Leveraging technology and building a team culture to improve after-hours patient care.

Nightlife at The Royal Melbourne Hospital

‘Hospital-at-night’ was the reoccurring theme at this year’s Improving Patient Flow conference in Sydney, with a number of leading hospitals sharing their insights about how best to ensure patient safety and clinician engagement after-hours.

This focus follows a recent review examining the outcomes of 26 hospitals and found that the mortality rate of patients admitted on weekends is as much as 10% higher than for patients admitted on weekdays.

In this four minute video, Victoria Atkinson shares best practice insights based on her experience leveraging technology and building a team culture to improve after-hours patient care at The Royal Melbourne Hospital. Watch now to learn how RMH achieved:

  • Increased patient safety in the form of a 50% reduction in cardiac arrests; and
  • Increased clinician engagement, as evidenced by HMO sick leave reducing by 50%.

Victoria Atkinson discusses the impact of the Nightlife project at The Royal Melbourne Hospital

Prefer to read? Here’s a transcription:

“Patients weren’t getting the same treatment at 10pm as they were 10am”

“The Nightlife project at Royal Melbourne was ostensibly about patient safety and improving after-hours patient care. We knew from looking into our data that particularly at weekends and at night, our patients weren’t as safe. They weren’t getting the same treatment at 10:00pm as they were at 10:00am and that was something that we couldn’t ignore.

“Medical staff overnight were siloed. They weren’t working as a team, they weren’t sharing workload equally, and there was no transparency about what people were doing overnight. Nursing staff on the ward and medical teams had no connection. Certainly, overnight we’d find that our MET calls for sick patients would drop off but our code blues for cardiac arrest would go up.”

“Any after-hours solution we implemented had to help staff connect and add value to their work”

“To solve the problem that we had at night, we needed a number of things. The first thing was buy in from the people who were going to be using any system, building any system or developing any system with us. That was really critical so that part of the solution had to be that this was better for everybody. It had to be something that people enjoyed using, felt that it added value to their work, and allowed people to connect. The wards to connect to the medical staff to connect to the access people. It had to be a thread that ran through that.”

Innovating on existing technology to develop the right solution

“We actually chose to go with our system that we already had, which was Patient Flow Manager and to approach Health IQ and look at adding an arm to PFM so that our journey boards on the ward were already Patient Flow Manager and if we could make it a part somehow of that, it would be intuitive because it was already embedded in the system.

“The partnership that we built with Health IQ was really critical to the project and one of the biggest features was that that partnership didn’t and couldn’t end when we launched. Health IQ was so responsive, on the day, of the moment, multiple times a day. Never once did they sort of say, “We can’t do that. We can’t do it today. We can’t do it by the weekend.” They would just get on and do it. That was a huge selling point and a huge value add for us.”

That first night

“My project manager and I walked in on that first night when we launched and what we got was nurses on the ward going, “Well, this is great. I love this. It’s so easy.” What the doctors liked about it, was they could keep track of their workload, they could share each other’s workload, everyone could see each other’s workload.

“They started to connect as a team. They started to communicate and say, “Hey, I can see what’s on your list. Would you like me to do it?” From the nursing side, they liked that they could see when jobs were acknowledged, they could tell that a job had been received, they could prioritise urgency so that they could sort of say, “This patient really needs to be seen now.” And the doctor could acknowledge that.”

“There’s been a number of really big changes: People are actually enjoying coming to work at night”

“There’s been a number of really big changes and it was almost instantaneous. It’s built momentum and I think the biggest changes since Nightlife have been in people’s attitude to how we deliver care overnight. Patient safety has definitely changed. Our MET calls have gone up overnight, which is actually good because our cardiac arrests have halved over the night.

“Our HMO sick leave has halved. People are actually enjoying coming to work at night. No longer do they come in expecting to kind of just hold tight overnight untill the morning teams get there. They come in ready to work, they come in as a team, they hand over as a team, and that’s been a really tangible difference.

“I think really what Nightlife’s done is integrate the entire hospital as one overnight.”

To learn more about how you can achieve improved patient safety and increased clinician engagement at your hospital, get in touch now. Call us on 1300 554 997 or email dave.piggott@healthiq.com.au.

Read more IQ insights to learn how else Health IQ has supported hospitals in their efforts to improve after hour patient care.


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