Building the Hospital of the Future

Nicklaus Children’s Hospital builds the hospital of tomorrow with quality standards as a baseline.

Nicklaus Children’s Health System is a nationally recognized, 309-bed children’s hospital, 15 outpatient care centers with more than 790 attending physicians and 250 pediatric sub-specialties. The facility serves not only the multicultural melting pot of Miami, Florida, including three other counties in Southern Florida, but draws patients from across the US, Latin America and other international locales.

To make a massive cultural and operational shift, Nicklaus needed a partner who not only shared their vision, but who would empower them to reach it with new paradigms in thinking and in operations. It found such a partner in its accrediting body, DNV GL Healthcare. Nicklaus received its first accreditation from DNV GL Healthcare in 2016.

Along with performing annual surveys (as opposed to every three years), DNV GL Healthcare also uses the ISO 9001 quality management system as part of its accreditation process. ISO 9001 was originally created for the manufacturing industry, but has been adapted by DNV GL Healthcare for hospitals. ISO 9001 creates a specific roadmap for hospitals to not only adhere to the Conditions of Participation for the Medicare program, but also to improve its delivery of healthcare services at every level.

“We used the new accreditation system with DNV GL Healthcare as an educational opportunity and a methodology to standardize how we identify and adopt processes throughout the hospital. ISO 9001 is a framework that adapts to every area in the hospital, from supply chain to finance to revenue cycle management,” Perdomo said. “It gives us the framework to build layer upon layer of process improvement. Combined with our technology, we now have an accreditation system that monitors us every day, ensuring that we are always excelling.”

This has helped Nicklaus Children’s Health System to reach a state of efficiency, standardization of quality care, and patient safety that makes it the hospital of the future. Such an achievement required a totally new view toward running a hospital.

“From an operations perspective, a hospital is really a collection of processes—workflows that become the culture which, in turn, become the standard of care,” said CEO M. Narendra Kini, MD, MPH. “With digital technology, we standardize smart processes that really don’t have to be done by humans, thereby freeing our nurses and skilled personnel to focus on their clinical priorities: taking care of patients. With this approach, we know that standards of quality and patient safety are always met, and immediately corrected if there is a problem.”

Today, enabled by implementing quality standards in their operations, Nicklaus Children’s Health System has digitalized a number of processes, improving efficiency and patient safety.

A true working partner

“We chose to work with DNV GL Healthcare because they would be a true working partner with us, instead of an organization that just checked off the boxes to be sure we were compliant,” noted Jose Perdomo, Senior Vice President of Ethics and Compliance and Privacy Officer. “We have always pushed the envelope on clinical excellence, and in fact we developed our own clinical excellence index to monitor 55 metrics required for quality care. Our previous accrediting organization did not give us any credit for this achievement. DNV GL Healthcare recognizes the progress we have made.”

The hospital version of Tomorrowland

Roaming the hallways of Nickalaus Children’s Health System is like visiting a hospital’s version of Tomorrowland. Robots navigate the floors performing tasks ranging from supply delivery to sterilizing operating rooms. Staff wear specialized tooth buttons that automatically pinpoint their location, reducing time formerly spent searching for an individual to handle a specific situation. Location technology is used to find wheelchairs and other specialized equipment, as well as guarantee the readiness of each crash cart in the hospital within 2–3 minutes. That task used to take several hours. That innovation has saved Nicklaus about $240,000 a year. Special detectors verify clinicians have washed their hands upon entering each and every room. A telemedicine center also provides connectivity between physicians and patients across the globe.

“We wanted not only to know where things are, but to use the technology to know more—are patients seen in a timely manner? Do healthcare providers wash their hands prior to each patient visit as required? How could patient safety be improved? This system enables all of these areas to be monitored and measured,” said Nicklaus Chief Information Officer Edward Martinez.

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