By ECRI
ECRI’s annual Health Technology Excellence Award competition provides insight into exceptional technology management initiatives undertaken at health care organizations around the world. The 2023 competition yielded multiple examples of health technology managers using innovative approaches to address challenges facing their organizations. Two of the most impressive submissions from the 2023 cycle are outlined below.
The Guthrie Clinic: Using AI and Video Technology to Address Staffing Challenges
The Guthrie Clinic (Sayre, PA) is a rural integrated health system that serves patients in hospitals and clinics across a 9,000-square-mile region in the states of Pennsylvania and New York. Delivering high-quality care in a rural environment can be a challenge. During the pandemic, the challenges grew exponentially. The health system’s beds, emergency rooms and clinics were becoming overwhelmed with patients. At the same time, many local nurses and other care providers were deciding to take positions in other regions or to leave health care altogether.
The organization’s strategic approach to addressing this challenge earned The Guthrie Clinic ECRI’s 17th Health Technology Excellence Award, which was formally presented to the organization in a September 2023 ceremony.
The Challenge: Address staffing shortages exacerbated by the pandemic, while also positioning the rural health system to better serve future patients in a changing health care landscape.
The Project: The Guthrie Clinic’s approach involved rapidly implementing a telesitting program to address the immediate need – a staffing crisis – but also to serve as the first phase and proof of concept for a virtual command center based on an AI-enhanced video and communications platform.
The first phase of this project – the telesitting program – led to immediate improvements in patient safety during a time of crisis, as well as demonstrable cost savings (an estimated $7 million per year reduction in labor costs).
Previously, patients who were at risk of falling either were going unwatched or were watched by overqualified staff, who were called on to perform the sitting function when other staff were unavailable. With the telesitting program, cameras in the patient rooms allow just a few telesitters at a central location to provide fall coverage for dozens of patients across the health system. The AI functionality built into the video system interprets the images in real time and highlights circumstances that require the sitter’s attention, providing an added layer of safety. This implementation led to better patient coverage using fewer staff, thereby improving patient safety while also freeing up skilled nurses to perform other patient care duties.
The success of the telesitter program facilitated the second phase of the project: the implementation of virtual critical care nursing. Using the same AI-driven platform along with other technologies, a central team of nurses now supports the bedside nurses staffing ICUs across the health system. The program provides an additive level of care: bedside nurses can consult with, or offload some tasks to, a central team of experienced nurses.
This initiative has allowed the organization to consolidate resources in a centralized location, standardize practices across care areas and facilities, and expand the reach of providers to help improve care, including access to care, across the broad region served by the health system.
Johns Hopkins: Building a Better Event-Reporting System
Health care organizations implement safety-event-reporting systems to provide a means for clinicians and other staff to document incidents that have (or that could have) adversely affected patient care or led to other harm. The goal is to identify problems and implement improvements to avert future incidents. The effectiveness of such programs can be hindered, however, by common barriers to reporting – namely lack of staff awareness about the reporting process, the time and effort required to submit a report, fear of retribution, and challenges in analyzing and responding to the reports that are received.
To eliminate or minimize such barriers, the team at the Johns Hopkins Armstrong Institute for Patient Safety and Quality (Baltimore, MD) examined event-reporting processes, both internally and externally, and assessed the functionality of available software applications. Unable to find a system that could effectively reduce the barriers to reporting and support productive use of reporting data, the Johns Hopkins team decided to build a better one. The organization’s exceptional efforts earned it recognition during ECRI’s 2023 Health Technology Excellence Award competition.
The Challenge: Design and develop a safety-event-reporting software application that (1) makes it easier for frontline health care workers to report safety events, (2) increases transparency throughout the reporting and review processes, and (3) helps leaders and analysts make sense of the reports in this unique dataset and prioritize opportunities for improvement.
The Project: The Johns Hopkins team convened focus groups with event reporters and reviewers from various disciplines, it conducted usability testing, and it initiated discussions with patient safety experts throughout the United States. This effort led to a few guiding principles: The software application needed to be intuitive and efficient, since any given reporter might use the system only once or twice a year. Also – and importantly – the application needed to consider the workflows of event reviewers, since they’re the ones who’ll be interacting most often with the software and data.
Led by these principles, software developers worked in close coordination with the Johns Hopkins team – which in turn consulted with user experience experts, human-centered designers, and future users of the event-reporting system – to develop an event-reporting software application that features:
- A single, short submission form.
- A machine-learning algorithm that automatically categorizes reports based on the event description.
- Communications functionality that supports seamless collaboration and transparency, allowing reporters to open reports they submitted and continue to communicate with reviewers.
- Innovative qualitative analytics using machine-learning algorithms that have been optimized using years of Johns Hopkins historical data.
Metrics related to user satisfaction and user engagement illustrate the success of the effort. Perhaps more importantly, however, the system has improved the organization’s ability to make effective use of event-reporting data, paving the way for real, positive change.
How to Apply for the 2024 Award
To be considered for the 2024 award, which is open to members of any ECRI program, visit https://www.ecri.org/health-technology-excellence-award. Applications will be accepted through the end of January 2024. To learn more about the projects described above, as well as others that have been recognized through this program, scan the QR code.
For more information, visit ecri.org.
