- At the University of California San Francisco (UCSF) Medical Center, pediatric patients can flip through nearly 160 channels on their hospital room television, or play Xbox throughout their stay. These amenities cast on a 65-inch television screen or a bedside tablet may be part of patient entertainment tools, but are also part of the patient education system.
These seemingly unrelated features come together to form what UCSF’s co-chairs of the Patient Engagement Governance Committees call “the interactive patient experience system.”
Hosted on Oneview Healthcare, a patient experience bedside tablet tool, this platform offers patient education videos, hospital introduction and wayfinding materials, food ordering functions, and entertainment, according to Valerie Bednar and Dan Henroid.
Bednar, MA, BSN, RN, CCRN-K, also serves as UCSF’s nursing project manager, and Henroid is director of Nutrition and Food Services at UCSF.
The tool is geared toward modernizing and enhancing the entire patient experience, Henroid told PatientEngagementHIT.com. The medical center made this investment to match its new and modern facility, which opened in 2015, Henroid said.
“We moved from an existing set of towers – one from the 1950s, one from the 1970s – into a brand new place,” he explained. “When the facility is bright, shiny, and new, everyone's expectations are elevated, particularly when you have people who maybe, unfortunately, have had to be a patient of ours a number of times due to their condition over the years.”
Source: UCSF Medical Center
The food ordering and entertainment functions on the tool are valuable to both pediatric and adult patients, Henroid and Bednar noted. But at the heart of the tablet are the clinical functions, the patient education, and care coordination features.
In an academic medical center, patients often receive care from multiple care team members from various departments. This can lead to disjointed care and patient concern. Patients can become confused when they meet yet another new provider.
But on the bedside tablet, patients can view pictures of each care team member keyed into the EHR.
“The common patient complaint is in a large academic medical center, you don't know who's taking care of you from a day to day perspective,” Bednar pointed out. “We don't always do the greatest job of introducing ourselves. We at UCSF wanted to provide a consistent experience around the care team by putting that information in front of the patient before clinicians would come and introduce themselves. Hopefully, no one is a stranger when they walk in the room.”
Additionally, clinicians can use the patient-facing tool – which takes both the form of a television and a bedside tablet at UCSF – to assign patient education videos, forming a three-pronged approach.
“Clinicians are really able to put patient education material in front of the patients early and through different modes instead of just verbal communication,” Bednar said.
The tool connects seamlessly to UCSF’s EHR and helps providers assign one of hundreds of patient education videos based on a patient’s healthcare needs. This digital approach is not intended to replace the patient-provider relationship and communication, Bednar and Henroid asserted.
“The bedside team are the ones that make or break the experience much more than any type of technology,” Henroid said, noting that technology must reinforce interpersonal interactions. “There are things that this technology can do to sort of round out the experience not only for the patient but for the family.”
Instead, the technology supplements provider-led patient education, Bednar maintained.
“The patient education functions are trying to offer multimodal education,” she said. “We do a lot of verbal education, we do a lot of written education, and we were trying to cover that third mode and provide a lot more visual education. We try to get that in front of the patients earlier in the experience, as well, because a lot of times with discharge education you print it out two hours before the patient goes home.”
Source: UCSF Medical Center
The bedside tablet also establishes a baseline for patient education, Bednar added. When the videos can establish what a condition is, or other basic information, nurses can focus on the higher-level patient education notes.
Of course, installing this sort of patient engagement technology did not come without its hiccups, the pair admitted. UCSF had to work around issues related to patient and clinician ability to even use the tool by deploying a group of technology volunteers.
“We have a small force of volunteers in the children's hospital and in the adult hospitals,” Bednar explained. “They are rounding several times a week to see the patients who are admitted in the last 24 to 48 hours as appropriate.”
Volunteers review system navigation and ask for specific questions using the tool, the pair explained. These volunteers focus on assisting patients with tool use and easing the burden for busy providers and those clinicians who aren’t technologically savvy themselves.
Additionally, each patient and family member views an introduction video that plays automatically during each bedside tablet registration. This video reviews key system functions and navigation.
Likewise, connecting the tablet to the EHR stemmed for provider complaints with the tool. When UCSF first deployed the patient education videos, clinicians had to access the videos from their vendor’s website, and then manually note the video in the EHR.
After eliciting clinician feedback, Bednar and Henroid knew to seamlessly connect the tool to the EHR, reducing hassle for the clinician.
“You have to consider existing workflows for clinicians doing the functions when you ask them to add the interactive patient experience to their toolkit,” Bednar explained.
“There's already a lot of required documentation for clinicians, so any additional steps or things that take them outside of their comfort area is going to be a bit of a harder sell,” she continued. “You want to make sure that you're taking a long look at their workflows and making sure wherever possible you're making it seamless and integrated with existing workflow.”
This is a part of the longitudinal view and planning necessary for any technology implementation, Henroid added.
“Make sure that you involve patients and family in the design and development of the material,” he stated. “Then, make sure that you take a long view of how this system is going to be supported over time. Hospitals usually have a whole lot of support at the beginning and a lot of that support goes away because they move on to the next project.”
Technology and hospital leaders can garner more support by ensuring a tool aligns with organizational priorities and will support a long-term goal, Henroid said.
“Never implement technology for the sake of doing it,” he concluded. “Always do it with a goal in mind. All of the different features should solve a problems and substantively enhance the patient and family experience.”