Case Studies

Hocking Valley Community Hospital Integrates Lippincott Solutions to Optimize Hospital Operations

Located in Logan, Ohio, Hocking Valley Community Hospital (HVCH) is a 25-bed critical access hospital with a staff of approximately 100 nurses. Lippincott Procedures has been used for four years as a point-of-care solution and education resource in the nursing and respiratory departments, and most recently, in the physical therapy department. Kandy Fizer, M.S.N., R.N., Director of Education at HVCH, is a firm advocate of how Lippincott Procedures supports evidence-based practice.

“Now that Lippincott is continuously providing our hospital with updates on the latest evidence-based research, we have peace of mind knowing that staff have the resources available to deliver the best quality care,” says Fizer.

Since realizing measurable benefit from the use of Lippincott Procedures, HVCH decided to add Lippincott Advisor and Lippincott Professional Development to its arsenal of evidence-based resources. Lippincott Advisor gives clinicians immediate access to clinical decision making, care planning, and patient teaching support, while Lippincott Professional Development offers comprehensive nursing competency and staff education solutions. Hocking Valley only integrated Advisor and Professional Development into its clinical practice in December 2014, and has already seen valuable improvements in care planning and patient education.

Integrating Lippincott Procedures to Improve Quality of Care

For many rural hospitals, keeping current with the latest medical research can be an arduous task. Recognizing that its small staff had limited time to update resources, HVCH sought other opportunities to improve its quality of care. This led HVCH to Lippincott Procedures. Through regular updates, this solution instantly provides the most current research and evidence-based practices.

“Lippincott is a one-stop-shop where staff can access current, evidence-based procedures and decision-making support with ease and speed,” says Fizer.

Fizer has worked hard to integrate Lippincott Procedures into the staff’s everyday hospital activities. This has meant giving clinicians quick access to Lippincott products for clinicians at every turn by placing easy-to-find, color-coded links to Lippincott Procedures, Lippincott Advisor, and Lippincott Professional Development on each computer desktop. Clinicians can also access Lippincott on their iPads and tablets.

“Before partnering with Wolters Kluwer, it took a long time to find a procedure,” says Director of Inpatient Services Tammy Little, B.S.N., R.N. “Now that we have Lippincott Procedures, units throughout the hospital can quickly access standardized procedures through a simple and optimized keyword search. Additionally, we have the ability to customize procedures through the placement of Critical Notes.”

To further promote the use of Lippincott Procedures, Fizer regularly sends reminder messages, often identifying new Lippincott resources or features that clinicians should view. Fizer also conducts one-on-one education and a bi-annual nurse training, during which she reinforces the use of Lippincott Procedures in education and at the bedside.

Enhancing Patient Care Through Evidence-Based Procedures

Lippincott Procedures has helped HVCH effectively standardize and improve its approach to patient care. Two examples include implementing evidence-based practices for maintaining vascular access devices and improving indwelling urinary catheter insertion and maintenance techniques.

Prior to having Lippincott Procedures, nurses often had questions around timeframes for the changing of IV tubing and bags. With different units observing different timeframes, Tammy Little, Director of Inpatient Services, immediately reviewed the recommendations in Lippincott Procedures. She realized that not all departments were adhering to the current standards for timeframes and emailed each department to change the practice. Now all departments are following the evidence-based protocol per Lippincott Procedures. This has given Little the peace of mind that HVCH’s clinicians are standardizing patient care in accordance with the most current research and evidence.

HVCH was also able to reduce its CAUTI occurrences using Lippincott Procedures. The CAUTI rate at HVCH was about 4 per thousand catheter days, and leaders wanted to bring this number as close to zero as possible. Through computerized physician order entries (CPOE), HVCH successfully standardized the orders for patients entering surgery. Now, catheters are removed after 24 hours and reminders are set to notify physicians to submit a new order if a catheter needs to be continued. As a result, HVCH was able to dramatically limit CAUTI to the rate of 1 per thousand catheter days.

In addition, Lippincott has helped HVCH standardize and effectively perform clinical procedures that are not conducted on a routine basis. If a clinician is not familiar with a procedure, he or she will turn to Lippincott Procedures for assistance. This provides staff with the confidence that they are doing their job correctly. Lippincott Procedures offers detailed written step-by-step guidance, as well as abbreviated ‘quick lists,’ images, and videos. This helps appeal to a variety of learners and situations. Even for a more common procedure such as lead placement for bedside cardiac monitoring, HVCH nurses frequently reference the pictures in Lippincott Procedures to confirm correct positioning.

