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3 Key Elements to Improve Clinical Workflow Protocol Adoption

We know digital technology has the potential to help clinical teams improve clinical workflows, enhance the health of populations and support better outcomes.1,2  Deployed wisely, it can potentially reduce care variation, which may enhance efficiency and improve patient outcomes.3,4 Realizing that potential, however, remains a tremendous challenge.

Take adoption, for example: Many hospitals and health systems face resistance from clinicians who see changes to existing technology as a burden. The irony, of course, is that these changes will be anything but a burden — new technology tools can streamline clinical workflows, make physicians’ and clinicians’ lives easier, and improve patient care.

How do we change hearts and minds? By looking beyond implementation. Implementing technology doesn’t ensure adoption. Consistent, compliant use requires change management. Here, we’ve identified three elements to help your healthcare team successfully adopt new technology.

1. Focus on Adoption to Inform, Engage, and Educate

It all starts with creating the change that leads to adoption.

  • Involve clinicians and other users from day one. Being invested in the technology’s success will foster buy-in.5. Moreover, by making user-recommended changes now, you avoid unintended consequences later. It also provides an early opportunity to show—not just tell—how the changes will enhance efficiency and reduce provider burden.
  • Information often fails to flow to those who need it, leading to delays in adoption. Communicate to everyone concerned before implementation and throughout the process. A comprehensive communication plan promotes awareness and minimizes the rumors that undermine acceptance.6

Talk about the implementation schedule, what changes everyone can expect, and, most importantly, how the changes will improve patient care. Take, for example, extubation. Critical care teams often fail to extubate patients promptly, and these delays put patients at higher risk for serious complications.7,8 A clinical surveillance tool can alert clinicians as soon as a patient requires extubation.9  Explaining how the tool could assist with more timely extubations may help drive buy-in from clinical teams.

  • The literature and real-life practice are replete with examples of how to train well. To start, offer training in formats that reflect various learning styles.10  For example, kinesthetic learners prefer hands-on options, while aural learners listen to learn. Avoid relying on old-school classroom lectures. Many physicians dislike classroom training, preferring self-paced modules and other flexible options that give them control over their time.11 However, each user must be proficient individually and as a care team member, so provide hands-on practice for each team.12
  • Consider creating “champions” at each location to lead the transition. These early adopters can help customize training to fit the culture for each site. They can also drive user buy-in by talking up the benefits of the new platform and addressing any misgivings.13 You not only want just physicians as champions—draw from across a range of users and potential users.

2. Identify Gaps, Then Fix Them

What’s interfering with full adoption once implementation has been rolled out?

  • As you monitor adoption, look at clinical outcomes. Evaluate clinician and staff comfort and satisfaction, which is crucial to consistent use of any clinical workflow technology.14 If adoption seems sluggish, ask users why and, if appropriate, make modifications. Listening to and acting on user feedback increases end-user utilization.
  • Even the most tech-savvy clinician may sometimes struggle. Built-in guidance and speedy access to the tech support team can prevent frustration and delays.
  • Sometimes, clinicians may not agree with the guidelines. When you see a pattern of overrides, ask the physicians why. If you haven’t already, embed the appropriate scientific citations or make adjustments if there are legitimate concerns. Physicians aren’t trying to be intransigent; they just want to make the best evidence-based decisions for patients.15

3. Leverage the Right Tools

Put in place the right tools and resources to support adoption. We’ve talked about several already, including ongoing training, tech support, and robust feedback loops.

But what about the technology itself? It should provide a comprehensive, integrated viewof patients in real time and allow for centralized monitoring clinical workflows to ensure everyone is following the right protocols.16 Clinical surveillance tools provide this oversight, allowing you to identify and address compliance gaps in real time.

On the clinical side, clinical surveillance tools also provide a consolidated view of a patient’s status across multiple systems, applications, electronic health records (EHRs), etc. This makes operations more streamlined and responsive to patient needs. It lets clinical team members know—in real time—when to take action.17 When clinicians have the tools to do their jobs, patients have a better care experience and health systems become more efficient.

From Implementation to Adoption

We’ve touched on only a handful of ways to improve technology adoption. We believe that with the right approach and the right tools, it can be done and done well. Many hospitals have deployed digital technology, including clinical surveillance solutions, to solve clinical workflow challenges. It’s a massive undertaking, but well worth the effort when you consider the impact on patient care.

Now is the time: The need to manage vast amounts of patient data, the advance of value-based care, the increase in clinician burnout, and, of course, the coronavirus pandemic, make it imperative to improve efficiency and reduce variation. The future of patient care depends on getting this right. Clinical surveillance tools represent a path forward.


References

1. Hernandez-Boussard T, Blayney DW, Brooks JD. Leveraging Digital Data to Inform and Improve Quality Cancer Care. Cancer Epidemiology, Biomarkers & Prevention : A Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology. 2020 Apr;29(4):816-822. DOI: 10.1158/1055-9965.epi-19-0873.

2. Rundo L, Pirrone R, Vitabile S, Sala E, Gambino O. Recent advances of HCI in decision-making tasks for optimized clinical workflows and precision medicine. Journal of Biomedical Informatics. 2020 Aug;108:103479. DOI: 10.1016/j.jbi.2020.103479.

3. “Activating a Virtual Hospital with Intelligent Clinical Surveillance Solutions,” Frost & Sullivan, 2020

4. Sutherland, K, Levesque, J‐F. Unwarranted clinical variation in health care: Definitions and proposal of an analytic framework. J Eval Clin Pract. 2020; 26: 687– 696. https://doi.org/10.1111/jep.13181

5. “Advancing Clinical Decision Support: Key Lessons in Clinical Decision Support Implementation,” Office of the National Coordinator for HIT, (ONC) prepared by Westat.

6. Ibid.

7. Epstein SK. Predicting extubation failure: is it in (on) the cards? Chest. 2001 Oct;120(4):1061-3. doi: 10.1378/chest.120.4.1061. PMID: 11591539.

8. Suntrup-Krueger S, Schmidt S, Warnecke T, Steidl C, Muhle P, Schroeder JB, Labeit B, Minnerup J, Dziewas R. Extubation Readiness in Critically Ill Stroke Patients. Stroke. 2019 Aug;50(8)

9. Frost & Sullivan, 2020 op.cit.

10. “Maximizing mandatory education programs,” Wolters Kluwer, Expert Insights – Health, Nov 30, 2017

11. ONC op.cit.

12. “Improve Pharmacy Workflow in 6 Simple Steps,” Elements, Oct. 3, 2018

13. ONC op.cit.

14. Ibid.

15. Sutton, R.T., Pincock, D., Baumgart, D.C. et al.An overview of clinical decision support systems: benefits, risks, and strategies for success,npj Digit. Med. 3, 17 (2020)

16. Frost & Sullivan, 2020 op.cit.

17. Ibid.