We really do make your workplace, and your workday, better. But you don't have to just take our word for it. See what other healthcare professionals are saying.
We arranged to have existing customer personnel interviewed about Watershed. To make sure we got the straight scoop, we didn't just ask what they liked - we also asked about things like what they were most concerned about, and what they would like to see change. Remarkably, the interviews were overwhelmingly positive anyway!
So, to see what people in various roles have to say about Watershed, select from among the roles listed here.
I would tell other hospital systems considering OR-Max that they don't realize how impactful a system like this can be. It gets people out of their silos, focused on their piece of the world, and what they control and influence, and back to people thinking more in terms of a team concept – how my actions impact someone else. That's huge, for an OR. They're seeing a much broader context than what they were seeing before.
This access to data is allowing us to be much more proactive. We can see earlier in a process what we're doing, to intervene, to take corrective action to get us back on track. That's huge!"
A benefit I hadn't seen coming is the frequent complements we get from patients' families. We've all commented on the frequent feedback we get when we're doing post-op patient rounding – family rounding – of how well received that is. It's been amazing."
A physician makes some negative comment about an operation: 'oh my patients are never teed up over there in pre-op holding for me to come by and do my pre-ops by 6:30.' Just a general comment. We didn't have the access to information before, so you couldn't defend – or corroborate, sometimes – their complaint. If it's real, we need to respond to it, but if it's not, we need to correct the misperception. And the good thing is that physicians respond to facts. They're scientists. When you give them actual results, there's not any mystery to it any more. Factual data is pretty hard to argue with. We need factual data, and I think OR-Max has given us a lot of factual data that we didn't have before."
The biggest benefit for me is enabling front-line staff to see the broader perioperative process than just their own direct minute-to-minute responsibilities, which, previously, they were limited to. And therefore their relative disengagement with the processes – that was a barrier to their engagement. They're more engaged because they feel better connected to the overall process. And that engagement is something that's gonna pay out in spades. When I talk to the 'super' users, that's what comes back to me. That is the biggest deal to me. They actually care about what's happening beyond the door of their unit."
I think the tolerance of the staff, of the surgeons for how the OR runs – or the expectations for how it runs has changed because of OR-Max. I just remember, gosh, the magnetic white board we had with the little placards and how meaningless that became – there was a tolerance for a certain level of inefficiency by the time we got to 1:00 pm and people were waiting around, and you might as well just take those things down because they were just place-holders in ORs; the times meant nothing. That is different today because of OR-Max."
With OR-Max we have better predictability, in the sense that we know that things are derailing the processes, predictability in terms of we know patients are late on arrival and its very much going to be hitting your radar screen sooner; or, we're getting ready to get to a choke point in PACU. We have more information today than we had before, to know those types of things."
That's always the challenge with Lean and Six Sigma projects: you don't have the data to really hone in on where the opportunities are, what your current process is. We're just data-poor in health care, data-poor. So, you go through and you've got all this focus, right, for a period of time. And you make your improvements. And then, all of a sudden, you've moved on to something else. And if you haven't hardwired all those processes, then all of a sudden six months later you realize you're back doing what you were doing before. You had to go through a lot of efforts to capture the data to know where you were at the beginning of the process and where you were after you re-engineered it. But you don't continue that same effort to capture data to make sure you're holding the gains. It's too time-consuming. You can't just manually capture all this and track it. OR-Max just does it in so much more of a passive, automated way, that you're not expending any effort to capture the data."
For us, clearly it's been impressive just how responsive IBSS has been to our needs. This has been a marriage, that you guys were here all the time. It was a leap of faith for us, originally, that you could take what you had done out in other industries and translate it to health care. You clearly have done that."
I get to spend much more time at home. I was so excited when they told me I could have it on my phone I nearly died – because I use it constantly, constantly.
I wouldn't trade it for anything. I would be very upset if somebody took it from me, very upset."
Probably one of the most eye opening experiences lately has been the 'super' user training – my supervisors who have been through it. Now, they've got their hands in it. And now, they wish they had done it a lot sooner. They're very interested; they're very engaged. They've learned that it's a benefit to them, and it's not that hurdle that everybody sometimes thinks it will be when you're starting a new program. It's easy for them to use."
