The Hospital Built to Enhance the Millennial Experience

Technology and real-time communication at Dayton Children's Hospital optimize the patient and family experience for a new generation.

This article appears in the September/October 2018 edition of HealthLeaders magazine.

As health systems move toward more consumer-centric practices, children's hospitals are the leading edge of serving millennials, a tech-savvy generation with different expectations than the age groups preceding it.

With a new patient tower opening last year, Dayton Children's Hospital in Ohio, which serves more than 300,000 children a year in more than 50 specialties, presents a case study in designing a patient and family experience for this generation.

While its administrators acknowledge that many factors and processes influence patient satisfaction, the infrastructure now exists to optimize the patient experience.

In 2012 Deborah Feldman joined Dayton Children's as president and CEO. The next year she debuted a vision for 2020, which included plans for the new facility, which opened in 2017.

Those plans took a deep dive into the needs and behaviors of millennials—the generation of parents whose children are now treated there—and included a commitment to offer best-in-class technology as part of the up-front investment.

The Millennial Factor
 

"As a children's hospital, our consumers are increasingly millennials," says Kelly Kavanaugh, vice president of marketing and strategic planning at Dayton Children's 178-bed inpatient facility.

During the planning process for the new patient tower, "I compiled research about millennials and how they think about care, but more importantly, how they behave in the rest of their life, which really influences how they think about healthcare," she says.

Among the most essential findings were a need for technology that enables real-time, two-way communication, and processes to instantly address needs and provide instant gratification.

While these concepts are hard to find in healthcare settings, they are well-refined in the world outside of hospitals where Amazon, Apple, and Google operate and are now becoming players in the healthcare arena. These brands are respected by millennials and ones that Dayton Children's wanted to emulate.

For inspiration, the team's project manager, a nurse who is now retired, visited hospitals around the country, gathering information about best practices and names of preferred vendors.

Satisfying a Driving Need for Technology
 

Nikkia Whitaker, MSN, RN, CCRN, clinical technology integration manager, later joined the team, serving as the liaison between the IT department and end users. Rather than letting vendors drive the process, she further refined plans by asking patients and families what features and benefits were most appealing.

"There was a lot of involvement with our patient ambassadors and our family advisory board," says Whitaker. "We asked what things were important to them, and then reached out to vendors and asked, 'How can you make this happen?' "

In the end, Whitaker was responsible for launching a dozen new systems with interconnectivity between many of them. Among those were:

• GetWellNetwork, a patient engagement software system that works through the patient's television
   
• Vocera, a wearable smartphone device for nurses
   
• Hill-Rom Nurse Call, bedside call technology

While a few of the systems were piloted ahead of time, remarkably, Whitaker decided to go live with all technology simultaneously. Even more remarkably, the launch went smoothly and continues to operate efficiently. Here's why:

• Before the launch date, Whitaker organized six groups of "super users" and conducted training with 12 vendors over a two-day period
   
• During the following six weeks, the super users trained staff members on their units
   
• After the launch, training continues as the hospital enhances the technology, and vendors issue updates
   
• Every other week, Whitaker conducts a four-hour technology training class for all new nurses and PCAs

"We're using technology to the fullest capability of what IT says we can do with it and what nurses say they want to do with it," says Whitaker.

Patient Experience Features
 

The new patient tower not only houses state-of-the-art patient care equipment, it also showcases technology and features that appeal to millennials. Among the highlights:

Some of the updates were not complex, but had a significant impact, according to the hospital's marketing executive. Ideas other hospitals could emulate without a huge technology overhaul include:

• Bedside buttons that allow patients to speak directly with their nurses, no matter where the nurses are located in the hospital
   
• Whiteboards built into the television system that enable patients and family members to register real-time complaints and compliments
   
• Electronic name badges that track hospital personnel throughout the floor and will soon project their picture and identity onto the patient's television screen when they enter the room
   
• A coded lighting alert system outside each patient room that enables staff members to determine key information at a glance, for example, if a patient is a fall risk or a procedure is in process
   
• Electronic signage outside each door embedded into a tablet that lists patient precautions, as well as welcoming messages
   
• A video-based patient education system that tracks programs watched and documents viewings into the EMR
   
• Interconnectivity between many of the devices, such as smart bed monitors and vital sign monitors that feed directly into the EMR
   
• A reliable wireless network for millennials who arrive at the hospital with their own devices. They use the network to continue working and stay connected to family and friends. 
   
• Parents of patients admitted through the emergency department often have their phones, but not their chargers. Keeping a variety of chargers available is an easy solution and a "huge win," says Kavanaugh.
   
• Installing larger television sets in patient rooms. Interestingly, says Kavanaugh, this was one of the greatest sources of complaints in the old facility. Patient rooms in the new tower offer two televisions: a 40-inch monitor and keyboard for patients, and a 20-inch television in the parents' area of the room—a much-desired diversion from kid's programming, she says.
   
• The ability to order meals via the television, a measure that also created efficiencies for the dietary department

New Ways to Measure Impact
 

While patient scores have not changed dramatically due to these upgrades, as measured by traditional survey mechanisms, Dayton Children's now has new ways to capture feedback and data:

• Each day, two survey questions are pushed out via the GetWellNetwork, appearing on patients' television screens. On a 10-point scale, with 10 being the highest grade, 90% of respondents consistently rate satisfaction at nine or above.
   
• Staff members now respond immediately to concerns patients and family members raise.
   
• "If there's a negative response to a daily survey question or a complaint is received, it immediately triggers a message to our nurse leaders who then deal with it in real time," says Cindy Burger, MS, RN, vice president of patient and family experience.
   
• In addition, families or patients now have an easy way to provide positive feedback. Each month about 60 employees are recognized for outstanding service.  

"We have an industry that's slow to respond to new things," says Burger, "but [our hospital is serving] a whole new generation that has very different expectations. We're seeing it now; the adult hospitals will see it soon, when more of their patients are millennials."