READ TIME | 3 MINUTES
Going One Step Further for Patients and Nurses
Eliminating manual vital signs documentation to prioritize value-added care
A 636-bed specialty care and teaching hospital
Key Business Outcomes
- Savings of 59 seconds per vitals capture event after documenting vitals directly in the EMR
- Increase of 18 minutes per nurse, per shift spent on value-added care activities
Moving from Good to Better
This large, specialty care and teaching hospital has long been a model of nursing efficiency—even before connecting a single vital signs device to the EMR. Early on, they reduced lag time between vitals acquisition and documentation by placing mobile workstations in each patient room and requiring clinicians to enter vitals before leaving the room during each round. In 2016, the hospital took the next step in Lean methodology by connecting Welch Allyn Connex® Vital Signs Monitors to the EMR in its medical/surgical units.
“Our goal is to provide clinicians with timely, accurate information,” says the Vice President of Nursing Informatics & Clinical Excellence. “Our physicians need data anywhere, anytime—even standing in line at Starbucks. So if a patient has a spike in temp but those vitals are still written on a scrap of paper or on someone’s scrubs, our doctors can’t access the information they need to make the best clinical decisions.”
This customer knew time savings due to vital signs device connectivity was well documented, but wanted to extend the value one step further by asking a simple question:
What could our nurses do more of if they spent less time documenting vital signs?
That’s why the hospital embarked on a study to determine the impact of vitals connectivity in two areas:
- Quantify documentation time savings for nursing staff
- Identify how nurses spend their time differently as a result of those time savings
The First Step: The Value of Time Savings
By measuring time spent on vitals capture and documentation pre- and post-connectivity, the hospital determined that CNAs and RNs saved 59 seconds per vitals session by sending the data directly from the monitor to the EMR—essentially eliminating the documentation function from the workflow. This represents a 34% reduction in time spent capturing and documenting vital signs.
Extrapolating these results out over a 12-month period, this would result in:
- 6 minutes per caregiver, per round
- 36 caregiver hours per day
- 13,208 caregiver hours per year
One Step Further: Using Time Savings to Prioritize Value-Added Care
Beyond measuring the volume of time saved, this customer wanted to determine how nurses spent their time differently as a result of the device integration.
A work-sampling study was undertaken utilizing the Time Study RN™ methodology, in which nurses recorded the type of activity in which they were engaged at random times throughout their shifts. The data showed that, after connecting the vital signs devices to the EMR, nurses spent 2.5% more time on value-added care activities.
- That adds up to 18 minutes more per nurse, per shift to spend on direct patient care.
- As an organization, it represents a full quartile of improvement compared to the national benchmarking database.1
“We want our clinicians practicing at the tops of their licenses,” says the hospital’s Manager of Clinical Informatics. “The time we save allows the entire care team more time at the patient’s bedside and less in documentation.”
Valuing Nurses’ Wellbeing
Beyond these powerful impacts on patient care, removing documentation from the workflow also led to significant benefits related to staff satisfaction.
“Our CNO noted that beyond giving time back to patients, this solution also allowed a positive work environment for our nurses,” says the Manager of Clinical Informatics. “This may seem simple, but it’s important to take care of our employees.”
This customer succeeded in proving the time-savings benefits of connecting vital signs devices to the EMR. The organization also went one step further and proved the power of reallocating time saved to value-added care activities.
"As nurses are tasked with more responsibilities, any time we can give back to them is a win. This allows them to more quickly respond to the needs of their patients."
1 Vitals Sign Time Study and Nursing Unit Assessment Report. Rapid Modeling Corporation. July 31, 2017.