I think the piece that has been helpful is the flexibility of OR-Max, and the ability to say to IBSS 'ok, this is what we're thinking' and their responsiveness. I know you don't get that with everybody that you deal with. Lord knows I'm sure we've called you at all kinds of times. We ask a lot of questions and I know we ask for some challenging things sometimes, but that's the way everything gets better. I think that's a big success. It's being able to show small successes, those are really the things that matter to people: the small wins day in and day out."
I know my nursing staff see OR-Max as a tool that has opened the doors for transparency for our periop as a whole. When decisions were made at the board, they didn't always take into consideration what is on the front end or on the back end. OR-Max has opened that door so they can see. If they're going to make a decision they can see if that patient's in pre-op and where they are in the pre-op checklist. They can see how PACU is, either log-jambed or empty. When it comes to predictability, my staff can actually move staff up or move staff back depending on what OR-Max is telling them. That transparency is a key thing that OR-Max opened up for us. It really, really opened a huge door."
I have it on my phone. I can access at home. It is a mobile system. Sitting in a meeting at 6:30 this morning, being able to look at it, know where I am with the day, know where I'm starting with on the add-on list, so that I can roll around again at 7:30 and see if they placed all those cases where they had opportunity to place those cases. I know what the vacancies are and where they should be putting cases, and then it's me following up. It does bring accountability, which I've never had before without running over somewhere, taking extra steps, having to leave a meeting because I get called with 'I've got a surgeon available, is there anywhere we can put this case? I'm getting resistance from the charge desk' or 'I'm getting resistance from anesthesia' or whatever it is. I can call the shots from anywhere."
Helping the charge nurse and the anesthesiologist know – 'ok, if we open up this room, taking another room down...' – it's easy to do that within OR-Max. Let's say we get a case we need to move because another room is running late, or we just get an urgent case and we need to get it going. Now, if our anesthesiology board runner is in a case, he can pull it up in the room and we can call the shots, and not have to wait."
It's as much a matter of resources for the chief resident as it is anything else, to know that, 'gosh, we don't have any cases on the add on list, so if I call with this case now, we're probably going to get a placement immediately, vs. a wait'; and being able to know whether H&P's been done, the consents, so he knows who he needs to latch hold to, to get it done. I think, efficiency-wise, it stops some of the things that pre-op runs into trying to get things at the last minute."
I would love to have tracked Brenda [Core Coordinator] pre-OR-Max, and then Brenda with OR-Max, because before she would run from our B-core to pre-op, or to PACU and back. Now she doesn't. She's got that ability to look without leaving the core. And it's good because she's got one view on the core board, but then she's got another view on the computer so that she can look in more detail specifically at a case that she's focusing on. Just the number of phone calls that it's cut down on for them is phenomenal."
The big board, and the ability to get rid of the dry-erase board was instant relief. When it went up, it went up without problem. That was an easy transition. So the first steps were successful because they were implemented well. There wasn't a painful pinch period. It's a big-picture product – you're not 'baby-sitting a hand-held,' you're actually taking care of the patient through communicating to other departments in how they can take care of them. It's a concept, a technique for caring for your patient, that you maybe don't realize initially. In any process when you feel like you're adding a step, you're pretty certain it's taking something away. But, in fact, I don't think that's the case. Communication here has always been a huge challenge. Your ability to focus on one task for an extended period of time was almost impossible, just because of the phone ringing and all that. I think we quickly have forgotten how bad it was, how much the phone rang because we're constantly talking to the OR or anesthesiologists. There's still a good bit of that, but if it was, you know, 90% of your time before, it's down to 30% of your time now. But we've gotten comfortable with that so we've forgotten. Now we want it to be only 10% of our time. Some of that is that last bit of understanding the product. Your ability to accurately use the product will get you down to that 10%.
I'm a big fan."
