Home health service creates healthier workflow to improve patient care

Published on June 28, 2018


Visiting Nurse Service & Hospice of Suffolk (VNSHS) serves its community in New York with compassionate, in-home medical care. Staff members care for many patients in the field, and the nonprofit needed a digital way to track processes, communicate between care providers, and improve staff mobility. VNSHS adopted Microsoft Flow and Office 365 to automate its workflows and standardize how its Firstline staff get notifications. Freed from extra paperwork and travel, nurses can now spend more time with patients and ensure consistent, high-quality care.


Identifying the challenges of consistent home medical care

Hospitals are not the only place where patients need medical care or where clinicians dedicate long hours and heartfelt treatment. Visiting Nurse Service & Hospice of Suffolk (VNSHS) sends its Firstline staff such as skilled nurses, physical therapists, and occupational therapists to care for patients in their homes. Based in Northport, New York, the nonprofit also provides hospice care to manage patients’ pain and ensure their comfort at the end of life.

Those are important jobs, and not always easy. On top of those responsibilities, VNSHS nurses and other staff have to track a staggering amount of data over the course of 90,000 visits to 3,000 home care patients and 600 hospice patients each year.

Firstline staff had to complete all admissions and incident reports on paper, physically bring the documents to the office, and then return to the field. “Bringing paperwork back to the office took a lot of time, and things could get lost. Since we had no consistent, digital record of our processes, steps would get missed,” says Alvin Ledwidge, System Specialist at Visiting Nurse Service & Hospice of Suffolk.

When staff admitted a patient or filed a report, they had to manually add the names of all pertinent employees to an email to notify everyone. A staff member could sometimes be left out. “With our previous system, things could fall through the cracks, like a therapist or social worker not getting a notification and missing an appointment,” says Ledwidge. “Patients and their families rightfully express a lot of emotion around missed appointments. We needed a way to more consistently meet our commitment to delivering the outstanding care our patients deserve.”


Centralizing data and looping in the right staff

VNSHS wanted to digitize its processes and make sure the relevant staff were included on each patient’s care plan from the beginning. In July 2017, the organization decided to use Microsoft Flow to create automated workflows. At the same time, VNSHS adopted Microsoft Office 365 and connected Microsoft Flow to Microsoft SharePoint Online. Now, for incident reports, admissions, and remote monitoring of patient vital signs, VNSHS uses 12 specific flows that it built for its most important business and clinical processes.

Ledwidge and his team created SharePoint lists with the right staff, group, and managers for specific services. Employees fill out workflow forms in Microsoft Forms or PowerApps, which connect to the SharePoint lists and Microsoft Flow. “By using Microsoft Flow, we’ve made processes for the firstline staff a lot faster. They worry less about who’s on the email—they simply fill out a workflow form and know that the right staff and supervisors will be automatically included.”

Previously, staff had to update notes from the electronic medical record, but the next staff in the care process wouldn’t be notified until the update was complete—which could take two or three days. “Now with Microsoft Flow, when our firstline staff start to fill out a PowerApps form, it notifies others on what type of service the patient needs next,” says Ledwidge. “That way, staff can prioritize and plan accordingly, which reduces stress, last-minute scrambling, and risk of missed appointments.”

By using Microsoft Flow, we’ve made processes for the firstline staff a lot faster. They worry less about who’s on the email—they simply fill out a workflow form and know that the right staff and supervisors will be automatically included.

Alvin Ledwidge (System Specialist, Visiting Nurse Service and Hospice of Suffolk)


Decreasing administrative time, improving patient care

All 250 staff members have access to Microsoft Flow, including the 180 firstline staff who use the tool on iPads. For each admission, staff save 15 to 20 minutes of paperwork. Staff appreciate that they now can make notes in real time, know that the right staff members are updated, and avoid driving back and forth between the office and patients’ homes.

“Microsoft Flow is the glue that’s holding everything together,” concludes Ledwidge. “Before, we lost valuable time driving documents to the office and trying to communicate the care plan. Now staff are spending less time doing paperwork and more time taking care of patients.”

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