Two Way Radios in Primary and Acute Healthcare

Communication plays a crucial role in healthcare. Timely dissemination and sharing of information is critical for acute healthcare providers. Similarly, primary healthcare can be easily administered by using practical and handy communication channels. However, there are several factors that need to be taken into account before deciding upon an effective mode of communication in both primary and acute healthcare institutions. Reliability, coverage and confidentiality of transmitted information along with the institution’s capacity in handling the equipment, play an important role. Healthcare institutions can largely benefit from a mobile clinical staff and two way radios can provide prolific results if used effectively for sharing information.

Functionality and Build of Two Way Radios

Two way radios allow only one function at a time – either receiving or sending the signal. This helps the users efficiently communicate without interrupting the interlocutor. These devices are helpful in exchange of crisp information, rather than constant communication. Two way radios are also known as transceivers or walkie talkies.

Two way radios are simple devices made of primarily six components: power source, receiver, transmitter, microphone, speaker and the crystal. This implies that running and maintenance costs for these devices are not too high. Two or more communicating devices operate on the same radio frequency and a push-to-talk button switches the device between receiving and transmitting modes.

Primary Healthcare and its Challenges

There is a growing emphasis to offer primary healthcare to one and all. This requires creating an environment where equal emphasis is laid on healthcare for all individuals. However, shortage of trained medical practitioners poses a serious threat to achieving this objective. Medical planners have to focus on the use of technology to make the maximum use of the available resources.

Isolation of patients is a big problem that surfaces in primary healthcare. Patients who need medical attention are usually dispersed, especially in rural areas and may not have access to medical facilities. The supply of drugs and medical tests are difficult to conduct and this defeats the very objective of primary healthcare. Lack of communication is another major problem in administering primary healthcare.

A quick exchange of information offers a suitable solution to meet all these challenges. Two way radios enable exchanging of crucial medical information and gradation of current medical practices. The absence of advanced technologies in many locations also increases the importance of two way radio communication devices.

Using Two Way Radios in Primary Healthcare Settings

The most important use of two way radio in delivering primary healthcare is in connecting local medical practitioners with hospitals in cities and more advanced areas. This is critical to diagnosing a patient as well as for prescriptive purposes. A timely decision whether the patient must be referred to a hospital with advanced facilities can be crucial in saving lives. The hospital can also monitor the condition of a patient at another location through two way radios.

How well two way radio technology is implemented for primary healthcare will be dependent on medical and health protocols. Doctors in some countries contact health aides and monitor the situation of the patient by use of two way radios. The medical structure of a community and the country determines how effectively the two way radio can be used for primary healthcare.

Emergency situations can also be addressed by using two way radio. Lack of good transportation and communication facilities can jeopardize a community in case of a medical emergency. Two way radios can be used to send news of such medical exigencies to hospitals or district headquarters and help save many lives.

In some countries, two way radios are used to connect fieldworkers with doctors who are constantly on the move. Use of airplanes helps attend to critical patients in a very short time as soon as the news is delivered by way of two way radios.

Two way radios can also help in training field workers who play an important role in primary healthcare. It depends on the level of existing competence of the medical workers and the desired levels of training. Moreover, field workers can listen in to the conversation of co-workers with physicians and learn by observing the standard medical practices adopted in different cases.

Using Two Way Radios in Acute Healthcare Settings

Clinical information in a hospital can be shared with the help of two way radios. A mobile unit of clinical staff will be more efficient in dealing with day-to-day problems faced by patients and in specific cases where a patient requires immediate attention. A patient who undergoes a complicated heart surgery may require constant monitoring for a few hours after the operation. However, it may not be possible for the doctor who operated on the patient to stay by his side all the time. Two way radios can prove to be a handy solution for helping healthcare institutions, solve such critical operational issues. A nurse attending on the operated patient can inform the doctor about the patient’s progress or whether the patient needs immediate attention, using two way radios. This will not just update the doctor on the patient’s condition but also help him take immediate decisions based on the available inputs. The healthcare industry has successfully tested and used two way radios for acute healthcare. Hospitals make wide use of two way radios for exchange of information among healthcare workers.

Two Way Radios: Advantages

Two way radios provide for a cost effective medium of instant communication. Healthcare industry requires rapid and extensive sharing of information in the most cost effective and efficient manner. A large healthcare institution can be brought under the ambit of wireless radio communication without running up high costs. Moreover, radio signals are quite reliable as compared to mobile networks, where one must depend on the network strength and connectivity. Also, issues of interference do not surface often. Maintenance costs for these devices are also considerably low.

