HCA Healthcare Innovators Award: Financial Impact

Financial Impact Recipient:

Joanne T. Orlando, RN, MountainView Hospital, Las Vegas, NV

When Joanne Orlando quotes Nobel Prize winner Linus Pauling, she’s not referencing a book. She’s spent time with the gentleman, and the lessons she learned are helping Sunrise Hospital in Las Vegas offer better and more efficient care.

“When I was managing a critical care unit, [Pauling] had a friend who was in the ICU,” recalls Orlando, now the director of clinical research at MountainView Hospital. “We spoke many times, and I will always remember him saying that inventions don’t come from something obscure or way out of the ordinary, but to just look for what’s right in front of you.”

She took that lesson to heart, working within the Crimson information-management system to build a system of dashboards that pinpointed opportunities based on the data, and then began working with physicians to improve their performance based on that information.

“The goal was to help them work smarter and better, so that they could be more efficient and productive — and spend more time with their patients,” Orlando says.

Orlando built a system of dashboards that pull from the Crimson information-management system’s data, and then set about working with some of the facility’s 26 hospitalists who needed assistance. Since this group handles almost 40 percent of inpatient admissions, they are central to patient care. What Orlando wanted to do was create a framework for them to handle their day-to-day duties efficiently, which would free them up for patient care and also reduce re-admissions and improve clinical outcomes.

“I didn’t want to just hand them a bunch of data and say, ‘go for it,’” Orlando says. “I wanted the dashboards to be understandable, and so I went on rounds with them, watched what they were doing and learned their organizational and priority-setting skills. I wanted to use their documentation and data to help them understand where there were opportunities for improvement.”

For instance, one physician was getting 50 to 70 queries monthly from the clinical documentation staff, and those kept her from patients. By working with the new dashboards, the doctor was able to move into the green zone and spend more time with patients — a win for everyone, because it decreased queries while also increasing positive clinical outcomes.

“At the same time, her readmission rates for seven days and 30 days also went down, as did her average length of stay and her complications of care, so everything improved once she learned how to document more effectively,” Orlando says. “We can use data to identify problem areas, and then track performances to fix the issue. And the doctors love it — when others saw the improvements the group I was working with were seeing, they all wanted individual help!”