How Integrating Communication and Scheduling Workflows Enhanced Patient Care

Background

Beebe Healthcare is a multidisciplinary, multi-location health system providing care to patients in and around Sussex County, DE. Hospitalists at Beebe Healthcare’s Margaret H. Rollins Lewes Campus were using Excel and Microsoft Teams to build schedules for 27 physicians and 6 APPs. Dr. Kristie Zangari, administrator Lauren Phillips, and Acute Medicine Program Manager and RN Kerri Wiggins were charged with building and managing the schedules.

Challenges

Before using PerfectServe’s Lightning Bolt Scheduling, Dr. Zangari had to type out each provider’s name while building a shift or copy a previous schedule before manually adjusting names and shifts to create the best possible schedule.

This process was fraught with obstacles, including trying to keep up with changes and time-off requests via word of mouth, email, or text message. When requests were granted, Dr. Zangari had to email providers individually to update them. This process had to be done with each request, no matter when the original schedule had been built, meaning multiple versions of the schedule existed at any given time.

Kerri kept the master schedule on a public computer drive so teams could see the schedule easily, though it changed often—sometimes daily. All updates had to be individually made inside the PerfectServe Clinical Collaboration schedule as well.

Despite Dr. Zangari’s best efforts, manually managing requests, editing Excel sheets, and distributing the most up-to-date version of the schedule became too difficult—there was just too much room for error.

Solution and Implementation

Several years before these difficulties started piling up, Beebe Healthcare implemented PerfectServe’s Clinical Collaboration solution to improve enterprise care team communication. They discussed Lightning Bolt during the initial sales process, but it wasn’t until Dr. Zangari and the hospitalist group expressed a desire to update their scheduling system that Lightning Bolt officially came into the picture.

Lightning Bolt’s seamless integration with PerfectServe is a major benefit. The tight connection ensures that the group’s communication workflows are always driven by real-time schedules.

Once the group elected to move forward with Lightning Bolt, deployment was efficient—the solution was up and running in just a few weeks. But even for the most intuitive software, learning all of the tips and tricks takes a bit of time. A dedicated Technical Consultant was with the team during implementation and remains a main contact point today for any support or needs. Through implementation and training, the assigned technical consultant gave the scheduling team small tasks to acclimate them to the system and to help them practice all the ways they were likely to use it moving forward. The consultant even left them with a test schedule to play around with so they could learn more about how the system would benefit the group.

Results

Time Savings
With Lightning Bolt, Dr. Zangari has abandoned the manual process of the past to take advantage of advanced schedule automation. Now that she no longer uses Excel to create schedules, Dr. Zangari estimates a time savings of 50%.

The previous process could take a few hours per day spread across multiple weeks, but she estimates that auto-generation has reduced schedule development time by 50-75%. Because Lightning Bolt automatically pulls approved requests onto the schedule, Dr. Zangari no longer has to manually enter shifts and vacations once they’re approved, which previously took up a significant portion of her time building the schedule.

Additionally, thanks to a public, easily accessible link, the hospitalist and NP schedules can both be shared in real time.

Auto-Generation
Outside of time savings, auto-generation boasts many other benefits. Lightning Bolt can also equalize nurse practitioner shifts, including weekend rotations, ED rotations, academic service providers’ FTE requirements, and nocturnist shifts.

Other examples of auto-generation in play include:

• Putting weekend work for NPs on a rotation (for example, every other weekend)
• Spacing out nocturnist shifts
• Having a minimum and maximum number of ER shifts per person in a given 14-day pay period
• Blocking time for academic service rotation to support a new residency program

Because Lightning Bolt builds these rules into the schedule automatically, Dr. Zangari knows that her group’s requirements are always being met. It also ensures that providers are working the most equitable schedule possible to reduce provider burnout.

“I anticipated that, being a hospitalist group, [the schedule] would be really difficult to reflect with rules. Somehow, [the Technical Consultant] worked his magic and made it fit with what we needed.”

