In this Clinical Dashboard Series interview, Skilled Nursing News sits down with PointClickCare Director of Value-Based Care, Samantha Vosloo. With a background in health care and nursing home administration, Vosloo brings a boots-on-the-ground perspective to her Clinical Dashboard wishlist — from the nice-to-have data points to the need-to-haves, as well as the clinical dashboard elements that are already a reality thanks to today’s cutting-edge technology.
Skilled Nursing News: What are the three most important data points for an ideal skilled nursing clinical dashboard and why?
Vosloo: Ideally, your dashboard is going to be tailored to your workflow based on your role.
Given my background in nursing home administration, in that work, I needed to see the population as a whole to best understand how to prioritize my day and then my team’s time and effort. Predictive elements are top-of-mind for us to think about. For example, those predictive elements might include return-to-hospital data and estimated discharge dates. Predictive change in acuity score, which signals to us a change in condition for our residents, is going to be most important. That’s because this information makes it easier to triage where our critical focus needs to be throughout our day.
How does an ideal clinical dashboard drive patient care decisions for operators?
By using personas and dashboard data, we can bring to the surface the information that each individual needs within their existing workflow so that we can be most effective with our decisions and time. For example, if I’m the attending physician and I’m coming to the building to conduct rounds, I may find valuable a filter to show me who needs my time and attention at any given moment. This may be someone who’s had a significant change since the last time I saw them, someone who’s at a high risk of returning to the hospital, or someone who’s about to be discharged home. Those types of insights let that physician be more efficient when they round and influence outcomes that we’re all striving for. Alternatively, if I’m the nurse at the bedside, I may need something that helps me make critical decisions regarding care in the moment. Or, if I’m a nurse manager or an administrator who’s overseeing the resident population, I may need a more global view so that I know where to place my time and attention.
How does the ideal clinical dashboard help optimize reimbursement for operators?
As we’re transitioning from fee-for-service to value-based care models, much of the work we do today is tied to our reimbursement directly or indirectly. Ideally, the clinical dashboard is going to help us identify gaps — whether that’s gaps in documentation, care provided, or capturing clinical acuity. From there, the care teams can fill those gaps as appropriate. For example, if I’m providing a level of care to a resident but I’ve documented a lower level of care in the MDS, that ideal clinical dashboard is going to be able to bridge that gap and identify to leadership that we have an opportunity to optimize our reimbursement for taking credit for the things that we’re already doing.
How can the clinical dashboard improve staffing efficiency?
There are two primary factors at play. First, the way that skilled nursing centers have staffed their buildings historically is different from the way they need to be staffed in the future. The residents that we’re caring for are more clinically complex than they’ve ever been, so we need more skilled clinicians and support services at the bedside. And we need their time to be freed up without having the burden of over-documentation or cumbersome documentation to provide that direct care. Staffing is a finite resource.
Second, skilled nursing centers need technology to help support the competency and the capacity of the staff to take care of the residents. Having a dashboard that can aggregate the clinical need of the resident population will allow leaders to tie staff capacity to that need. This allows them to place team members where they’re going to be most effective in driving outcomes. The skilled nursing center can’t just put six CNAs on a long-term care unit and know that that’s going to be effective in providing the care that’s needed. The leaders need data in order to drive efficiency, which will enable them to more adequately address the ever-changing complexities of the residents that they’re serving. When we think about this clinical dashboard, it will allow the skilled nursing centers to have insight into those personal items. Previously skilled nursing centers used a model where we may staff at a particular level, given our census or given the unit type, but that’s something that can’t be done anymore to rightfully address the
complex and varying needs of the residents that are in our communities.
How would you like to see the clinical dashboard integrated with predictive analytic tools?
It really does go hand in hand with what I said before about staffing. The skilled clinicians that really understand the building and how things operate are becoming fewer and fewer. With that shift comes the important need for predictive analytics to be the rising tide that raises all ships. For newer nurses, analytics provide them with insight to support their clinical decision-making.
For tenured nurses, it gives them an efficient way to remove the noise and know where to place their attention. This also allows nurses to take credit for the good work that they’re doing.
Who do you think are the most important roles in a skilled nursing organization to have access to the clinical dashboard?
To do the work of overseeing a population, especially being an administrator and not a nurse, I have to rely very heavily on the smart individuals around me to execute the goals that I’ve set. It’s important for those individuals across the organization to have access to that clinical dashboard. When we think about clinical leadership, like the director of nursing or other unit managers, we want them to have systematic oversight of the clinical outcomes of the center. We want them to have insights at the point of care — for example, pain that was documented the previous day — to help influence their actions when they’re interacting with the residents. And one persona that I think is often overlooked is the ancillary care team. For example, in physician and pharmacy services, these people are important in how they contribute to the outcomes that the SNFs can achieve in their building. They need to be involved in the daily operation of the center.
And by having access to a dashboard, it allows them to only focus on what they’re needed for because, just like everyone else, their workload is so vast.
What are some things you think SNFs could do to improve the collection of patient health data?
The health care ecosystem is so connected now. As I said before, the types of residents that we’re caring for are more clinically acute than ever. With that comes the importance of creating a unified language that allows entities to communicate with each other across the continuum of care. When you think about that and all of the people who have the ability to impact the outcomes of the residents — the health system, the health plan, the case manager, the family, the primary care in the community — all of these entities speak different languages. To combat this, the industry needs to pay some time and attention to creating a unified language through the clinical dashboard, so that we’re able to influence each other and impact care across the continuum. We all have really valuable insights into our residents’ care history, their preferences, their wants and their needs. By having a way to interact with each other across the continuum of care, we’re empowered to be more efficient in how we impact outcomes.