In this Clinical Dashboard interview, Skilled Nursing News sits down with Lisa Fetterman, Quality Care Coordinator at Hurlbut Care Communities. Fetterman has worked in long-term care for over 20 years, with roles including RN and a LPN. In this interview, Fetterman reveals her hopes for the ideal Clinical Dashboard, focusing on staffing needs and minimizing risk.
What are the three most important data points that you would want to see each day on your ideal clinical dashboard and why?
First is the resident ADL scores (Activities of Daily Living) to manage the staff assignments and staffing needs per unit. The more needs of a resident, the more staffing that is required. The clinical dashboard could help determine staffing needs of a specific unit as well as give the ability to place admissions better based on acuity for residents with special needs such as medical devices, catheters, IV, nephrostomy tubes, and wounds, etc.
Second is the infection status of the facilities. There are many infections we want to prevent from coming into our facility—and at the very least, stop them from spreading. Data points to show risk and where the team is at could help prevent the spreading of infections, resident infection tracking, antibiotic use, isolation and more.
Third is any data to help identify a risk to the patient such as heart attacks and falls. This would be helpful for the staff to know a risk factor for the day to keep a closer eye on the patient to prevent injury.
How would the ideal clinical dashboard drive patient care decisions?
Ideally, the dashboard could help the facility determine staffing needs. Nursing homes aim to help hospitals take on some clinically complex residents. If there are too many residents with high clinical needs, it can strain the care of the other residents. A clinical dashboard scoring the residents’ needs could help administration to better staff facilities with the appropriate care. It could help answer if we need more RNs based on patients’ needs versus using LPNs.
How would the ideal clinical dashboard help optimize reimbursement?
The clinical dashboard could include items helping nursing homes with their Minimum Data Set (MDS). If the nursing home miscodes the resident on any of their needs and provided care, the facility will be underpaid. If the facility miscodes for overpayment or the medical care notes show up in a wrong location, the government will step in to take the money back. The majority of patients in nursing homes have a long list of diagnoses and each one is associated with a code. Each code will lead to a different amount of reimbursement. So incorrect coding can negatively impact the reimbursement.
How can the clinical dashboard improve staffing efficiency?
The ability to see the acuity for a specific unit/assignment will allow for adjustments in those assignments. Also, it would give the team the ability to adjust staff assignments for a specific group based on staff experience.
How would you like to see the clinical dashboard integrated with predictive analytics tools?
There are many predictive tools that would be beneficial in healthcare. For nursing homes, an accurate way to predict falls would be an enormous help. The elderly are a vulnerable group when it comes to falling. Their bodies cannot handle bumping into something or falling down and hitting the ground. Facilities want patients to be safe but also as independent as possible.
Besides yourself, what are the most important roles in your organization to also have access to the clinical dashboard?
All staff who are part of the interdisciplinary team should be reviewing the clinical dashboards.
What would you do to improve the collection of patient health data?
We would do just about anything to improve the collection of patient health data if it doesn’t increase costs. The more data the better for accuracy. If this means altering when nursing staff would be acquiring data such as vital tests then we would do that. Also, if we needed to change specific assessments to collect the data needed, we could do that or develop specific tools needed. The more data the better for tracking the resident. We would like anything that can take a measurement such as getting vital signs or food consumption and to be instantly uploaded to their medical record.
Can the ideal clinical dashboard help with value-based care?
Yes. Value-based care is about reaching patients’ goals depending on their needs. A dashboard using predictive tools and comparing to past cases could definitely help a care plan to help patients meet their goals.
Can the clinical dashboard improve care denials from managed care?
Not sure. Managed care is motivated to deny patients coverage so they can make more money. They might not care what the facility has to say.
