More recently, Reichert has found that she also can use the new-look tracking system to keep an eye on patient outcomes, including post-TAVR complications such as paravalvular leak, bleeding events, and stroke. Consistently monitoring complications has helped Riverside’s team judge the effectiveness of change implementation.
“The real-time data we have now has been instrumental in evaluating effectiveness,” she says. “If we want to implement change, we can learn rather quickly if it was a success or not.”
One the biggest pieces of evidence that Riverside’s manual tracking system has made an impact is the improvement in groin complications. By tracking data and evaluating each operator’s technique, Reichert and her team were able to drastically reduce the number of complications by ensuring everyone’s closure was performed in the exact same way every time. The group was also able to stop unneeded procedures by examining pacemaker rates, characteristics of patients with post-TAVR electrical abnormalities and implementing outpatient monitors for high-risk patients.
“Patients are able to discharge home sooner and safer than ever before,” Reichert says.
In addition, the team at Riverside is spending less time inputting data and shuffling through papers and more time interacting with patients.
“This has dramatically reduced a lot of our workloads,” she says. “If you need an answer, on any patient, you can open up the system and find it quickly, even if you happen to be away from the office for any reason. Our coordinators have more freedom now.”
Looking ahead, Reichert hopes she can continue improving Riverside’s referral process.
“I’m always looking for ways to improve care for our TAVR patients and help the healthcare providers who take care of them,” she says. “We are always looking to make this complicated coordination more efficient. We want to ultimately grow our already robust program, and these improvements are the first step in that direction.”
Automated referral tracking makes an immediate impact
At the University of Alabama Birmingham (UAB), Laura Raye Byrd, operations manager for the facility’s structural heart clinic and interventional cardiology offices, has witnessed huge improvements in UAB’s ability to track patient referrals. The key to her team’s success? Automated referral tracking.
Byrd recalls working in a cardiovascular surgery office that tracked all referrals manually. As rewarding as the job was, tracking patients was awkward and tedious.
“When a referral came in, I would get a text message asking me to bring a certain patient in,” she explains. “I would often have a first name for the patient, but no last name or date of birth, which sent me scrambling around just to get some answers.”
If it wasn’t a text message, Byrd adds, it would be a letter in the mail or a fax. Sometimes, it was a sticky note with minimal patient information that showed up when she was away from her desk.
“It was a lot of information coming from all different angles,” she recalls.
In her current position at UAB, however, Byrd says tracking patient referrals is much more efficient. This high-volume facility gets approximately two dozen TAVR referrals a week, in addition to patients in need of a variety of other structural heart procedures. When UAB’s leaders saw how many new patients were being brought in on a regular basis, they chose to invest in VitalEngine, a cloud-based, HIPAA-compliant automated software solution designed to be a one-stop shop for the entire referral process.
The tool allows referring providers to log in and share the patient’s name, date of birth and reason for referral, Byrd explains. Then they simply send a note through the software—no text messages, faxes, phone calls or sticky notes necessary—and UAB’s coordinators can reach out to set up an appointment for the patient to come in.
But there’s much more to the referral process than simply handing off patients. Automated referral tracking also serves as a bulletin board, a conference room and a group text thread, connecting the entire care team.
“We can communicate as needed within the software,” Byrd says. “There’s no phone tag, no wasted time. It all takes place right there, where everyone is already connected. If our team needs an alternate phone number for a patient, for example, or if one of our surgeons wants to see how many TAVRs are scheduled for a certain week, all of that communication happens in one convenient place.”
The front desk employees at UAB’s structural heart clinic are grateful too.
“They were always the ones taking phone calls about referrals, often spending 10 minutes at a time just to secure one basic piece of information,” she says. “I bet this updated process saves them two hours per day, maybe more.”
When patients are sent to UAB’s structural heart clinic, their referring physician has already determined they have severe aortic stenosis. The next steps, however, are up to the clinic’s team of cardiologists and surgeons, who confirm the referring doctors’ findings, order echocardiograms and schedule appointments and procedures. All of these actions are stored and recorded in VitalEngine, keeping everyone on the same page as the patient moves through the care process.