Jodi Pahl

Since the beginning of 2013, the Joint Commission has required accredited hospitals to meet certain standards for patient flow through the emergency department. To comply, St. Rita's Medical Center, a Catholic Health Partners hospital in Lima, Ohio, has focused on nursing workflow and patient comfort by emphasizing mobile communications both inside and outside the building.

For nearly five years, the 350-bed community hospital with a catchment area of 10 counties in Northwestern Ohio, has had software from PerfectServe, a Knoxville, Tenn.-based vendor of clinical communications services, and wireless handsets from Cisco Systems to keep nurses in contact with each other and with physicians. "It's very important for us to have our nurses be mobile," said Chief Nursing Officer Jodi Pahl.

The technology serves as the in-house paging and nursing communications system. "It's part of the handoff [between shifts]," Pahl explained, noting that the devices stay in the hospital. "It's as important as the narcotic keys."

This technology lets nurses make voice calls or send secure texts to physicians, which, for HIPAA reasons, require a passcode to read. Though about 60 percent of St. Rita's physicians are employed by the hospital and issued smartphones, others are allowed to bring their own devices, according to Pahl.

The system tracks whether a nurse did indeed try to contact a physician, so the hospital maintains an accountability trail. Users can key in "HELP" on the phone keypad to reach a PerfectServe call center, which will then track down the right physician. Doctors can set their phones on "follow me" mode or have messages delivered to their office staff, Pahl told MobiHealthNews.

Nurse managers can page a group of people when there is a backlog in the ED, alerting everyone from hospitalists to cleaning staff to help smooth out patient flow and throughput. "It allows for more communications across departments," Pahl said.

"It's truly our notification system for any alert that goes out," Pahl continued. This, she said, has eased the transition to care teams at St. Rita's, a key building block for an accountable care organization. Or, as Pahl summed up the reform-driven attention on accountability, "no outcomes, no incomes."

In September, the hospital expanded its wireless push by implementing MyChart Bedside, a patient-facing Android app from EHR vendor Epic Systems. (St. Rita's claimed to be the first hospital in the country to do so.) Upon admission to the hospital, patients are given tablets – or they can use their own Android devices – to access their own records, test results, vital signs, and educational material.

The app also serves as a point of communication between patients and clinicians. Users can send non-urgent requests to nurses, for example, who then can respond when they have a spare moment, so as not to take them away from more pressing tasks. Patients get notified when they are due for medications, and after administration, the medication list is automatically updated.

"It frees up our nurses so they can be at the bedside," Pahl said.

She said that this also helps improve patient satisfaction and builds brand loyalty for the hospital.