Scheduling from a Paper Process to a Digital Platform
Nicole Limpert
Washington Health (WH) was founded in 1958 in Fremont, California, and became affiliated with UCSF Health in June 2013, after they entered into a collaborative relationship. WH is one of Northern California’s most distinguished healthcare systems remaining independent and community-based.
Over the years, the system has grown to include a 415-bed acute care hospital, the Morris Hyman Critical Care Pavilion, Bell Neuroscience Institute of Silicon Valley, Washington Outpatient Surgery Center, Washington Outpatient Rehabilitation Center, Washington Institute for Joint Restoration, and Research, Washington Urgent Care, Outpatient Imaging Center, UCSF-Washington Cancer Center, and Washington West – a complex that houses Washington Women’s Center, and the Washington Health Medical Group – a multi-specialty group of providers providing care locally, close to home, to meet the community’s health needs.
Upgrading from a Paper Scheduling Process
Research indicates that effective communication about physician on-call scheduling is strongly associated with better patient outcomes. Clear communication ensures hospital staff can quickly contact on-call physicians, and accurate on-call information prevents miscommunications that could lead to adverse outcomes. Easy-to-understand on-call schedules facilitate smooth communication and handoffs between providers to improve the continuity of care.
WH previously had a manual paper scheduling process for its medical staff. In anticipation of WH receiving provisional designation to open the first level 2 trauma center serving Southern Alameda County, one of the requirements was to have a digital scheduling system in place for physicians.
“We invited our operational staff and did demos with five different vendors,” says Armando Bravo, Director of Inpatient Clinical Application. “The vendor we chose was one of the top two, but our operational staff definitely liked the functionality of what they saw with our new vendor’s scheduling app compared to the others. Plus, we were already using their software within our system and knew it would be easier to integrate.”
Gregg Dillenbeck, Director of IS Operations, adds, “Also, our vendor has always been incredibly helpful and very responsive. We knew we would continue to get the same great support.”
Seamless integration with solutions from other vendors translates to better efficiency for an organization. “I think it creates a baseline where we have a stable, organized structure that we can rely on,” explains John Lee, Chief Information Officer.
Preparing for Implementation with Epic
Jessica Javier, Inpatient Orders Application Analyst, was a newer analyst when she was tasked with preparing the system. This was her first time being involved in a project that integrated a third-party system into Epic, and she had to make preparations and identify resources to help.
The three main resources identified were herself, an implementation specialist from the chosen vendor, and technical support from Epic. These three resources would work together to prepare the most critical part of the integration: the data transfer pipeline.
Jessica explains, “This was a great learning process and experience for me, but I needed help from our analytics analyst to give me a secure local server file location. We took our vendor’s flat file export that pulled all of the on-call assignments, and I created a report with that info to export into a local server location. Our analytics analyst used a managed file transfer (MFT) solution to securely transfer that report to that location. This enabled me to pull my batch job within Epic and have the data from that report crossover into Epic.”
The vendor’s system contains a vast amount of information. However, Epic’s system would only allow some of that data to be transferred. Jessica worked with the vendor to identify the data that needed to be moved and to determine if the information was transferred correctly into Epic. “Epic has a tool with very specific requirements for data import,” says a vendor Sr. Implementation Specialist. “So, it was a matter of figuring out those requirements and working with Epic’s technical support.” Jessica and the Sr. Implementation Specialist also had to resolve differences between the roles Epic’s data import tool was looking for and fit those with the vendor’s representation of that role.
It was crucial that data mapping was done to ensure ID values were successfully integrated into Epic’s system. “I reached out to our Health Information Management (HIM) team because they had to create some new IDs for us in order to map to the Epic side,” explains Jessica. “No matter how good my batch job is on the Epic side, without the mapping piece, information isn’t populated, and nothing shows up in Epic.”
Nora Penn, Clinical Applications Coordinator, adds, “Working with our vendor and getting this implemented was pretty amazing. We had to do some out-of-the-box thinking, but it was a collaborative effort, and we succeeded.”
Jessica agrees, “Everyone responded, usually on the same day, or set up a meeting. I can’t thank the vendor staff enough for their help through this upgrade. They expedited the process, and I would say it all happened as quickly as it could have.”
The Benefits of an Efficient Digital Scheduling Platform
The scheduling app was purposefully designed to be intuitive, easy to use, and flexible when modifying schedules, dispatching messages, and maintaining directory contact methods. The operators at WH had used the vendor’s call center software for more than 10 years. However, the system was entirely new for some of the employees in other departments. Armando says, “The operators saw the app as a new function they didn’t have before. It was a greater transition for the analysts and operational staff. It was a huge change from a paper Excel process to a web-based platform, but they are pros and have become proficient with it.”
Jessica was thoroughly trained on the vendor’s platform, including the app, by the vendor’s training staff. “I became a superuser so that I could be available to Falisa Fullard, Trauma Department Executive Assistant, and the director in the emergency department,” explains Jessica. “I also conduct training sessions with anyone at WH who needs to be trained. The platform is pretty straightforward to use, and once the trainees see it in action, many of them will say, ‘Oh, that’s it? That’s all I have to do?’ We also provide tip sheets in a read-only view in the app for each kind of user.”
The benefits of using the scheduling app were experienced right away. Falisa says, “The app has definitely cut the time it takes to enter on-call schedules in half. I can make recurring schedules for staff and even add comments. It has been absolutely wonderful.” Jessica agrees, “Our on-call scheduling and managing process is much more efficient now.”
Customized Software and Reports for Specialties
Every hospital has unique needs or circumstances. It’s essential to use a software platform that provides options when challenges must be overcome. WH has 22 specialties, and Falisa is responsible for entering and managing the on-call schedules of the staff who work for 20 of the specialties. Because there are limitations regarding the type of information Epic allows to be transferred between its system and the vendor’s platform, some creative use of the vendor’s software is done as a workaround.
“I can’t live without the ‘Click to Comment’ field,” says Falisa. “We really manipulated the ‘Click to Comment’ box because some of our specialties are more complex and need additional information to be correctly identified.”
Jessica agrees: “I have some defaults entered into that field so Falisa can just click and indicate which physician is primary or secondary and what contact number they prefer. Otherwise, calls will be placed to physicians who shouldn’t be called.”
Most call centers run reports to collect information about call data, but there are other ways to harness the vast amounts of useful data gathered by a health system’s call center. At WH, one of the reports generated by the vendor’s system ensures physicians from each specialty are paid correctly for their on-call hours. “We generate a monthly report that contains all of the on-schedule assignments for the current and previous month, which is used to ensure physicians are paid accurately and on time,” says
Jessica. “There are a lot of very helpful reports I can generate from the platform.”
“We also track who’s on-call and if anyone changes the schedule,” says Armando Bravo, Director of Inpatient Clinical Application. “We need to know who called in and made the change and track it like an audit trail. We also modified a few reports that mostly involve recording and tracking physician responses related to trauma events.”
The app works natively with the call center software, but it also integrates with software from other vendors. The application enables both on-site and remote staff to access on-call schedules, directories, messages, reports, telephone scripts, and even historical call management data quickly and efficiently through the Internet or an organization’s internal networks.
Staff can view, edit, copy, override, assign, and unassign schedules in real time. Directories enable employees to quickly find and contact staff without interrupting co-workers, and the reporting function provides accurate statistics about interactions and communications.
“We really value our partnership with our vendor’s team,” says John. “We went live with the scheduling app, and it’s been a successful transition for us as an institution. I certainly feel like the app has contributed to our success, and we appreciate what our vendor has put into this project and making it work.”
Nicole Limpert is a marketing content writer for Amtelco.