BOSTON – After implementing artificial intelligence into the systems where nurses are accustomed to working, Mercy was able to realize $52 million in talent retention and engagement, a 20% improvement in nurses’ experiences with electronic medical records and a 17% increase in nurse efficiency, the health system’s SVP Betty Jo Rocchio said Thursday at the HIMSS AI in Healthcare Forum.
According to Rocchio, a nurse practitioner and nurse leader, health care has “a huge responsibility and at the same time an opportunity for human flourishing.”
By moving to mobile registration, developing an automated nurse accreditation system, and using AI to resolve bottlenecks to improve emergency department-to-inpatient handoffs across the health system’s 51 hospitals, Mercy has been able to create a more resilient workforce and increase retention.
The reward for the efforts can be found in the figures.
“We need the analyses in the background to be able to say that we are taking the right step.”
Why a Technology-Driven Workforce
Hal Wolf, president and CEO of HIMSS, the parent company of Healthcare IT Newsopened the forum with a discussion of the anomalies that healthcare continues to face.
The skilled worker challenge will come up again and again — “one that makes every health system look up and think about how can I use new tools to improve or expand my capacity to care for people,” he said.
In 2018, the health care sector was projecting a shortage of 13 million clinicians worldwide by 2035. The World Health Organization adjusted that shortage to 18 million about a year ago, he noted.
Rocchio agreed. “I just don’t think we can wait another 10 to 15 years to figure out if we have the people we need in the care model that we’re delivering today,” she said.
“One of the key focuses is how we can build the workforce.”
To address this, Mercy is focused on leveraging AI to solve workflow and work environment challenges.
“If we could get those three things right in health care — regardless of the location of care, whether it’s home care, virtual care, or care at a patient’s bedside in a clinical setting — we would be a lot further along today,” she said.
Rocchio said the team of technologists, nursing leaders and informaticians, based on evidence-based data, concluded that flexible pay, work-life balance and control over scheduling are most important for all generations working in nursing today.
“We cannot underestimate the value of the concept of human flourishing and say we need people to work in a certain way, but the new generations are just not going to do it,” she said.
“I’ll just say it like it is, we’re a mess in health care, sometimes in the process. We need to go back and clean it up in an organized way, in the way that the technology is meant to be used.”
The digital transformation of the healthcare system followed a path based on Everett Roger’s theory of innovation diffusion. Now there is a system and a process around the shop floor.
By adding an automated nurse accreditation system, Mercy has reduced the time it spends on staffing and scheduling by about 25%, she said.
When permanent, temporary and flexible nurses are hired, they use the qualification system to schedule the desired shifts. And it works.
“The supply-demand concept has been around for a million years,” she said. “We’ve applied it to health care, put the technology in, and we have the analytics to measure ourselves.”
Although nurse managers were initially concerned about filling their schedules, data shows that staff are actually filling open shifts.
“Two years later, it still works great, and you can still see all the data, and everyone is calm. But to get to that point, there is a little bit of pain.”
Reducing the cognitive load of nurses
If nurses spend 240 minutes per shift in the EHR, it leads to higher mental stress and faster burnout, Rocchio says.
“The whole goal of addressing the work environment and workflows is to reduce the cognitive workload of the nurse,” she said.
“We know it’s important to keep them at the patient’s bedside. But if we increase their workload while we’re doing that, we’re likely to drive them away.”
To address this issue, Mercy is deploying mobile surgeries with Epic’s Rover to minimize time spent at their desktops, and is using augmented intelligence to improve patient transfers from emergency departments.
By traversing the various paths in the EHR (the doctors, medications, labs, pharmacy and more), an AI-enhanced system searches the entire ED record to surface critical information and literally put it in the hands of nurses.
“That recommendation section looks at the orders, sees what the physician has approved, and then takes whatever the physician still needs to do and forwards it to the nurse on the floor and sends it to their cell phone.”
Andrea Fox is Editor-in-Chief of Healthcare IT News.
Email address: afox@himss.org
Healthcare IT News is a publication of HIMSS Media.