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Nurses live by the old adage: If it wasn't documented, it wasn't done.
But imagine how great it would feel to be free of the tedious task of writing down every aspect of patients' daily care.
Voice-assisted care allows that to happen, and an increasing number of nursing homes and hospitals are finding the portable systems to be accurate, efficient and cost-effective.
"When you implement this system, you gather up all the pieces of paper you used before and you throw them away," said Susan D. LupPlace, BSN, RN, director of clinical services, Preferred Care Partners Management Group, Plano, TX.
The Texas-based chain of 64 managed-care facilities began phasing in voice-assisted documentation in March 2009. The system, called AccuNurse by Vocollect Healthcare Systems, is designed to remove all the guesswork involved with documenting care.
"With this system, you have documentation every single time you toilet a patient, every time you feed a patient, every time you transfer a patient," LupPlace explained. "And the voice system documents it as it's done, in real time. You can do it while you're walking out of the room or while you're washing your hands, enabling multitasking."
Protects Against Errors
Voice-assisted care puts each patient's needs right at providers' fingertips or, as LupPlace puts it, right at their ears.
Nurse managers load individualized care plans into a computer that relays easy-to-follow voice instructions to caregivers wearing lightweight headsets. The voice prompts the caregiver on each task to complete from the resident's individualized care plan, and providers respond with verbal confirmations that are immediately captured in a database or electronic medical record.
Even if a caregiver is called to assist a resident she's unfamiliar with, she can quickly access that person's specific care plan and know, for example, that she'll need lifting assistance or that the patient can't put weight on his left leg and he can't be left alone in the bathroom.
"There's no longer any need to go to the nurses' station and flip through a resident's care plan," explained Troy Baumann, chief operating officer of Community Eldercare Services, a Mississippi-based nursing home company. "There's no need to remember anything, because the voice prompts them as they go."
Community Eldercare Services, which operates 20 facilities with a total of 1,550 beds, introduced the hands-free, voice-assisted care system in 2009.
"Before, we had to rely on our CNAs to go back to the nurses' station and write down what they did for a resident or else tell the nurses everything they did," Baumann said. "A lot was lost in the translation. Now, the documentation is done at the point of care."
What's more, caregivers' hands are always free, and they no longer have to leave a patient alone to summon help or retrieve equipment.
"They can discreetly page anyone in the building through the system," LupPlace said. "They say, 'Come to room 302 and please bring a lift.' They never have to leave the room."
Still, there's always a chance that a caregiver will choose to improvise or deviate from the care plan. The system's verbal prompts and the required confirmations, however, cut that risk significantly, LupPlace said.
"That (possibility) is so much more reduced from the previous way of doing things," she said.
Worth the Investment
Make no mistake, voice-assisted technology comes with a cost. Community Eldercare pays about $1 a day per bed for its system, Baumann said.
However, he contends the expense is more than recouped through increases in federal and state reimbursements. Facilities now are reporting the true level and intensity of care. Nothing is missed, and case-mix index scores are rising.
"This system ensures we are getting credit for all the work we are doing, while also assuring that the work is being accomplished," Baumann said.
LupPlace agrees that the investment in voice-assisted care has been well worth it for her company.
"We have made up the cost and than some because we are now collecting an amount in reimbursements that we had previously been leaving on the table," she said. "It's what we should have been collecting all along but we weren't because we didn't have the complete documentation."
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