Written by Jean McCormick, R.N., M.S.N.
Innovation is key to improving patient care while reducing costs and enhancing the health of Oregonians. Telemedicine is an effective tool for meeting these goals particularly when transferring a patient from a hospital to a skilled nursing facility.
Discharging a patient to a skilled nursing facility is all about coordination and timing: Interventions. Care plans. Paperwork. Prescriptions. Nursing notes help paint the picture of a patient when “handing off” care to another nurse.
By tradition, nursing notes were long, handwritten narrative descriptions of a patient that were attached to care plans. Electronic Health Records (EHRs) have streamlined nursing workflow and notes. Thus, notes on a patient today can seem less descriptive.
Both forms, handwritten or EHR, combined with a phone call to another unit or another site–for example a skilled nursing facility–help communicate patient needs to the receiving nurse. Unfortunately, this doesn’t always allow the patient to participate or provide visual information sharing with the receiving nurse.
Technological advances now enable OHSU to use video conferencing equipment to connect nurses at both ends while involving the patient in the discharge process: “a warm video discharge hand-off.” Videoconferencing allows nurses to communicate with one another, build a rapport, demonstrate parts of the care plan and educate one another while being at the patient’s bedside–empowering the patient to be involved in their discharge and care. This reassures the receiving nurse and alleviates anxiety regarding the “who and where for care” for the patient and family.
One OHSU nurse said that the video nurse-to-nurse hand-off gave her the feeling of being in the same room with the receiving nurse.
Our first warm video hand-off involved a stroke patient who was intrigued with the technology of connecting with the facility before she arrived. She and her husband were able to speak to the receiving nurse and ask questions about their care. The OHSU nurse was able to visually demonstrate care and use of the patient’s feeding tube.
OHSU has performed dozens of additional “warm video” hand-offs since our pilot program began a few months ago. Patients, families and nurses give high marks to using telemedicine to make this connection, which not only is faster than other approaches but also provides better results. Clearly, using video conferencing to hand-off care of a patient brings nursing to a whole new level. It’s now becoming a standard part of OHSU’s discharge program.
As Dr. Miles Ellenby, medical director of OHSU’s Telemedicine Network, puts it, “A phone call is helpful, a picture is worth a thousand words, but live interactive video is priceless.”
You can read more about the difference the OHSU Telemedicine Network made for an Oregon infant in this recent news story.