As Chief Clinical Officer for North Shore Healthcare, a provider of a variety of care services including skilled nursing across nearly 70 locations across the Midwest, Tina Belongia is intimately familiar with the countless data points that come with each and every patient.
From steering away from “information overload” to her top three data points, Belongia gives her take on today’s skilled nursing information age and how she sees the ideal clinical dashboard coming into play when it comes to patient care and management.
What are the three most important data points that you would want to see each day on your ideal clinical dashboard and why?
- Key resident outliers (vital signs outside of baseline, new wounds, falls, new behaviors, critical events, infections)
- Resident risk for return to hospital
- Infection risk
How would your ideal clinical dashboard drive patient care decisions?
Dashboards can bring critical information to nurses to help them prioritize assessments, create CNA assignment groupings, and plan for the number of staff required to care for the residents. Useful dashboards can also help highlight subtle resident changes that require attention and monitoring, which is important for disease management, timely discharges to lesser care environments, and prevent returns to the hospital.
How would your ideal clinical dashboard help optimize reimbursement?
Notification of potential Interim Payment Assessment (IPA) need. Given the fact that reimbursement is inadequate in our sector, we cannot afford to miss getting paid for care that is provided. The MDS process is often convoluted and difficult to complete flawlessly, so it’s easy to miss documentation that could result in better or more accurate payment. Having a notification that calls attention to care that we could and should be getting reimbursed for providing is extremely valuable.
How can the clinical dashboard improve staffing efficiency?
As I mentioned earlier, having information on resident acuity and needs can result in better acuity-based staffing decisions, better division of assignment workload for our nurses and CNAs, and allow us to make quicker decisions on when to add staff in order to meet the needs of those for whom we provide care.
How would you like to see the clinical dashboard integrated with predictive analytics tools?
There are some dashboards that do this already. For instance, predicting return to hospital risk based on current resident status, existing comorbidities, subtle changes and historical patient data can provide valuable insight into the necessary monitoring, education and follow-up required to keep a resident on the right trajectory towards a successful discharge. It can also help prevent returns to the hospital.
Besides yourself, what are the most important roles in your organization to also have access to the clinical dashboard?
Nursing home administrators, directors of nursing, nurse managers, MDS personnel, and licensed nurses could all benefit from having a streamlined clinical dashboard. Notice I said streamlined. Dashboards with too much information become “noise,” so we need to determine what is most important and eliminate information for the sake of information. In our company, we are challenged with information overload at times. Too much information can become confusing and result in frustrated employees. We need to think about what is most important. If we are not doing something with the information on the dashboard, then does it truly need to be there?
What would you do to improve the collection of patient health data?
Long-term care staff need time to be able to document. We need to eliminate duplicate documentation, streamline documentation as much as possible, and eliminate unnecessary documentation so that what is documented is meaningful, accurate and tells the story of the resident’s needs and care.
It’s also important the information that is shared across the care continuum is accurate and reflects the true needs of the resident. Oftentimes we review documentation for residents we are admitting, and when the resident arrives, their care is nothing like what we anticipated. This can impact both residents and the staff caring for them if information is not shared between care settings accurately.