Standardize healthcare practices and improve patient outcomes with solutions available in AWS Marketplace
In the annual ratings by U.S. News and World Report*, Seattle Children’s Hospital is consistently named as one of America’s best pediatric hospitals. It’s nationally ranked as a top provider in 10 specialties, including pulmonary and cancer. The main campus is located in Seattle’s Laurelhurst neighborhood, and the hospital operates clinics throughout the Seattle Metro area. This includes the Ambulatory Surgery Center in nearby Bellevue, WA.
Just like many of today’s healthcare organizations, Seattle Children’s is dealing with multiple ongoing challenges. These include:
- Higher patient expectations – In the information age, patients are more knowledgeable about healthcare options, and they demand better-quality services from providers.
- Workforce shortages and engagement – Faced with limited staffing resources, providers must keep their employees actively involved and engaged. Employee morale issues can negatively impact the quality of care.
- Care equity – Organizations must prioritize health equity to make sure that all patients get the best care, regardless of race.
- Limited time and resources – Under normal circumstances, caregivers face constant pressure to attend more patients and do more with less. Healthcare crises, such as the COVID-19 pandemic, can max out the availability of time and resources.
- Cost pressures – Organizations must continue to find ways to reduce medical costs for patients without sacrificing quality of care.
In this post, I will show both the challenges that Seattle Children’s faced in standardizing healthcare practices and the improved patient outcomes they enjoyed after implementing them.
The challenge of standardizing healthcare practices
As part of their Quality Improvement (QI) efforts, Seattle Children’s sought to standardize healthcare practices. By encouraging all of its providers to follow the same treatment and caregiving plans, Seattle Children’s hopes to provide all of its patients the best possible experience. But these efforts were met with some resistance.
“It’s important to understand our efforts in the context of the culture of modern healthcare,” says Dr. Lynn Martin, Director of Continuous Improvement at Seattle Children’s. “Many physicians, myself included, are resistant to cultural change. However, they need to understand the impact and costs of the care they provide, and work with administrators and supervisors to address these issues.”
In 2018, Seattle Children’s began utilizing AdaptX, an Adaptive Clinical Management™ solution, available in AWS Marketplace. Powered by an artificial intelligence (AI)-driven Mission Control Center, AdaptX extracts and charts real-time data regarding healthcare procedures and patient outcomes from electronic medical records (EMR). By comparing data against AdaptX’s control charts, caregivers can analyze the results of clinical trials to improve treatment plans and practices continuously.
Improving patient outcomes with AdaptX
With help from AdaptX, Seattle Children’s has made the following improvements:
Eliminate opiates in surgery
Beginning with a focus on tonsillectomies and adenoidectomies, the Ambulatory Surgery Center sought to eliminate the use of opiate medications in surgical procedures. Providers used AdaptX to collect the following data:
- Patient level of post-operative pain (on a 1-to-10 scale)
- Number of patients who required additional post-operative pain medication
- Average length of stay for patients in the post-operative recovery room
- Number of patients who experienced complications that required additional surgery
By using AdaptX to monitor patient results, caregivers identified a combination of lower-cost, non-opioid medications that could be safely used in surgeries and recovery agendas. The new medications gave surgical patients a better treatment experience, while helping eliminate opiate-related side effects, such as post-operative nausea and vomiting. To date, Seattle Children’s has performed over 40,000 opioid-free surgeries.
Maximize surgical capacity
In 2019-20, Seattle Children’s faced a severe backlog of surgical procedures, due to the COVID-19 crisis and an ongoing operating room (OR) renovation. Seeking to improve operational efficiency, hospital QI researchers used AdaptX to track the daily start and end times for caregivers in the gastrointestinal (GI) unit. From this collected data, researchers identified and interviewed providers who demonstrated best practices for time efficiency, and who trained other providers to follow these practices.
Using these best practices, Seattle Children’s caregivers can service more cases per month and reduce the amount of overtime needed to handle backlog cases. System-wide, these improvements are expected to save approximately 250,000 minutes and $5 to $6 million in revenue per year.
Improving racial equity
Using AdaptX’s data analysis tools, an Asian physician at the Ambulatory Surgery Center conducted a self-survey to identify racial inequities in patient care. He found that African American and Asian patients had a higher incidence of medical complications following a tonsillectomy. A multi-disciplinary team of clinic and OR staff developed several strategies to eliminate these inequities. For example, the team redeveloped post-operative literature regarding visual, language-independent diagrams. One such diagram was a hydration chart showing how many cups of water recovering patients should drink per day.
Dr. Martin has used AdaptX to identify areas where standardizing practices may help to eliminate inequities. When comparing results of anesthesia care, he found that African American patients at the hospital’s main campus had higher instances of post-operative nausea and vomiting. At the Ambulatory Surgery Center in Bellevue, it’s standard practice to give patients two post-operative anti-nausea medications. Until recently, this wasn’t standard for patients at the Seattle campus.
Data analysis aids quality improvement
Prior to adopting data analysis, Seattle Children’s used an “Old World” QI methodology and completed only three Plan-Do-Study-Act (PDSA) cycles in four years. After implementing AdaptX in 2018, the organization completed five PDSA cycles in a single year. Now the organization goes through one PDSA cycle every five months. Using AdaptX has allowed caregivers to accelerate changes in clinical processes, and to drive dramatic improvements in clinical outcomes.
“The primary tenet for improving care at Seattle Children’s remains standardizing our practices,” says Dr. Martin. “In my view, it’s the Holy Grail for any physician attempting to improve clinical practices and outcomes. If you don’t have stable standard processes, it’s virtually impossible to make improvements within the system. Standardizing your practices builds a stable foundation for learning and making further improvements.”
To learn how to improve clinician outcomes and quality of care using software and services from solutions available in AWS Marketplace, check out the Enhance the clinician experience with real-time data solutions in AWS Marketplace webinar. It is hosted by Michael Leonard, Global Healthcare Lead, AWS Marketplace, and features Dr. Lynn Martin, Director of Continuous Improvement and Innovation at Seattle Children’s Hospital.
In this post, I showed the challenges that Seattle Children’s faced in standardizing healthcare practices. I also showed the improved patient outcomes they enjoyed after implementing AdaptX from AWS Marketplace. These included eliminating opiate use in surgery, maximizing surgical capacity, improving racial equity, and data-based quality improvement.
About the author
Michael Leonard is responsible for growing the AWS Marketplace healthcare vertical business. His previous role was as a Principal Product Manager on the AWS Storage Gateway team. Over the past 20 years, Michael has progressed through a variety of roles in business development, product management, and engineering at AWS, Commvault, Iron Mountain, Merge Healthcare, and GE Healthcare. He built and managed teams to develop Healthcare IT solutions focused on medical imaging, Electronic Health Record (EHR) systems, hybrid cloud storage services, and data protection solutions.