The lack of the need for verbal communications is the most important benefit. To best understand that, you have to know how we operated before. Even just on the out-patient pre-op side we had a huge white board, that I literally employed somebody to write all this stuff up there, erase it and rewrite it as the day went on. When we were busy and had 80 patients – this is a huge whiteboard – she would get up on a stool. Then, because of HIPAA, it had to be in a corner. It was like all of us trying to be right here and all of these physicians would come around, and then they would wonder why their case wasn't up there. Well, it isn't up there because it's hand-written and she hasn't gotten to it yet. So there was this constant 'is my patient here yet? what's my patient's room going to be?' all this kind of stuff. If the CRNA didn't come around and write when they left with the patient (which nobody did), then they would have to get scolded and we'd have to verbally call them: 'what time did you leave? was it a couple of minutes ago?'
All of that information now pops up automatically. Really, it has built morale in the sense that you're not badgering. You don't have to get questions from surgeons that seem scolding, and you don't have to scold people. That non-verbal communication that's set into place just makes everything smoother, and you can just say 'Good morning' instead of 'why haven't you done such and such'. For that reason it's great."
I know what's going on with my staff from my office, which is really interesting. I can pull up both my in-patient pre-op staff and my out-patient pre-op staff, and I can see if they're swamped. Because if I've got all these patients and they haven't been picked up, then something's wrong. I can pull up my in-patient pre-op staff and see that they have one patient in there, and then I call and reassign some of them. Not that I don't want to be out with them and visible, but it's nice to be able to quickly look at that, and have that ability. That's been a huge change for me. And also just to see, really, the efficiency of how patients are being placed in rooms, because I can look at the OR schedule and see if they're coming on time. It's totally different. Before it was just perception – walking through and seeing if people looked busy."
Often big projects like this get thrown in without a lot of conversation and inquiry about how it impacts you. That tends to be painful, and there tends to be a lot of re-work. Then you have to worry about front-line backlash, and then you have to deal with backlash on the management side, too, so you get sandwiched. But that's not what we did with this project, so that was a relief, because we didn't experience that. There was a lot of communication, a lot of questioning, weekly meetings – just consistency really helped with that.
It all interconnects. It's perioperative services. It's not OR. It's not AM Admission. It's not Outpatient Services. We are a unit. The progress this department's made is pretty impressive. I don't know of any other anesthesia providers that have this technology, and I know quite a few people in different states. No-one's doing this."
My concern going into this was ease of use. Because when there's a magnetic white board up there, I can just stand up there, and I can move this case over here, and I can move that one over there. And I can change the time with an ink pen, if a case is not starting til 4:00 now instead of 2:00. It seemed easy, it took nobody, no computer. I could fix it myself right then and there. I was very skeptical. I told them from the beginning 'Don't take my white board away. Don't take my white board away.' Now it's gone. I was concerned about how accurate it would be, and how easy it would be to update, change and manipulate.
But it is very easy, and very quick to move stuff and manipulate stuff. Just point and click, and its moved, and it does what it needs to do. I'm all over this. I like this thing. OR-Max works. You've got the total package for whoever would want it."
As each case falls off, you're like, 'oh, wonderful!' Because with a magnetic board, it required a nurse to walk by the board, pull off the tag, and put it down. When you've got ten cases and the surgeons are moving quickly, you just didn't have time. Now, cases just automatically pop off the board. You can sit up there between 3:00 and 5:00 and just watch the cases fall off. They're just falling off and your like 'Whew! We're going to be ok, staff-wise.'"
It used to require phone calls and pages and things like that. And now, anesthesiologists get pages when we finish, we don't even have to call them. They just walk in the room. And you're like 'I didn't call him', but he was getting pages. It's incredible. Because originally we would have to physically call, and our communication system does not work nearly as well as OR-Max does."
The staffing component is incredible, with the color change according to status. It saves time. It saves effort."
I like seeing case progression: anesthesia ready, start, procedure finish, reversal. It's incredible to have that access, when you're running the board. Because you look up there and you're like 'oh – we've got to relieve that person' and then all the sudden 'poof' procedure-finished pops up. Normally, I would be getting on my Vocera, running room to room – 'What does it look like? How long do you think you're going to be? Do you think you can stay?' Now, that information just pops up, and I don't have to make a phone call; don't have to hunt anybody down, don't have to walk in that room, I just take that one out of my mind. That's what's nice. I like to be able to see the progression of the case. It helps me in running the board in the afternoon, knowing what's left to go, and knowing it's accurate."
