Written by Vivian Kane.
Case prioritization is a critical function across various healthcare units, each with its unique demands and challenges.
From emergency departments and ICUs to specialty clinics, every unit has a triage system that helps organize cases based on the level of emergency or severity to ensure optimal patient outcomes and efficient resource allocation.
In emergency department triage, nurses evaluate the severity of each case using standardized protocols. In the US, we use the Emergency Severity Index (ESI) or the Manchester Triage System (MTS).
Case prioritization also happens in non-emergency units. Here, they are used to improve efficiency by ensuring that patients are seen in a timely manner based on their needs.
However, standard patient prioritization is not as flexible and inclusive as we like to believe. Many of the current protocols can create bottlenecks, mismanagement of resources, and other issues that ultimately affect the patients and the staff.
In today’s article, we will discuss the need for a better prioritization system and the framework that may be able to move things along: the use of expanded spreadsheet tools.
The Problem with Standard Case Prioritization
Both the ESI and the MTS have been shown to be effective in improving the flow of patients in high-pressure settings like emergency departments. However, their effectiveness can vary depending on the specific context and resources of the healthcare unit.
For non-emergency units, prioritization helps identify patients who may need immediate attention, even if their condition is not life-threatening. It also helps in the optimal use of resources, ensuring that staff and equipment are used where they are most needed.
Each healthcare unit is free to choose the case prioritization system that works best for their needs. However, the available methods come with a few massive caveats, such as:
- Manual Processes: Manual data entry and tracking can lead to delays, increased workload, and staff burnout. These inefficiencies hinder timely patient care and resource allocation.
- Inconsistent Criteria: The lack of standardized criteria for case prioritization results in subjective decisions, which can vary widely among healthcare professionals, leading to inconsistencies in care.
- Static Data: Traditional systems often rely on static data that fails to reflect real-time changes, such as bed availability or patient deterioration, leading to outdated and inaccurate prioritization.
When you manage a large influx of patients, these caveats become bottlenecks that can block the entire system. Also, the varied and complex nature of medical cases requires nuanced prioritization, which standard methods often struggle to accommodate.
The Consequences of the Current Prioritization System
The inadequacies that plague standard case prioritization in emergency and non-emergency settings can result in adverse consequences, such as:
- Poor Resource Allocation: Specialized staff, nursing staff, laboratory services, equipment, available spaces, and other resources can be mismanaged by a system that can’t handle everything dynamically.
- Missed Urgent Cases: Failure to identify and address urgent cases promptly can result in delayed treatments and poor patient outcomes.
- Staff Frustration: The cumulative effect of these challenges leads to increased stress and frustration among healthcare staff, impacting job satisfaction and retention.
- Compromised Patient Outcomes: These issues can compromise patient safety and outcomes, as seen in a clinic’s struggle during flu season, where outdated tracking methods lead to overload and delayed care.
Can Expanded Spreadsheet Tools Save the Day?
Most modern healthcare facilities use EHR systems to manage patient data in real-time. These systems are designed to handle the complexities of patient care, including triage and prioritization.
However, they need good-quality data to operate at maximum capacity. Plus, if your unit is suffering from any of the aforementioned problems, an EHR won’t be able to give you the answer.
You need a different tool to analyze all the aspects that may hinder efficiency and provide useful insights.
This is where expanded spreadsheet tools come in. They integrate data from various sources, such as Electronic Health Records (EHRs) or lab results, process them, and provide a comprehensive view of each case.
Expanded spreadsheet tools offer a range of advanced features that go beyond the basic functionality of traditional spreadsheets.
They provide enhanced analytics, automation, data integration, visualization, collaboration, scalability, and security, making them more suitable for complex applications like the ones needed in case of prioritization.
For instance, automation is great for streamlining workflows and reducing manual errors. On the other hand, advanced analytics capabilities enable the identification of patterns and prediction of outcomes, allowing for more effective prioritization based on urgency and resource availability.
Moreover, expanded spreadsheet tools facilitate better communication and collaboration among healthcare teams. Dynamic data can be used to design live dashboards that track critical metrics like bed availability, which are updated in real-time via integrated EHR feeds.
Practical Use Cases
The many interesting features of expanded spreadsheets allow each healthcare unit to create personalized tools that respond to its unique needs of data processing and analysis.
Here are a few practical uses to consider:
Acuity Scoring
With data from the unit’s EHRs and lab results, these tools can automatically calculate acuity scores and apply conditional formatting to highlight critical cases. Patients with high acuity scores can be flagged in red to create a visual description of their current state.
This real-time scoring system helps to identify and prioritize critical cases quickly, reduce wait times, and improve patient outcomes. In the fast-paced environment of an emergency department, it’s incredibly helpful to get a full assessment just by glancing at a screen.
