations and safety quality of the physicians. I have oversight of physicians and also other folks in the quality departments to make sure that we’re accomplishing all of our goals for patient safety and quality. So there’s a lot to it, but that’s in a nutshell where I’m at now.

0:03:09.2 MB: Wonderful. Can you describe some of the communication challenges that clinical teams face in the hospital setting? What does care coordination look like?

0:03:16.3 MC: It’s hard to summarize in a short period of time because I have so much to say about it. But really the challenges that we had was sort of an archaic system of communication. And even with some of the latest platforms you may see outside of the TigerConnect platform, still communication can be very cumbersome. So I always say that in medicine especially, communication has to be perfect. And I always liken it to the military because the military, they don’t try to be good at communication, they have to be perfect, ’cause there’s lives on the line. And then it’s no different in medicine, lives are on the line even with minutes of communication. So what we had was a lot of relay systems where you call an answering service or you page somebody or you call through the nurse or the doctor might communicate through the nurse.

0:04:05.8 MC: And when we layered upon that a new residency four years ago, it made it even more complicated, because that’s one extra point in the whole matrix of communication that you have to go through. So we had many challenges in that regard, many difficulties with patient flow due to the number of calls that were being made and the wrong people were being called. Right? So you have to know who’s in the system to make it work right, to know exactly who’s available. So with those challenges, this is the tee up for TigerConnect, and I actually had known about the platform for quite a long time and was able to enter into the world of TigerConnect here in the past year, which has been a great benefit, which we can talk about.

0:04:54.0 MB: What motivated you to adopt TigerConnect for clinical communication and collaboration?

0:05:01.7 MC: Patient safety. I see everything in my role, and I also am a hospitalist. So I still practice that that’s the white coat today. So I’m in the weeds of the hospital, and I see how this goes. And having been here so long, I’ve seen situations that really go badly because of communication, and it’s not any individual’s fault, it’s a system problem, and people are set up for failure. And there’s been instances that trigger in my mind all the time about, “We could have done this better or that better if somebody would’ve just gotten the communication directly to the providers, to the staff.” So I can think of many ways in which we were failing in communication as a system, not as individuals.

0:05:49.0 MB: I see. So can you describe how TigerConnect has impacted communication within Trinity Health, and the outcomes you’ve achieved since you implemented it?

0:05:58.4 MC: You can talk about different aspects of what communication does, but you know we focused on patient flow to begin with. We use it for a number of other different processes as well. But if you focus on patient flow, patient comes in through the emergency department, and they’re going to need attention from multiple providers and also providers that are not in the hospital, so your consults or specialists. And for the ER to know exactly who that is at all times, not to go over and look at a list to see who’s on call, but actually see that in real time. Also with the nurses being on the same page, you save extra phone calls that you might otherwise have to do in order to get the same answers. So the consultants are brought into the fold of the ER, almost like they’re there.

0:06:45.5 MC: So when you look at the scheduling integration and in the TigerConnect, you can see that all in one area of your computer. So the nurse can see that immediately. When that happens, everything else works more efficiently, right? So within that 24-hour period, if you’re opening up an ER bed, that’s an extra patient or two extra patients that are gonna be seen in that period of time, that means they’re not sitting in the waiting room. That means they’re not being ignored, and that means that they’re getting to the floor of the hospital more quickly. So patient flow with staff shortages right now in 2023, it’s critical that we focus on that. And all efforts are being made to micromanage that to the closest degree that we can. So we don’t even look at just movement into seeing a doctor in the ER, which means door to doc time.

0:07:39.8 MC: These are measurements we’ve done for years. We’re actually looking at, “How long does it take for a patient that’s going upstairs to get from that bed to the bed upstairs?” So it affects flow, it affects quality. And if you look at all the data out there, it will all tell you that the longer the patient stays in the emergency department, the worse the outcome. So that’s well accepted in all hospital systems. I always say this to every single resident that we have. This is not all about just finance and money and saving money and time, this is about quality and patient experience. So when you’re moving patients efficiently, that improves safety, that improves your quality.

0:08:21.5 MB: So could you share any tangible results or metrics that showcase those improvements in patient care and hospital operations after implementing TigerConnect?

0:08:31.7 MC: Sure. No, I love talking about it. Because I knew when we went into the project that what we were gonna see, you could see it in front of your eyes for those of us that do this on a daily basis. So if you look at just… We’ll just stick with the left without being seen. Left without being seen as sort of your trophy, that means that people are in the emergency department and they leave early, so they’re not gonna be seen by the providers, right? So they’ve left without being seen. That’s no good for anybody. That means the patient didn’t get care, that means the patient didn’t get to take care of the patient in the hospital and give their services. But that all happens because of all the pitfalls of flow ahead of that. So I always say if you get the flow done further downstream, that means getting the patient in to the emergency department, getting the patient to the floor, and all those other processes that happen after that.

