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Burnout Reduction via Workplace Gratitude
The potential for clinician and care team burnout is a standing concern for Washington University School of Medicine (WUSM) and BJC HealthCare (BJC), especially during the current pandemic. As such, the Lab is working on a proof of concept aimed at reducing rates of medical trainee (resident and fellow) burnout by developing and testing an extensible and integrated digital platform for expression of gratitude within our organization. This effort is in partnership with the WUSM Graduate Medical Education Office, and with support from the Division of Emergency Services, the Department of Surgery, and the Primary Care Medicine Clinic at Barnes-Jewish Hospital. This work is currently in the design phase, in which we outline how this proof of concept will be conducted, including details on the care team engagement process, technical build, and evaluation. Stay connected with the Lab for more information as we move beyond the design phase!
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Non-Emergent Medical Transportation: A year in review
As of July 1, non-emergent medical transportation vendor Kaizen Health has been implemented at five different organizations across the BJC and Washington University School of Medicine, as well as a standalone system-wide platform for COVID-19 patients, who have limited options. In the first half of 2020, there have been over 1,500 rides scheduled and completed through this platform and the response has been very positive. First and foremost, patients without any other options have been able to get home or to their medically necessary appointments, but we’ve also seen improved satisfaction among the staff that coordinates rides; the feedback has been that the new system is easier to use and provides much more transparency. Cost savings are beginning to be realized, and with all of this together we’re seeing more interest from additional clinical areas.
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COVID-19 Home Monitoring Update
BJC HealthCare was recently awarded a grant from the Federal Communications Commission (FCC) COVID-19 Telehealth Initiative for $996,119 — a large part of which was driven by the work the Lab has been doing in remote patient monitoring. A significant part of this funding will go toward purchasing devices to monitor patients with and without COVID-19 away from the health system, where they will receive high quality care without exposing themselves and others to the deadly coronavirus. This funding will help to kickstart the program, which will drive the system digital strategy toward meeting patients where they are along their journey. You can read the full press release here.
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Patrick Lyons, MD, MSc, puts key lessons from Innovation Fellowship to work leading COVID-19 ICUs
“As an intensive care physician researching health care delivery innovation among critically ill patients, I always knew I would translate my Innovation Fellowship experiences into clinical practice – I just didn’t know it would be this soon, in the midst of a global pandemic.
In mid-March, I became the first physician to supervise the Barnes-Jewish Hospital COVID-19 intensive care units (ICUs), as well as the medical director for COVID-19 critical care during the initial wave of the pandemic. My team and I faced unique challenges with COVID-19, many of which involved the need to rethink how we deliver care in the ICU amidst a rapidly changing, sometimes resource-constrained environment. I credit our success in the COVID-19 ICUs in large part to three lessons from my ongoing Innovation Fellowship.
- Successful (re)design of care delivery systems requires empathy (seeing a problem through another’s eyes to gain a deep understanding of their perspective and needs) for the system’s end-users.
- Solutions co-designed with end-users are often more robust than those designed with unilateral input.
- Rapid evaluation and revision are essential for optimal human-centered design of health care services, especially in a fast-paced environment such as the ICU
These core lessons – empathy, co-design, and rapid “prototype testing” – are key elements in Human-Centered Design, a way of creating, evaluating, and updating products or services to best meet stakeholder needs in the real world. As an Innovation Lab Fellow, I’ve taken courses in Human-Centered Design, which have given me a new lens through which to examine problems as well as a set of skills and techniques to create and evaluate these problems’ solutions. It’s clear to me that, already, these learnings have been beneficial to our institution’s care for COVID-19-positive patients in the ICU. While I am hopeful that our ICUs will not see another “wave” of COVID-19 patients, I am also confident that if we do, we will be prepared to deliver high-quality care and to adapt to whatever comes our way.”
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Farewell to our Inaugural Innovation Fellow!
With the turning of the academic year, we say goodbye to our first Healthcare Innovation Lab fellow, Ankit Bhatia. Ankit is a cardiology fellow at Washington University School of Medicine’s cardiology division, and he spent the last year working with the Lab in the area of remote patient monitoring.
During his fellowship year, Ankit designed, launched, and oversaw a 100-patient pilot study using a novel remote monitoring technology to monitor heart failure patients. Working with our Myia Labs, he established monitoring parameters for these patients, coordinated with the research nurse and the technologists from Myia to enroll and monitor patients, and reviewed patients’ status with our division cardiologists. We expect to complete enrollment in early 2021 and report out results next summer. Ankit became our resident expert in remote patient monitoring and participated in the various other Lab innovation projects focusing on this topic. He also established himself in the cardiology professional society, the American College of Cardiology, as a “rising star” in the areas of telehealth and virtual care.
Ankit now moves on to an advanced heart failure and transplant year here at Wash U, then will be seeking a practice and care delivery innovation position, likely closer to his family’s home in Ohio. He anticipates using his experiences and skills from the Lab fellowship to advance the role of remote monitoring and virtual care in heart failure patients, both in his own practice and more globally.
The Healthcare Innovation Lab fellowship provides a unique opportunity for fellows to learn about health care delivery innovation and gain skills and experience in innovation development, evaluation, and implementation. The fellowship is designed for clinical trainees or faculty with a strong interest in clinical innovation, care delivery and implementation science. Applicants are required to hold an advanced degree in a medical, nursing, or allied health field, as well as have the capacity to devote a minimum of 50% of their time to the fellowship. Innovation fellows will take a primary role leading one or more care delivery innovation projects, in line with their professional and clinical interests. In this role, they will drive project design, evaluation and implementation. They will also be expected to generate one or more manuscripts connected to the innovation project and oversee its publication in the peer-reviewed literature. Finally, fellows will also supplement their experiential innovation work with didactics tailored to their innovation work and career goals. Courses include clinical informatics, clinical investigation methods, quality improvement methods and health system administration.
Current Lab fellows include Patrick Lyons (Division of Pulmonary/Critical Care), Ryan King (Department of Anesthesiology) and Brad Fritz (Department of Anesthesiology). If you are interested in learning more about the fellowship, please email its coordinator, Victoria Fretty, at victoria.fretty@bjc.org.
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What the Lab Has Been Up To
As this era of COVID-19 continues, we depend on many different digital offerings in our daily life to stay connected. In some ways, this pandemic has led to a renewal of community and allowed for connectedness locally, nationally and internationally. The month of June offered many opportunities for the Lab team to participate in trainings, forums, networks and conferences through various digital platforms. We started the month with AVIA Convenes Executive Forum with over 55 leaders from various member organizations engaged in great discussions on the impact of COVID-19 on our health care organization, priorities for leveraging digital innovation over the next 1-2 years and organizational structures needed to support digital innovation. Themes and insights from this forum and our overall plan with AVIA are informing various workstreams throughout BJC and WUSM.
The end of June brought many opportunities for training and development as we participated in BJC’s inaugural Agile Boot Camp, Vizient’s Innovation Practices Network meeting and ATA’s annual conference. Our own clinical fellow, Ankit Bhatia, presented two topics at ATA entitled (1) “Co-Developing a Remote Monitoring Platform for Heart Failure Management: Factors to Consider for Effective Clinical Integration” and (2) “Designing An Effective Clinical Interface for Remote Patient Monitoring for Heart Failure Management.”
We look forward to what July will bring us!
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