As the largest private, not-for-profit healthcare system in South Carolina, Prisma Health grappled with several pressing challenges common to the modern healthcare industry: limited resources, financial pressures and widespread provider burnout.
THE PROBLEM
These problems were exacerbated by the organization’s size: a network of 18 hospitals serving more than 1.5 million patients annually with 30,000 team members.
One of the biggest challenges was efficiently managing patient care and staff involvement on such a large scale. Tracking critical metrics such as patient safety, quality of care, and staff performance in real time was difficult for leadership teams.
“Without the right tools, it became nearly impossible to ensure that key leadership behaviors, such as patient/leader rounding and goal-oriented rounding, occurred consistently across our hospitals,” said Tina Hunter, executive director of patient experience in the clinical care department. healthcare experience at Prisma Health.
“Additionally, our emergence from the merger of two large organizations brought its own complexity when it came to unifying processes and workflows,” she added. “Staff shortages and the increasing demands of caring for a diverse patient population only made supervision more difficult.”
Prisma Health also had problems maximizing the impact of its workforce. Team leaders and nurse managers often had limited time and resources to ensure they could focus on the highest priority tasks.
“With so many responsibilities and insufficient visibility into performance data, critical tasks can easily be overlooked or postponed,” Hunter explains. “This lack of structure and real-time visibility has contributed to inefficiencies in healthcare delivery, making it more difficult to maintain high-quality care amid increasing financial pressures and increasing patient demands.
“It became clear that technology could provide a solution to help close some of these operational gaps and optimize our existing structures, which would be critical to improving our systems, increasing accountability and driving better results,” she added.
PROPOSAL
The core idea behind Prisma Health turning to vendor CipherHealth was that rounding – whether focused on the patient or team members, in both acute and outpatient settings – had to become a fundamental part of the workflow.
“By moving to a structured rounding framework, we wanted to create a culture of continuous improvement and accountability across the organization,” Hunter said. “The system didn’t just have to track key metrics like patient safety concerns or lessons learned from patient/leader rounding; it also needed to provide our frontline teams with real-time data, allowing them to make informed decisions to improve the quality of care.
“We wanted to ensure that leaders at every level of the organization, from C-suite executives to frontline team members, were involved early in the development process,” she continued. “This top-down and bottom-up approach has helped everyone in the organization align on the importance of rounding and tracking care metrics and made it easier to integrate Pulse, our clinical operating system, into our daily operations.”
Prisma Health also wanted to ensure that one of the key strengths of this technology was flexibility and an emphasis on continuous improvement. Rather than creating a rigid system, the health system encouraged feedback from both staff and leaders to refine the platform as it implemented the technology.
“When we started using the system, we allowed hands-on experience to guide further improvements,” Hunter explains. “This iterative process ensured that this element of the Pulse OS was a co-constructed unifying model, focused on eliminating variability in care and tailored to our specific challenges over time.”
MEETING THE CHALLENGE
Prisma Health integrated CipherHealth’s rounding systems into the Pulse OS for its rounding system. By integrating CipherRounds, the healthcare system has been able to track critical activities such as patient/leader rounding and goal-oriented rounding and monitor the correlations with improvements in patient outcomes.
“We observed near-perfect alignment between completion activities and key performance metrics, demonstrating the tangible impact on quality of care,” Hunter said.
“CipherRounds worked with us improving patient safety by flagging high-risk patients, helping leaders prioritize them during rounds and allowing staff to focus on those at risk of infections or falls,” she continued. “This system enables quick, informed decisions, improving the efficiency and effectiveness of handling.”
Additionally, vendor Prisma Health’s rounding technology helps leaders integrate real-time service recovery and escalation processes, enabling rapid resolution of issues and uncovering hidden issues. This visibility has increased both patient satisfaction and operational efficiency across the 18 hospitals.
“In addition to data collection, the rounding platform has become a powerful tool for driving organizational improvements,” Hunter noted. “We have also introduced CipherHealth’s Self-Service Rounding to Pulse, starting in our busiest mammography clinics.
“Self-Service Rounding collects real-time feedback via SMS or QR code, enabling immediate service restoration and quickly addressing safety issues,” she added. “It also recognizes staff performance, and we plan to expand Self-Service Rounding to all imaging centers and our entire medical group this month. Future expansion of this tool will be to our medical group practices and then to the acute room.”
RESULTS
The vendor’s rounding technology has enabled Prisma Health to think differently about how the business continues to improve. The healthcare system has shifted from a reactive, error-found organization to a true learning organization, where it sees finding gaps as a good thing.
“Once a gap is identified, we can systematically improve processes to better care for our patients and support our teams,” Hunter said. “The impact of this focus on learning and improvement has been tremendous, in terms of both quality of care, patient experience and team member engagement. An example of the improvement achieved as a result of implementing CipherRounds can be seen at our emergency departments over the past year.
“System-wide, our Emergency departments improved by 17 percentile points in overall ‘Likely to Recommend’,” she continued. “Our largest emergency department (a Level 1 Trauma Center, Comprehensive Stroke Center, with an average daily caseload of more than 300 per day) has improved by 35 percentile ranks in overall likelihood of recommendation over the past two years – despite the negative challenges that they faced after the pandemic.”
These improvements can be correlated with the collaborative approach and process improvements implemented as a result of patient learning. The supplier tool has helped Prisma Health track and trend opportunities and guide metrics when a new process is implemented, she added.
ADVICE FOR OTHERS
“Healthcare organizations facing resource constraints and workforce challenges must fully embrace technology as a critical tool to bridge operational gaps,” Hunter advised. “In today’s healthcare landscape, no technology is perfect, and many systems aim to address multiple issues simultaneously.
“The real challenge is finding the right balance – using technology to improve efficiency without overwhelming staff or compromising patient care,” she continued. “It is critical to use systems that can be tailored to your specific needs and empower your team, rather than looking for a one-size-fits-all system that may not fit every scenario perfectly. “
Technology-enabled workflows should focus on helping leaders be more efficient and employ multiple functions to help them achieve that – it should always be complementary and not an extra step to complete, she added.
“Don’t be afraid of technology,” she said. “Instead, focus on how your staff can support technology for operational workflows while providing the space to also provide that essential human connection that patients need when they need it. Technology should complement, not replace, the interaction between healthcare providers and patients. workflow insights to truly maximize interactions in a concise format.
“It is also critical to gain buy-in from leadership and frontline staff early in technology adoption to ensure systems fit all the needs of the organization,” she concluded. “Embracing continuous improvement and flexibility will help technology evolve and remain effective in addressing challenges such as workforce shortages and financial pressures.”
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