Two Way Radios: Standard Practices for Operation

Some of the standard practices followed for using two way radios in healthcare institutions are:

The devices are used in “receive only” mode in patient areas.
Medical staff is advised to leave the patient area if the device has to be used for outgoing communication.
Two way radios must be kept at a distance from highly energized medical devices.
Lowest possible setting must be used to avoid any interference if the device so permits.
In case of malfunctioning of any medical equipment, the use of radio devices must be stopped immediately.
Unnecessary use of two way radios may distract a medical practitioner during surgery. Therefore, such devices must be used only when required to avoid any delay in patient care.
Using Two Way Radio Systems: Interference and Other Issues
Two way radios do not generally interfere with other medical equipment. Research studies have proved that hospitals can safely use two way radios for communication purposes. These devices can be safely used at a distance of 0.5 meters from most medical equipment. The reason is that these devices operate at high frequencies and do not cause any interference. However, the use of two way radios is discouraged in highly sensitive medical environments like the ICU.

Some of the other issues with two way radio systems include problems, like poor maintenance, lack of power, non-availability of spare parts and poor training of the medical staff regarding the usage of these devices. Any compromise with the quality of the device can prove disastrous and defeat the entire purpose of setting up two way communication radios.

Conclusion

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The Evolution of Healthcare Mystery Shopping

Patients answer patient satisfaction survey questions based on their perception, and yet there is limited context for the healthcare provider. It leaves one asking the questions – who were they interacting with, what was said, when did it happen, and how capable and reliable was the patient to make those interpretations? So instead of convening a committee to explore the reasons for poor scores, healthcare mystery shopping provides healthcare clients with the research intelligence needed to make real-time improvements.

In an era of value based purchasing with a focus on inpatient stays, I have estimated that over 80% of the lives touched by health systems in this country are not patients at all, but rather family members, visitors, outpatients, and consumers of everything from equipment to Starbucks. By all means make the patient room environment as clean and silent as possible, communicate effectively with the patient, and ensure that they are fully prepared to be discharged, but the emphasis must still be on the patient’s perception. Observations, opinions, and ultimately consumer decisions derive from that source.

The elevated importance of patient satisfaction data means that as the data is digested, more and more questions will arise. For instance, a survey will tell you there is a concern with the friendliness of the radiology staff. Instead of creating a broad-brush customer service program for the Radiology Department, the logical next step is to determine how the department is being perceived by end-users, what the department’s behavioral weaknesses are, and who on the staff is exhibiting those behaviors.

Together patient satisfaction data and healthcare mystery shopping can begin to focus on meaningful solutions that cause providers to say, “We know from patient satisfaction there is a problem and from mystery shopping we know what that problem is and who is primarily responsible.”

While it is recommended that managers look for coaching opportunities by observing their employees in action, expecting them to alter the service culture is less likely since – for the most part – they created the culture. Because this type of research is strictly consumer perception, it provides an unbiased view of a department or organization’s culture. This gives managers a third party perspective that increases coaching opportunities.

Types of Healthcare Mystery Shopping

From those early days of healthcare mystery shopping, healthcare provider requests have gotten more creative, more targeted, and more sophisticated. For example, a client may request something as all encompassing as a 24-hour inpatient stay in which the shopper is admitted for a 24-hour period to evaluate the patient experience from registration to discharge. Or shoppers may be asked to call physician offices to make appointments with the intent of determining how long it will be before they can be seen tying the research to more efficient use of resources.

In 2008, healthcare mystery shopping received significant national press when the American Medical Association attempted to take up a position on the practice. What was not as readily reported was the fact that the issue was tabled indefinitely. In fact, it was already the custom of one of the leading providers (prior to the accusation that healthcare mystery shopping was unnecessarily taking up physician time) to utilize what they call process observations. This form of mystery shopping, which is most effective in Emergency Departments, avoids taking up valuable patient time by having a shopper join a patient as a friend as they go through the patient experience.

Two of the most beneficial types of perception research are: 1) shopping the competition, and 2) evaluating individual employees. Call it spying, many do, but it is important to know your competition’s culture. For example, what do they believe in and how is it transferred to the patient, and can the anecdotal stories you’ve heard be verified?

A great deal of value can be derived from conducting evaluations of individual employees. For a number of reasons – cost certainly being a factor – this works best in a departmental environment and gives managers an apples-to-apples comparison of each employee as it pertains to specific standards, i.e., is Cindy more likely than Jeff to greet patients immediately (setting up a coaching opportunity for Jeff)? Or, does Jeff do a great job of cross-selling services and should be commended?

Healthcare mystery shopping also gives managers concrete examples of the specific behavior that “turns patients on.” This sets up the perfect opportunity to present to staff the behaviors the organization would like emulated while giving kudos to the employee who displays them.

