Reducing Communication Breakdowns: Interview with Steven Harrington, MD

Henry Ford Macomb Hospital recently switched to the PerfectServe system to reduce communication breakdowns among its clinicians. PerfectServe is a clinical communications system linking hospitals and practices that automatically routes calls and messages to physicians in the manner in which they wish to be reached. By transitioning to PerfectServe, the hospital has facilitated more peer-to-peer communications among physicians, improved the coordination of care and reduced risks. In this interview we speak with Dr. Steven Harrington, a leading cardiac robotic surgeon at Henry Ford Macomb Hospital, about his use of the PerfectServe system and how it helped with effective care coordination. Henry Ford Macomb Hospital is located in Clinton Township, Michigan. Describe your position at Henry Ford Macomb Hospital. What is a typical day like for you? I am the medical director of cardiothoracic surgery, chairman of the quality committee for the hospital, as well as serve on the medical executive committee for the board of trustees. I also serve on the board of trustees and on the quality committee for the Henry Ford Health System. I have been a cardiothoracic surgeon for about 30 years now. What procedures do you most often work on? Typically I will perform about 1-2 cardiac operations a day. Approximately 75 percent of cases will be coronary revascularizations, which is typical for most cardiac surgeons. However, one of my specialties is that for about 6 years now I have been doing robotic cardiac surgeries; we perform anywhere from 100-150 robotic cardiac surgeries annually using the da Vinci robot system. This system gives us the ability to do, for example, a mitral valve repair surgery through about a 20-millimeter incision between a patient’s ribs, as opposed to a larger sternotomy incision in which we crack the patient’s chest open. We can also do lung surgeries using this system as well as several other operations. The other percentage of my day is spent doing medical administrative duties as medical director of cardiothoracic surgery and quality within Henry Ford Health System. In what ways do you utilize PerfectServe? Where is it being used in your hospital? At Henry Ford Macomb Hospital, the term we use for PerfectServe is “source of truth.” All of our physicians are on board with PerfectServe. Every single physician is enrolled in the PerfectServe network, so if you’re part of the Henry Ford Macomb Hospital, you’re given a PerfectServe number and put in the PerfectServe network. This allows us to have one single source for peer-to-peer communication as well as for nurse-to-physician paging. Therefore, there is no need to worry about trying to go through multiple answering services or paging systems or telepage operators trying to find people. All calls are directed through the PerfectServe system, which gives you the ability to contact physicians and peers instantaneously. What were your reasons for choosing PerfectServe? I personally switched over to PerfectServe about 5 years ago when I formed my own practice — at the time we were using a typical answering service. In the new system I was looking for two things: 1) efficiency in ease of use, and 2) economy. I feel like I got both of those in PerfectServe. With the previous systems you called an answering service and talked to an operator, and every time you had to go through at least 2 or 3 different people in order to get your message across. Not to mention, every time you talked to the operator it was another little tick on the charge card for every contact that was made. The system was inefficient and the messages were often incorrect. For example, imagine the typical telephone game: by the time you talk to one person, who talks to another person, who talks to a third person and finally relays the message, it’s not the original message. With PerfectServe, everything is computerized and I pay one set fee per month for my entire services, no matter how much I use it. It has always been accurate and it keeps a log of every page. It has been so much easier to go through a system that controls my call schedule and directs my calls where I want them to go, whether to my home phone or pager or to my cell phone if I’m out of town. Changes can be easily made either by a simple call to the PerfectServe system or I can go online and make the change. I don’t have to worry about trying to change call schedules or call an answering service and go through all those hassles. Another benefit was cost: PerfectServe is at least a third less expensive than my old answering service. Tell us about your switch to the PerfectServe system. What steps needed to be taken to make the transition? For me it was seamless. It involved only about 2-3 phone calls to the PerfectServe operations center, and they set everything up over the phone and it was done. They will provide training if you prefer, but it is a very intuitive system and so easy to use. However, to set up an entire hospital system, PerfectServe will train the staff to make sure everyone understands how the system works. Instead of calling a telepage operating center to page a physician, clinicians dial the PerfectServe number and then the doctor’s PerfectServe number, and the call is immediately directed to the right person. If you don’t have the number, a help menu can find it. In the past, nurses have had to deal with calling 100 different doctors’ answering services to reach them; imagine the ease of use in dealing with just one call system that is the same for every one of those 100 doctors. How was PerfectServe a good fit for Henry Ford Macomb Hospital? It was a good fit because it standardized our system and reduced variation of care. From a process and outcome standpoint, you want to reduce variability. Problems arise if you have 50 different answering services or if you’ve got a telepage system and there are 5 different operators and one goes on break and doesn’t remember to leave a message — you have no way of knowing who called or what’s going on. However, with the PerfectServe system you’ve got one single reliable source. It is a tremendous improvement for outcomes in that you always get the right information across at the right time. How has PerfectServe helped you coordinate care? It has helped in two ways. First, it makes it easier for our nurses to reach physicians on a real-time basis. Second, it improves peer-to-peer communication. For example, if I’m in the operating room and one of my cardiologists does a cardiac catheterization on a patient and wants to leave me a message but can’t reach me, then it’s very easy for them to either leave me a voice or text message. They might want to let me know that this cath patient has 3-vessel disease and will need a bypass operation within his hospitalization, so their message could ask me to see this patient and give them a call afterwards. The message is complete and comes right from the doctor — it hasn’t gone through 2-3 other contact individuals who can make mistakes. To be able to have better peer-to-peer communication just makes everything so much easier. Give some examples of why PerfectServe might be helpful to the EP lab. Again, the ability for peer-to-peer communication is the biggest benefit. For example, an electrophysiologist may want to leave a message with a primary care doctor about his or her patient for whom he’s just finished an ablation. The doctor may be busy in the office and not have sufficient time to make a phone call to every single doctor that he or she has done procedures for, so this allows the electrophysiologist to leave a message that is transported to the primary care doctor, which improves those communications. Keeping the line of communication open is very important; you want to make sure you can communicate in real time back to doctors about what happened to the patients they sent to you. This kind of communication just keeps the referrals coming back. It sounds like this system translates well to all departments. Absolutely. At Henry Ford Macomb Hospital, it is the communication source that we use throughout the institution, whether it is for EP, family practice, cardiac surgery, etc. Is there anything else you’d like to add? I think I shared the highlights for you on why I think this is a great system. The driving message is that it’s just so easy to use for hospitals and physicians and customizable to any particular practice. If you want to set up your own call schedules then you don’t have to send out a new piece of paper to the answering service. PerfectServe has excellent back-up support and is the most economical paging solution you will find. For more information, please visit: www.perfectserve.com