Pulsara Blog

Here at Pulsara, our entire focus is on communication. When things break down in healthcare, the root cause is almost always a breakdown in communication. This communication breakdown is what drove our clinician founders to invent a solution so that our patients don't have to suffer for our mistakes. We believe that there is a communication crisis in healthcare that's costing hundreds of thousands of lives every year.

But communication alone cannot make teams fully effective -- no matter the advances in technology  -- if those teams are lacking engagement. From being in the field helping struggling teams, we've found that many confuse communication and engagement, and they are not the same. Whereas communication is defined as the imparting or exchanging of information or news, engagement is emotional involvement or commitment to a cause.

1.9 million neurons, 14 billion synapses, and 7.5 miles of myelinated fibers — this is what a brain experiencing an acute stroke loses every MINUTE that passes without treatment. Even more compelling, the brain ages 3.6 YEARS with every hour that a stroke goes untreated. It doesn’t require a medical degree to understand why reducing the treatment times of stroke patients is a vital priority for the healthcare community.

When the concept for EMS was born nearly 50 years ago, it was meant to be an integrated part of a smooth system of care beginning with the call to EMS dispatch and continuing through to definitive treatment. However, EMS-to-hospital communications have faced significant barriers including miscommunications due to archaic and unreliable technologies, issues transmitting ECGs and other patient data, inadequate training in STEMI recognition, and lack of access to patient outcome information for EMS. According to an article published in JEMS this week, recent studies have shown that prehospital notification by EMS improves time to treatment for stroke, however these notifications are not part of a consistent and standardized protocol, and in 25% of cases, EMS fails to alert the hospital of an incoming stroke patient.

I love my job, and I have the privilege of working with some amazing people around the US. But naturally, we are sometimes met with challenges from teams who haven't yet made upgrading their technology a priority. 

EDITOR'S NOTE: Special thanks to Scott Stanley for writing today's blog post. You can connect with him on LinkedIn. 

The holidays are upon us. All is calm; all is bright. But not in your local Emergency Room. Or at your community’s fire station. For providers of health care and EMS services, the holidays can feel even more stressful than any other time in their busy work lives. In addition to the usual stress they encounter as part of their job descriptions, they are burdened with being away from family and loved ones, making their shifts even harder.

 
A young Pulsara team (circa 2014) poses on the lawn outside our first office.

EDITOR'S NOTE: Huge thanks to Shane Elmore, Blogger of the Year, for the topic of this blog post and for submitting the three top ways to invest in people. The rest of the post practically wrote itself!

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"What is our company's greatest asset?" 

When Pulsara's Founder and CEO, Dr. James Woodson asked this question at an all-hands meeting recently, my mind jumped to the obvious -- We reduce time-to-treatment by 10-40%! Clearly, our biggest asset is our platform that helps care teams do their jobs more efficiently and improves treatment time outcomes for critical patients!

One of the most challenging things about working in a high-stress environment like a hospital is dealing with burnout. If you've been in healthcare for more than a day, you've probably met a nurse, doctor, or ancillary staff member who, for one reason or another, needs an attitude adjustment. If you've been doing it for more than two years, you have probably even been that person at some point. When it comes to burnout, it's usually easier for us to spot it in others long before we can see it in ourselves. Fortunately, there are some strategies you can employ to manage and reverse burnout. 

When it comes to communication in healthcare, do you ever feel like you're playing a game of "telephone?"

One of the most challenging aspects of living in the technological age is the speed of change. There was once a day when the person armed with the most knowledge and information had the upper hand. That's not the case in today's world. Instead, the person or company that can rapidly learn and adjust to changing trends, information, and technology will now lead the pack. Your ability to adapt to a rapidly changing world will be the one skill that separates you from your competition.

Imagine this: It's a busy Saturday evening at the hospital. You are understaffed and overworked and it's one of those days where everything seems to be happening at once. The medics bring in a patient suspected of having a STEMI. You know that when time is tissue, every second counts, so you follow proper protocol and, when you need to consult the cardiologist, Dr. Smith, you simply send him a page and continue on with your seemingly endless list of tasks and patients that need your attention.

Just for grins and giggles, I signed in to Netflix recently and watched a few episodes of the medical drama from the 70's, "Emergency!" I'm a little young to remember the show when it was on the air, but when I started in EMS, my paramedic partner insisted that I watch some of it. It was a rite of passage. Of course, there was also Bringing Out the Dead starring Nicholas Cage and Mother, Jugs & Speed with Bill Cosby, but those are for another post.

 What opportunities are hospitals missing out on due to their attitudes about risk? I have worked in the hospital setting since I was 20 years old (which was ... many .... years ago). Sure, I’ve had some frustrations when it comes to the inability to get things done, but I think we’ve all been there at one time or another.  Now that I work with hospitals, rather than in them, it has become clear where the root of some of these challenges lie. Let’s look deeper at one issue I see at almost every hospital I visit.

How do you solve care management problems at your hospital?

I think that's a fair question. I was talking with a nurse from reputable a STEMI receiving center just a few days ago, and he told me "our times are amazing!" In my role, anytime I hear that it makes me ask lots of questions. I want to learn what the leading hospitals are doing to solve the problems that we all face.

A recent article published on FierceMobileHealthcare.com calls attention to the increased use of smartphones by doctors for taking photos of patients to use in case records and how this can potentially pose security and privacy threats. The article describes careless doctors who save patient photos, often with faces or other identifying marks visible, on their personal phones next to "vacation photos," and then mistakenly share them with others outside of the immediate care team or hospital.

Feeling all alone out there on weekends/holidays/night shifts?

You’re not the only one. Any clinician involved in care of time sensitive emergent patients has experienced the frustration of delays in care during these “off times.” Unfortunately, strokes, STEMIs and traumas do not take time off. Two recent studies (here and here) released in London and Birmingham, UK allude to how process variations have resulted in a decrease in quality of stroke care. Specifically, the quality measurement of door to needle in less than 60 minutes took a hit, and was directly linked to day of week and time of day.

What do car-phones, pagers, Nintendo, and Sony Discman all have in common? They were the top contenders for the hottest gadgets of 1985. You read that right-1985, as in over 30 YEARS ago! While cell phones quickly displaced car-phones and pagers in the 1990s, it seems the world of healthcare never received the memo...

EDITOR'S NOTE: Special thanks to our guest blogger, Dr. Jeff McWilliams. Dr. McWilliams is an Emergency Physician, Assistant Professor of Emergency Medicine and Director of Customer Service at Leading Edge Medical Associates. He is also a thought leader in the realms of healthcare and servitude and his thoughts on effecting change in the world one individual at a time can be read on his blog, Advocates of Excellence. Enjoy!

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What is customer service in healthcare? Who defines it? Better yet who propagates and sustains it? Over the years I have been involved in this industry, I've been searching for the next best process, “key words” to excite and motivate my team, or other "secret weapons" of employee engagement.