In its quest to better serve Veterans, one Mid-Atlantic VA Medical Center partnered with GetWellNetwork in FY19 and FY20 to launch a video utilization initiative across its acute inpatient units. The technology used, GetWell Inpatient, is a dynamic solution, and a key component of this initiative was for each acute inpatient Veteran to view prescriptive health education in addition to automated safety education.
An identified need for timely and plentiful education
The intent was to develop a streamlined process to not only keep the patients safe while in inpatient treatment, but also to promote a safe and timely discharge and prevent avoidable readmissions. Prior to this initiative, the people and technology were in place, but the facility lacked a process — an important part of the triad.
One way for a VA site to realize value outcomes is to develop formal processes that incorporate GetWellNetwork technology into existing clinical workflows, offloading non-clinical work tasks and allowing an individual to practice at the top of their license.
This approach further completes regulatory requirements with automated education notes documented back into the patients’ charts upon video completion. This inclusion works as a supplement, not as a replacement, and allows for an interdisciplinary approach for patient engagement and service recovery.
Setting processes and objectives
To support the video utilization initiative, night shift clinical staff at this VA Medical Center would assign one patient-specific video and day shift clinical staff would ensure completion and teach-back methodology.
Together with the VA Medical Center’s interdisciplinary IPC Steering Committee, clear objectives were developed to achieve a goal of increased patient engagement via video utilization rates and measures of success. These included:
- Increased staff utilization of the system through chart audits
- Increased patient video completion tracked through Management Console enhanced Education Trending and Detailed Education reports
With these objectives, an increase in health video completion rates served as a measure of success and as a sign of clinical adoption. Prior to this initiative, mandatory education was (and still is) comprised of three safety videos. Therefore, together with automated pathways, patients were consistently only viewing safety-related videos with a different motivation to open the system.
The video utilization initiative started at the end of FY19 and proceeded throughout FY20. Prior to kick-off, baseline data was collected over a six-month period. The GetWellNetwork technology was featured on staff education boards, and new training documents were developed and disseminated. Unit leadership also identified unit champions and GetWellNetwork technology was reintroduced into staff huddles and bedside shift reports.
Measuring success in video utilization
Measures of success included health and safety video completion rates, Education Trending reports, Detailed Education reports, and Performance Improvement Plan monthly data.
Keys to success for this initiative depended on the following:
- Ensure leadership buy-in is obtained
- Set a measurable goal with accountability
- Develop a 12-month plan with extensive preparation prior to start
- Discuss which reporting metrics will be tracked ahead of launch, understanding that there are multiple ways to measure success.
Using enhanced reporting mechanisms within Management Console, a total picture of video completion was able to be created while also taking into account unit census and percentages, versus just raw numbers.
During the same time period of increased health video completion rates, there was a 14% reduction in hospital-wide 30-day readmission rates, proving that a streamlined approach of manageable change leads to very real positive patient outcomes.
When evaluating FY20 end of year results, there was one additional key indicator of sustained change. This initiative was limited to two acute inpatient units, totaling less than 30 beds out of 116 possible GetWellNetwork beds. In summary, there were only 130 more entertainment titles viewed enterprise-wide than prescriptive health titles (5540 vs. 5410).
The impact of COVID-19 and a silver lining
Although the advent of COVID-19 has impacted this initiative, it is evident through reporting metrics that there has been sustained clinical adoption. More important to address is that, with this process in place, patients can be educated at bedside while limiting clinical exposure hours and optimizing PPE use.
While a pandemic was never considered in 2019, the foundation was laid and the technology made available to continue to promote these outcomes when clinical staff were pulled in many unanticipated directions in 2020.