Asynchronous video for pre-surgery improves patient and staff experience

Northwestern Ontario covers a geographic area the size of France, but is sparsely populated, with a population of only about 230,000.

THE PROBLEM

Staff at the Thunder Bay Regional Health Sciences Center (TBRHSC) know that with limited health care resources across Northwestern Ontario, it is critical that they work together across all hospitals providing surgical services to improve access to care for remote and rural patients to improve.

PROPOSAL

“Asynchronous video technology is important to improving patient care, supporting equal access to care, and advancing our hospital’s strategic enabler, called ‘Sustainable Future – Advance Digital Health to Improve Patient and Staff Experiences,’” said Cindy Fedell, CIO at TBRHSC. “Providing tools to empower our patients is fundamental to our vision.

“We have begun implementing asynchronous video technology for surgeries at the four hospitals in TBRHSC’s Regional Surgical Services program,” she continued. “The overarching goal was to optimize clinical staff time while improving patient compliance, experience and outcomes.”

The key challenges the provider organization faced, Fedell outlined, were:

• Optimizing clinical staff time due to limited resources
• Long pre-anesthesia appointments pose a bottleneck in reaching available operating rooms
• No standardization of pre-surgical education, which can reduce quality assurance
• Poor patient compliance with pre-operative classes, resulting in no-shows for the pre-anesthesia appointment, surgery cancellations due to non-compliance, patients not understanding the importance of same-day ambulation and discharge, and much more

“Surgical care involves communicating a lot of information to patients and providers before surgery,” Fedell explains. “It is critical that the patient not only understands the information, but also remembers it and then takes appropriate action.

“Although we had invested in an app to provide this information to patients in written form, most pre-operative information was provided verbally by doctors, nurses and staff, in addition to a paper packet,” she continued. “The verbal repetition was incredibly time consuming for our clinical staff. On average, it would take an hour during the pre-anesthesia appointment to convey the redundant information.

These lengthy appointments created a bottleneck in getting patients to the OR. In addition, patients often forgot the information they heard and called with questions, and the staff repeated the information.

Asynchronous video technology made sense for the organization and supplier HCT Digital Care was chosen.

“The staff was on repeat, relaying preoperative information and then answering the same questions when they inevitably came in,” Fedell said. “If we put it all on asynchronous video, they don’t have to broadcast the same information all the time.

“And the message is scripted and standardized, which is great from a quality assurance perspective,” she added. “Patients can re-watch the videos as often as they need, at home with their caregivers and family, in the language they speak at home.”

The technology’s capabilities were also attractive to Fedell because the videos are interactive and include built-in surveys and analytics.

“So we could encourage patients to take action, such as downloading our digital patient engagement and monitoring tool from SeamlessMD,” she noted. “And with the surveys we could do digital ‘teach-backs’ to make sure the patient understood what they had just listened to. We could also get back experience data from the patients.

“Then with the video analytics, we can actually see the data to make sure our patients are actually watching and engaging with the video content,” she continued. “And HCT are experts in healthcare operations. They understand us and what we’re trying to do.”

MEETING THE CHALLENGE

TBRHSC automated preoperative messaging for all surgical hospital operations in Northwestern Ontario. It started with ten videos covering many topics including planning and consenting to surgery, how to download the app, what to expect at the pre-anesthesia appointment, general pre-surgery instructions, what to expect at OP and IP surgery, common misconceptions, what to expect after surgery, and how to prepare the patient’s home.

The videos are embedded in the organization’s website and in the Seamless MD app.

“HCT helped us build out our clinical workflows, use QR codes to promote the videos and communicate internally with all our physicians and staff about the launch,” Fedell recalls. “Now that we are live with the videos, we meet regularly and review analytics reports that show us the impact we are having on our patients.

“The project management and vendor guidance have had a major impact on our leadership team,” she added.

RESULTS

To date, patients have viewed more than 250 hours of video.

“That’s incredible when you think about how much time we save for our clinical staff,” Fedell said. “But beyond that, time is spent improving the surgical experience for our patients and their families.”

There have been more than 9,500 video views, meaning TBRHSC has standardized preoperative messaging for thousands of surgeries. That’s a big win in terms of quality assurance.

“Another statistic we know from the analytics is that 99% of patients found the videos helpful and felt better prepared for surgery after watching the videos,” Fedell reported. “That’s an A+ in the patient experience. Through the analytics, we can see patient comments about how the videos were educational and informative, answered their questions, calmed their anxiety and clarified expectations.

“A truly incredible statistic: we have reduced the number of incoming patient inquiries by a factor of 15 to 1,” she continued. “For every fifteen questions nurses used to receive from patients who called or wrote during pre-surgery, they now receive one. This means we are proactively answering patient questions with the video technology and making better use of our nurses’ time and employees.”

ADVICE FOR OTHERS

This is the future of health care, Fedell argued.

“Patients already use video in their daily lives and often turn to YouTube videos when trying to navigate healthcare,” she said. “We want patients to get the information from us, their trusted provider, in the best format for learning and remembering. And asynchronous video technology is a way to reach patients in the format they prefer, improving the care we deliver. It’s a win-win-win.

“Our administrators love it because it helps them achieve their business and operational goals,” she concludes. “Our doctors and staff love it because they don’t want to be repetitive 24 hours a day and they want their patients to be better prepared and engaged. And I want to thank Caroline Fanti, our director of regional surgical services, for lead the burden on these efforts at our organization.”

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