—Kerri Wiggins, RN

Centralized Requests
Before Lightning Bolt, providers would request time off or shift swaps via email, text, or face-to-face conversation. Kerri had to keep track of these requests by hand, and if they were approved, she then had to email each provider to confirm.

Thanks to detailed training, providers can now enter their own requests in the Lightning Bolt app. The scheduling team can quickly approve or deny each request from the same place, after which the affected provider receives a notification. No more scrambling to keep track of requests, and no more closing the loop by email each time a request is granted.

A Single Source of Truth
Beebe Healthcare uses its Admits, Consults, and Triage schedules to determine which provider receives daytime admissions, consults, and transfers. The same is true for nighttime workflows, except there are two nocturnist assignments available. The integration between PerfectServe and Lightning Bolt is key here, and so is Lightning Bolt’s role as the single source of truth for all schedules.

One example of this workflow is residents being paired with attendings. Residents are the first point of contact for patients, which gives them muchneeded practice and experience. However, if a situation arises where a patient needs urgent care from a more experienced provider, they can be escalated to the right attending at the right time.

Beebe relies heavily on the accuracy of schedules, especially Codes/Alerts and Rounding schedules. Providers working these shifts receive an instantaneous PerfectServe message for all stroke alerts, Code Blues, and rapid response alerts, so having an up-to-date schedule can drastically reduce confusion and expedite patient care.

Before they integrated PerfectServe and Lightning Bolt, Dr. Zangari said it wasn’t unusual to experience two to three communication errors per week when schedules had to be updated manually due to last minute changes, shift swaps, and other factors. This meant patient care could be delayed, and consults and other requests could mistakenly go to the wrong provider.

Today, PerfectServe automatically pulls the up-to-date schedule from Lightning Bolt, meaning calls and messages always reach the correct on-call or working provider. Because Lightning Bolt is Beebe Healthcare’s sole scheduling system, it also means no more dual entry—schedules no longer have to be created in one place and ported over to another to ensure continuity.

As the previous section outlined, Lightning Bolt has vastly improved the user experience for administrators and providers alike. For administrators, the process of building schedules and managing requests is much simpler. For providers, it’s much easier to request time off or a shift swap, and the instant alerts when requests have been processed are also helpful.

Lightning Bolt’s intuitive desktop and mobile applications have made a world of difference as well. Administrators can manage schedules at their desks or on the go, and providers can check their schedules, request changes, and otherwise stay in the know regardless of where they’re located.

Advanced Reporting and Analytics
Before automation was in place, Beebe Healthcare had no surefire way to know if their shifts were fairly distributed while meeting the organization’s requirements. Lauren Phillips, who often assists with scheduling, had to manually tally shifts and keep track of each provider’s workload as closely as possible.

Today, Lightning Bolt automates this process with its Reports feature to keep track of overall shifts worked. Beebe creates this type of shift report for the emergency room, the nocturnists, backup shifts, nurse practitioners, and the total shifts worked to ensure equalization.

Excellent Customer Service
Before Lightning Bolt, the team at Beebe Health had no support to lean on for their scheduling process. Now equipped with their dedicated technical consultant, the entire team found training and implementation to be smoother and easier than expected.

Today, they have full access to customer support and the option to schedule time with their technical consultant if they need additional training or troubleshooting.

“The post go-live support has been phenomenal. It’s fast, efficient, and correct.”

—Kerri Wiggins, RN

Conclusion

Finding and implementing an advanced scheduling solution can seem like a tall order when you’re starting from Excel. But for health systems of any size, the benefits of deploying a solution that both automates and optimizes the scheduling process are abundant: significant time savings, more satisfied providers and administrators, and—if you integrate your scheduling and communication systems—far fewer communication mishaps that lead to delays in patient care.

This was all true for Beebe Healthcare. After implementing Lightning Bolt as the single source of truth for scheduling operations and integrating it with PerfectServe’s Clinical Collaboration solution, they found themselves with better schedules, happier providers and administrators, and greatly improved communication workflows that accelerated speed to care.