Quantitative and Qualitative Appeal

Healthcare mystery shopping appeals to managers and administrators whether they are left brained (numbers focused) or right brained (narrative focused). On the one hand, mystery shopping is about story telling. Fred Lee wrote in If Disney Ran Your Hospital, “What seems to be a major component of both loyalty and dissatisfaction are stories. A satisfied person has no story to tell.” Stories are important in articulating the who, what, when, where, and how of the patient or consumer experience. The right brain approach to mystery shopping allows clients to clearly discern the difference between a completely satisfactory experience and all the various facets that went into it, and those elements of an experience that triggered displeasure or frustration. At the same time, healthcare mystery shopping is an effective compliance tool. Standards that are specific to the healthcare industry, and therefore can be benchmarked, are mixed with organizationally specific standards to create a quantitative amalgam that can be data spliced in any way necessary. Healthcare mystery shopping primarily answers the following question – How well does your organization perform on the behaviors and processes you told your people are important? In addition, it lets organizations measure those standards against perception-based goals.

The Flexibility of Healthcare Mystery Shopping

Patient satisfaction surveys are, for the most part, static. They are unchanging for a reason. Conversely, healthcare mystery shopping is much more flexible. It can be designed as a program that measures the same standards or processes over time, or studies can be developed to determine exactly what behaviors or processes are being performed.

Healthcare mystery shopping can also be redirected ‘on the fly’ if the desired objectives are not being met. For example, to their surprise, a physician practice that was asking shoppers to make appointments found out they weren’t accepting new patients. Another practice that was evaluating the customer service of their registrars discovered that none of the calls were being answered by a ‘live’ person. In both instances, the practice put on the brakes until they could fix the issue. One hospital was having shoppers go to their website to look for specific information and then having them request a response. What this uncovered was that the requests were accumulating on a PC that was not being used. This finding allowed the hospital to avoid upsetting hundreds of consumers who felt they were being rudely ignored.

How does one know if a service initiative is really working? Healthcare mystery shopping is an excellent complement to any service initiative. It can be directed in such a way that it provides real time verification that the initiative is being effective. Anything from a discharge process to valet service can be shopped at various times to ensure that the initiative’s message was received and implemented.

Flexibility does not, however, extend to internal programs. Sometimes in the name of saving money, healthcare providers will launch a do-it-yourself program. They attempt to get employees or volunteers to perform the same function that professional healthcare mystery shopping firms do. This rarely if ever works for any duration for obvious reasons. Insiders have internal biases and, despite their best intentions, are no longer able to be objective. The other reason this is not effective is that employees (and even volunteers) can think of a million things they should be doing or would rather be doing. And the lack of staying power for a do-it-yourself program puts a tremendous burden on the manager assigned to administer the task.

What Clients are Looking For

Hospitals, health systems and physician practices seek out healthcare mystery shopping vendors for a number of reasons. In some cases, they want to validate “good news.” For example, one health system client entered into a long-term relationship with the primary goal of proving that their services were superior to the competition that was also shopped. A recent wayfinding study of over 300 ‘shops’ conducted for a large hospital on the east coast concluded that less than 76% of their employees received a top box score of five for greeting consumers with a smile. This finding was indicative of a culture that was not treating consumers in ‘a personal and memorable way.’ However, healthcare mystery shopping afforded them the advantage of validating their original concern, isolating where this concern is most prevalent, and using the shopper’s language to convey to staff why greeting people was critically important to overall perception. Much like satisfaction surveys, healthcare mystery shopping is able to monitor improvement over time, but with the added benefit of story telling to pinpoint issues. It can also be instrumental in determining the specific nature of the concern and identifying where weaknesses exist.

A healthcare mystery shopping executive, who is undergoing therapy for breast cancer, wrote in a blog recently, “What matters to healthcare organizations are things like how many steps it takes to check a patient in, scripted greetings for frontline employees, record keeping for correct billing, and clinical training for new safety measures. However, as a patient, I notice if the person checking me in for chemo is smiling and greets me because she cares, not if she delivers a scripted sentence. Next, I notice if the nurses in the chemo area are working as a team and greet me personally (they should know me after two months). But what is most important to me is whether or not the clinical staff is aligned with my recovery goals.”

While this executive may be more attuned to her surroundings than most patients and able to articulate what it means to her, the goal for any healthcare mystery-shopping program is to use the shopper’s heightened sense of awareness and their ability to effectively communicate their experiences in a way that is clear and concise.

Kevin Billingsley is founder and president of Perception Strategies, Inc., a healthcare consulting firm specializing in Employee Perception Deep Dives and Healthcare Mystery Shopping. Opening its doors in 1998, Perception Strategies has conducted over 60,000 healthcare mystery shops and 250,000 employee service evaluations providing clients with consumer and employee insights resulting in substantial behavioral and process change. Billingsley is also the co-author of Turn Your Customer On,

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