Patient education at St. Luke’s is an important part of the clinical workflow – but after relying on the same technologies for years, the education and nursing staff felt it was time to look for more modern options. According to Shannon Isaacson, a clinical supervisor in the cardiac unit, the nursing staff had been using late-model televisions and VHS tape to help educate patients. “We would wheel these big TVs into the rooms and pop a tape in,” she said. St. Luke’s, the larger of the system’s two hospitals, also had two patient education tablets in the cardiac unit. The tablets were effective, Isaacson said, but “there was an overwhelming amount of content” on them. The St. Luke’s team was looking for a more streamlined, more accessible education option that could also track patient engagement and allow for patient feedback. “We saw how the HealthClips website worked, and it had the feel of something we wanted,” said Julie Clark, nurse manager, cardiac services at St. Luke’s. After consultation with The Wellness Network, St. Luke’s decided to pursue an updated tablet-based 90-day pilot program.
“When we started designing the pilot program, we assessed what they had access to and liked and what needed to be shifted,” said Jamie Haupt, national account manager for The Wellness Network. “They already had access to our award-winning patient education videos, but the challenge they faced was how to integrate them in to their workflow using distribution platforms that better fit their infrastructure. Their TVs were old tube TVs, so they had to roll them into rooms for patients to watch, and the tablet solution they originally purchased didn’t have some key features they felt they needed, including surveying and data capture. We opted to try a pilot program using a different tablet platform with a goal of increasing utilization and a more seamless integration into their clinical workflow – making it a better experience for both the clinicians and patients.”
Working in close consultation with content experts, the St. Luke’s education and nursing staff supervised the design of four new engagement tablets, which were developed in partnership with PadInMotion. The tablets were loaded with targeted education and surveys. Three of the tablets were to be deployed in the cardiac unit, and one was in day surgery. The tablets were easy to navigate and would feel instantly familiar to anyone who uses apps on their smartphone.
“They wanted something streamlined to save time and that could be left behind with patients so people could browse the library on their own,” said Jennifer Celio, vice president of clinical operations and population health at PadinMotion.
The content on the tablets was divided into sections on procedures, heart-healthy lifestyle choices, recovery, and more.
“The new tablets looked like an app with a button that you could select that would open up and give you access to the content you needed,” Isaacson said. “It was simple and straightforward and aligned with our quality measures.”
Once the tablet design was settled, Haupt and Celio created an onboarding program to both educate the St. Luke’s staff on how to use the tablets and give them tools to encourage its use. The onboarding program provided in-person instruction to almost 40 staffers at St. Luke’s, from both the day shift and evening shift.
“The nurses were all excited about the transition to something new,” Isaacson said. “But they were apprehensive about whether it would work or not, so we invited the nursing staff to an event and presentation on how to use it.”
After the training was over, the tablets were placed on a counter in the cardiac unit with the idea that nurses could grab them as needed and share them with patients. In most cases, nurses would leave the tablets with patients while they did something else, then come back after the patient was done watching to answer any additional questions or provide more information.
Expectations were high in the beginning, and the group, including the implementation team from The Wellness Network and PadInMotion, checked in with regular calls. Within the first few weeks, however, it became clear from the engagement metrics that tablet usage wasn’t as robust as the education staff at St. Luke’s had hoped. It was time to step back, reevaluate, and make some changes.
Lessons Along the Way
The first point to address was also the easiest: while the tablets were in a highly trafficked part of the unit, they were still not obvious. According to Isaacson, the tablets were lying flat on the counter and blended in with the surrounding material. A quick call to IT provided some tablet stands, and soon they were “flying off” the shelf.
Second, the implementation team came up with a novel incentive program: a sign-up sheet and gift cards. When nurses checked out the tablets, they noted it on a sheet. At the end of the week, the nurse who checked out a tablet most often received a Starbucks gift card. This program was reinforced with posters and printed materials, letting the nursing staff know that a mocha latte was easily within reach. The staff incentive was reinforced with a checklist that nurses could use to recommend which videos patients should watch and a laminated bedside poster encouraging patients to ask their nurse about education.
Finally, members of the staff reported that the mix of content on the tablet wasn’t optimal: a few of the videos overlapped each other in topic, especially in the popular catheterization units. This was addressed remotely; a new content map was created, and the tablets were updated remotely within a few days, with no added work from the staff at St. Luke’s.
With these changes in place, utilization began to pick up and both patients and staff gave positive feedback.
There was, however, still one area left to address: the usage metrics revealed a significant difference in utilization rates between the day and night staffs at St. Luke’s. In fact, after the shift change at 3 p.m., Isaacson noted that “you weren’t seeing usage at night.”
“Part of this was procedural,” she said. “We do a lot of procedures during the day, and a lot of the education was procedural as opposed to preventative. So we did some staff education about what types of preventative education the tablet offered and saw a spike in nighttime usage.”
The original goal of the pilot program was simple: increase patient engagement with education and integrate the education delivery via tablets into the clinical workflow. According to Isaacson, the program was a success on both fronts – and it showed. According to metrics compiled at the end of the pilot, the tablets experienced more than a thousand interactions, over the 90-day pilot period, with the most commonly viewed videos covering procedures, especially minimally invasive procedures like coronary angiography.
A staff survey also reflected a broad satisfaction with the tablets, with staff members remarking it was “great for patient education,” “easy to use,” and worked for “patients with a low reading level.”
Patients also gave the tablets positive marks, with the average patient rating the tablet experience as a 9 on a scale of 1-10.
“It met expectations because it got our staff into the habit of using tablets,” Isaacson said. “It was a learning curve. Every week we implemented something new, and we were happy to see staff and patients using the tablets.”
“I don’t think you can appreciate its value until you have it in your hands,” Clark agreed. “The best way for people to understand it is to try using it.”
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PadInMotion is the leading provider of patient care technology for health systems. Patients benefit from tailored medical information and hundreds of interactive tools that help in recovery and long term wellness. The platform is delivered via tablets and smartphones in a HIPAA compliant way using advanced technology and easy to use screens. Health systems benefit from higher patient experience scores, better health outcomes and improved financial results.