In the following interview with Sammie Mosier, Senior Vice President and Chief Nurse Executive, HCA Healthcare, we dive into HCA’s Cohesive Nursing Agenda aimed at improving the nurse experience. Plus, we dive into some of the ways they’re utilizing technology in this effort.
What is HCA’s Cohesive Nursing Agenda?
The Cohesive Nursing Agenda is a technology strategy aimed at improving experiences for more than 98,000 nurses across HCA Healthcare. It helps nurses collaborate on mobile devices, manage workload, learn virtually, and raise the bar for nursing practice. Our strategy is driven by one focus – the patient. We want to leverage the most innovative technologies to provide the best care and patient outcomes.
How has this effort impacted nurses?
HCA Healthcare is one of the largest providers of healthcare in the United States, with more than 32 million patient encounters a year. Investing in these technologies allows our nurses to deliver care more efficiently, decreasing the burden of redundant or unnecessary documentation and increasing the time they spend at the bedside.
What are some of the core technologies you’re using as part of this effort? What’s been the strategy when choosing those technologies?
In an environment of 30 hosts and 330 virtual machines running an enterprise archive with 72PBs of images, and supporting tens of thousands of unique users for decision support use cases, Nutanix helps make it all work. We use Nutanix for 9,000+ virtual machine workloads to run some of our most critical applications, and to enable image archiving, instrument readings (telemetry monitoring), care team communication and more…all critical to delivering on our mission. Some of the technologies supported by this partnership include:
- Mobile Heartbeat. This secure, smartphone platform has revolutionized communication and collaboration among more than 230,000 clinicians at more than 160 HCA Healthcare facilities. With this solution, the exchange of information between care team members and awareness of which care team members are involved with patients can all be facilitated from a mobile device. We continue to grow our use of this platform and embed it into our workflow.
- Heightened Alerting Response for Telemetry (HeART). Data from 2019 shows as many as 60% of HCA Healthcare patients are on telemetry monitors (equipment that captures patient information such as vital signs and displays information for care team analysis). The HeART solution integrates hardware and software with GE, Airstrip and ASCOM, allowing alerts informed by specific telemetry monitors to reach the patient’s care team via Mobile Heartbeat devices. The right alerts (most critical) can reach care team members where they are rather than only being noticed and assessed with a visit to the patient bedside.
- PACS Image library. Many care team decisions are informed by observations made from viewing images (ultrasounds, magnetic resonance images, nuclear medicine imaging, mammograms, etc.). As such, making images available to care teams across our large organization is critical to delivering quality care. An RDC VM environment consisting of four Nutanix Clusters, 30 Hosts and 330 virtual machines powers image archives, gateway servers, storage automation servers and more to help power our Collaborative Nursing Technologies.
With 98,000 nurses across 187 hospitals and 2,000 sites in 20 states and the United Kingdom, what does it take from a technology perspective to make this happen?
Collaboration. HCA Healthcare is fortunate to have an Information Technology group (ITG) that has been collaborating with our nursing team on a nursing strategy for a number of years. We collaborate at an executive, a leader and a care partner level.
At the executive and leader levels, we collaborate on the strategy and the prioritization of the work. We develop business cases together, set metrics for success and prioritize the work and work sequence. Our nursing leaders take point on understanding the people we are serving – our patients, clinicians and nurses. Our ITG partners take point on the technology, understanding what the technologies can do for us and making sure that they work appropriately. Both ITG and nursing collaborate on processes, making sure we understand clinical workflows and how they should be represented in the technology, as well as understanding how they should be implemented so they are well adopted and serve our patients.
What kind of reliability and redundancy have you built into this implementation?
HCA Healthcare has a stringent program for high availability and redundancy for our technologies, including a detailed plan for detection of issues and critical response times.
What’s been the hardest part of this project?
Since this is not a single “project,” the hardest part has been the coordination and interconnection of the components to accommodate our scale.
Where do you plan to take this next?
Investing in the nursing experience remains a top priority for HCA Healthcare. We will continue to expand features, integrate platforms and gain actionable insights from our data and technologies to improve patient care.