Waitlist Management Automation
Outpatient clinics tend to have long waiting lines, which inevitably excludes some patients who need timely care. This is where units can use expanded spreadsheet tools to identify and prioritize patients based on comorbidities and urgency.
The tool can automatically sort and update the waitlist, ensuring that patients with multiple or severe conditions are seen first. Since the system is automated, it reduces manual effort, minimizes errors, and ensures patients receive care based on their medical needs.
Implementation Tips
The implementation process follows the standard software tool implementation route, starting with analyzing the unit’s needs and ending with evaluating the outcomes.
Outlining Needs
To understand what features you want to handle through this tool, determine the specific challenges your unit faces in case prioritization (high patient volume, limited resources, or complex case management).
Outline what you aim to achieve with the new tool, whether it’s improving efficiency, reducing errors, or enhancing patient outcomes. Assess your existing tools and processes to identify gaps and areas for improvement.
Choosing the Best Tool
Once you know what the tool needs to fix, decide whether to go with an existing system like Excel’s Power Query (for real-time data aggregation) or Google Sheets + AppSheet (for mobile-friendly workflows) or design your own from scratch.
You can create your own developer-focused .NET spreadsheet tools that meet all your demands and have no additional features your unit doesn’t need. This route allows you to craft a user-friendly design that is perfectly compatible with the other software tools your team is using, such as EHRs and lab management software.
Staff Training
Any effective implementation requires comprehensive training to ensure employees are comfortable and proficient with the new tools. Offer practical sessions where staff can interact with the tool in real-time, applying it to mock scenarios.
Until everyone gets used to the features, establish a support system for ongoing assistance, such as a helpdesk or designated super-users who can provide guidance.
Monitoring and Evaluating Outcomes
The final step involves monitoring the tool’s impact and evaluating its effectiveness in addressing your unit’s needs. For this, define metrics to measure the tool’s success, such as reduced wait times, improved patient outcomes, or increased staff efficiency.
Conduct periodic reviews to assess progress against your objectives and identify areas for improvement. Also, it’s important to collect feedback from staff and patients to gain insights into the tool’s practical impact and usability.
Use the data and feedback to make necessary adjustments and make sure the tool continues to meet your unit’s evolving needs.
Barriers to Adoption and How to Overcome Them
Considering the level of flexibility and customization, expanded spreadsheet tools can clearly assist healthcare managers with case prioritization. However, this doesn’t mean there won’t be any adoption barriers – even if the tool is developed for your unit.
One of the most significant barriers is the staff’s resistance to change. Healthcare professionals already deal with impossible schedules, so they may be hesitant to use new technologies they’re not familiar with. Most of them fear that the novelty of such a tool will increase their workload.
From a technical point of view, incompatibilities with existing systems are the biggest threat. Also, staff may require time to become proficient with the new tools, which may lead to a drop in productivity and efficiency.
In healthcare, you can’t (or, at least, shouldn’t) ignore data security due to the sensitive nature of patient information. This is why it’s crucial to make sure your tool is compliant with the Health Insurance Portability and Accountability Act (HIPAA).
To increase security, educate staff on the importance of data security and the protocols in place to protect patient information.
Wrap Up
In conclusion, tools that use expanded spreadsheets offer healthcare managers a powerful ally in case prioritization, providing real-time data integration, automation, and advanced analytics.
These tools can enhance efficiency, ensure consistent decision-making, and ultimately improve patient outcomes by streamlining workflows and reducing errors.
Author Bio
Vivian Kane is a health writer with a passion for improving care for the elderly. With over a decade of experience in healthcare policy and senior care, she focuses on educating the public about innovative trends and best practices in eldercare. Vivian has contributed to various healthcare journals and blogs. Her work aims to bridge the gap between healthcare professionals and caregivers, ensuring that the latest trends in eldercare education are accessible to everyone. When she’s not writing, Vivian volunteers at local senior care centers and advocates for better care standards for aging populations.
References:
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Uslu, A., & Stausberg, J. (2021). Value of the Electronic Medical Record for Hospital Care: Update From the Literature. Journal of medical Internet research, 23(12), e26323. https://doi.org/10.2196/26323
Zachariasse, J. M., Seiger, N., Rood, P. P., Alves, C. F., Freitas, P., Smit, F. J., Roukema, G. R., & Moll, H. A. (2017). Validity of the Manchester Triage System in emergency care: A prospective observational study. PloS one, 12(2), e0170811. https://doi.org/10.1371/journal.pone.0170811
Damawan, Ahmad & Azizah, Siti. (2020). Resistance to Change: Causes and Strategies as an Organizational Challenge. 10.2991/assehr.k.200120.010. https://www.researchgate.net/publication/339190336_Resistance_to_Change_Causes_and_Strategies_as_an_Organizational_Challenge
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