A Data-driven Approach to Improve Nursing Workflow and Patient-centered Care

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DESCRIPTION (provided by applicant): Patient-centered care recognizes patients' desires, opinions, and preferences as equal in importance to those of healthcare professionals, and emphasizes the need to educate and empower patients to play an active role in their care. The achievement of patient-centered care is associated with increased patient and provider satisfaction, improved health outcomes, and reduced cost of care delivery (Caffarini, 2011; Silow-Carol et al., 2006; Wolf et al., 2008). Furthermore, as health disparities continue to persist, patient-centered care offers underserved patients the individualized and tailored care necessary to attain positive health outcomes. As the providers who spend more time with patients than any other personnel, nursing staff are central to the provision of patient-centered care (De Lucia et al., 2009). However, most of these front-line providers are burdened by numerous non-value added tasks that not only distract from direct patient care activities, but also hamper their ability to implement best practices such as proven care plans for preventing adverse events (e.g., falls and pressure ulcers) among at-risk patients (Hendrich et al., 2008; Storfjell et al., 2008; Aiken et al., 2002). The occurrence of such preventable events is especially concerning in light of the fact that such events fall disproportionately on already underserved populations, including certain racial/ethnic communities, limited English speaking individuals, and the elderly (Divi et al., 2007; Metersky et al., 2011; Rothschild et al., 2000). Fr patient-centered care to be truly realized, the healthcare system must introduce process innovations that can streamline mundane, indirect tasks such as service documentation for front-line nursing care providers and enable them to efficiently adopt value added clinical practices that benefit direct patient care activities. In this project, we will engage several partners-including a skilled nursing facility that serves predominantly monolingual Spanish- and Chinese-speaking communities and a long-term care facility for retired veterans-to implement an advanced patient-nurse communication and nurse workflow optimization system. This solution will: (i) track comprehensive care plans and associated tasks for individual patients; (ii intelligently assign and alert each provider of his or her care plan tasks, escalating pending tasks to appropriate staff members to expedite completion; and (iii) offer real-time analysis of task fulfillment status and workflow patterns, providing decision support to both staff and managers for identifying factors that may undermine staff productivity or contribute to adverse events.