“Having photos and videos for the procedures is extremely helpful,” says Director of Emergency, Urgent Care, and Special Care Unit Stacey Gabriel, B.S.N., R.N. “For those who are visual learners, it provides something more than just reading about a procedure from a book.”

Integration of Lippincott Advisor and Professional Development

While Lippincott Procedures has been part of HVCH’s operations for some time, the hospital only recently started integrating Lippincott Advisor and Lippincott Professional Development into its practice, in December 2014.

Using Lippincott Advisor, HVCH is furthering patient education and leader rounding to ensure patients understand why they are in the hospital, what their diagnosis entails, and how their new medications may affect them. Currently, patient education initiatives are steered through Advisor’s Lexicomp and UpToDate Patient Handouts, which provide detailed solutions to help strengthen the understanding of medications. These patient education efforts have had a remarkable impact at HVCH.

“Our readmissions rate was typically around 3%, but since implementing Lippincott Advisor, we have seen that number drop to around 1%,” says Little.

By reducing readmissions, enhancing evidenced-based care, and improving patient preparation for discharge, HVCH has also recorded an increase in patient satisfaction. HVCH is currently ranked ninth out of 157 hospitals in the state of Ohio for overall patient satisfaction, compared to 17th out of 159 hospitals prior to implementing Lippincott Solutions. Noticing the increased benefits Lippincott Advisor provided for the hospital, HVCH has sought to integrate this feature further by making it the source for Nursing Care Plans.

“Care plans for nurses were previously created through spreadsheets,” said Fizer. “Now, Nurse Care Plans can be developed through Lippincott Advisor and are accessible with the click of a mouse.”

HVCH is also in the initial stages of integrating Lippincott Professional Development for education and growth. Fizer’s aim is to develop an orientation protocol based on Lippincott Professional Development coursework, whereby nurses are required to complete a set of courses during their initial 90 days after hire.

Leveraging vital evidence-based information specific to each nurse’s position and specialty, Fizer hopes Lippincott Professional Development will help strengthen clinical confidence and competence for new employees.

HVCH is currently using Lippincott Professional Development to prepare new nurse hires for Advanced Cardiac Life Support (ACLS) certification. To maintain a high quality of care, HVCH requires that all nurses be certified for ACLS within one year after hire. However, HVCH directors have found that some new hires, particularly recent graduates, have difficulty balancing the adjustment to a new job with obtaining the certification. To address this challenge, HVCH has started ACLS training through Lippincott Professional Development by integrating various Basic ECG rhythm strip and 12 lead ECG interpretation lessons for nurses to study before working on their Advanced Cardiac Life Support certification.

Likewise, the Emergency Room Director has started developing plans to use Lippincott Professional Development for core curriculum assessments. This emergency-specific coursework will include competency assessments for stroke, cardiac, breath sounds, and trauma. Strengthening ED Nurse competency in these areas will ensure HVCH’s continued excellence in patient care.

Since HVCH has begun using Lippincott Professional Development, results have been successful. Because it is easy for learners to access and take tests, Professional Development saves the educators at HVCH a substantial amount of time. By simply assigning course options, educators no longer need to manually design their own tests and grade them by hand. Instead, they are now able to simply choose specific course from the Lippincott Professional Development catalog that meet their learning objectives, assign them to learners, and wait for the grades to appear in the gradebook.

“All we need to do is decide which program we want our nurses to take and everything else is done for us through the Lippincott Professional Development program,” says Gabriel.

Conclusion

Before using Lippincott Solutions, HVCH lacked the staff and resources required to continuously and routinely update materials with current evidence-based research. Recognizing the need for strategic solutions to improve its hospital functions, the facility integrated Lippincott Procedures into its practice. Using Lippincott’s evidence-based research and synchronized systems to upload and edit procedures, HVCH was able to reduce CAUTI, better manage IVs, and increase patient satisfaction. Moving forward, HVCH aims to fully leverage Lippincott Advisor and Professional Development to increase the knowledge of its patients, physicians, and nurses.