0:09:25.9 MC: If you get that right, then you get your left without being seen right. So that’s common for us to look at that. So we were in the range of the 7% range, and we dropped that over the course of time with TigerConnect helping us down to less than 2%, we got as low as 1.5%. So our goal as a hospital system is less than 2.5%. So the goal now is just to maintain. So what happens when you have better flow and you have less people in waiting rooms, that means more people come to your hospital, and so your systems are tested even further, and that’s a good thing, and that’s where we’re at. Because billboards say all sorts of things but at the end of the day, people in a community like ours will tell everybody else what it’s like when you go to the ER. They’ll tell people, “Hey, I had to wait this long or that long. They’re too busy there. They don’t see you fast enough.” And then when you start to get that right, then your volume of patients comes in, and that’s good for any hospital.

0:10:32.1 MB: Absolutely. Thank you. And Dr. O’Connor, I have some questions for you now. Can you tell us about your role at TigerConnect, and your experience as a physician in helping healthcare organizations improve their clinical communication and workflows?

0:10:46.2 WC: Yeah, I am CMIO at TigerConnect. And you know my job here, part of it is really helping our customers realize the value of the TigerConnect solution and making sure that we install it in a way, and that we adopt it in a way to do some of the things that Dr. Colflesh is talking about, reducing cost, improving quality and safety. And improving experience both for the patient who’s gonna be getting treated faster and moving through the system faster, but then also for all the providers, the nurses everyone working with a patient. It’s a much more pleasant experience when it is easy to find and collaborate with the people that you need to talk to, to take care of any given patient.

0:11:45.3 WC: So that’s really what I do. And my experience is rather varied in terms of what I find when I go to work with customers. Sometimes we work with people that are rather sophisticated and they’re already using a little bit of a solution and need more help. And then other times, I find some fairly archaic setups where people are still using pagers. They have some folks trying to use the EMR to communicate with just a subset of people. So I find lots of different things, but the goal is always really the same, is really try to help our customers leverage TigerConnect to get the most value they possibly can.

0:12:25.5 MB: Could you talk to us a little bit about the importance of communication in healthcare, and does it have an impact on staff’s ability to do their jobs and treat patients?

0:12:32.9 WC: Yeah, definitely 100%. You know, you heard Dr. Colflesh say it. “We don’t try to be good, we try to be perfect.” And that is really the goal. We know that about three quarters of all errors, all bad things that happen in medicine, especially to someone in a hospital, it usually has to do with communication. So that is really what we are after fixing and what we’re after trying to improve. And when we do that, it does have a measurable impact on quality, safety and that patient experience that we are after.

0:13:15.5 MB: I see. Now Dr. O’Connor, how do you see the future of healthcare communication evolving, especially with platforms like TigerConnect? And what potential benefits and challenges do you anticipate?

0:13:27.6 WC: Let me start with the challenges. I think the challenge, I typically find, is change. Change in healthcare is really hard to do, especially when you have different factions of people around a health system that have something they’ve been using in many cases they’ve been using or doing something a certain way for a decade or more. That’s usually the hardest part is driving change. But when you can show someone what the benefits are, that really makes the change a lot easier. And the benefits as you asked, can be tremendous in terms of lowering average length of stay, lowering costs, lowering your left without being seen, increasing the capacity of your hospital both in the OR, the emergency department, up on the floor, simply moving people through faster.

0:14:39.7 WC: And I think my favorite most of all, just as a clinician coming from a physician’s point of view, is really reducing the toil for physicians and nurses. If I can find someone in 10 seconds and communicate with them versus having to wait five minutes or 10 minutes or 20 minutes or struggle to find someone, or struggle to find a team of people that I need to help me, to me, that makes the job of that clinician, and of all caregivers so much easier that it really provides a benefit in terms of how they enjoy their jobs, and then we give them that time back, so they can spend it treating their patients and delivering outstanding patient care, which is really what we’re all after.

0:15:31.1 MB: Absolutely. Dr. Colflesh, Dr. O’Connor, thank you both so much for joining us today and thank you for sharing your insights with us.

0:15:36.4 MC: Thank you so much for giving the opportunity.

0:15:39.9 WC: Thank you.

0:15:41.2 MB: And of course, special thanks to TigerConnect for sponsoring this podcast. Have a fantastic rest of your day.

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