Case Study: Tenet Healthcare Corporation

Tenet Healthcare Raises Bar on Quality Through Lippincott Advisor

One of the leading health systems in America, Tenet Healthcare Corporation wants all of its 45,000+ nurses and clinicians to be on the same page — especially when it comes to advancing clinical excellence.

They strive to accomplish this goal with Lippincott Advisor, an online decision-support solution designed specifically to provide fast, evidence-based answers at the point-of-care.

The Tenet network includes approximately 50 hospitals across 11 states all of which are using Lippincott Advisor as the standard product for clinical knowledge and best practices.

A fundamental principle of Tenet’s organization is an enduring focus on quality. This unwavering focus has helped it emerge as a top provider of quality healthcare in the United States. Tenet has built a foundation of products, tools, training and strategies to ensure that its employees are providing the best patient care. Lippincott Advisor fits squarely into this approach by giving Tenet’s staff access to a consistent base of current, evidence-based information that nurses and other clinicians need to know on a daily basis.

“Lippincott Advisor is an overall, over-arching right fit for us because of its state-of-the-art technology, ease-of use and ability to seamlessly integrate into our point-of-care environments,” said Kathy Cottrell, Sr. Director of Organization Learning & Development for Tenet Healthcare. “Most importantly, it creates a common language and framework from which our clinicians can work. It provides the ‘why’ behind what clinicians should do.”

Cottrell and her colleague Julie Dippel, Director, Organization Learning & Development, together led the implementation effort from Tenet’s home office in Dallas, which ultimately made Lippincott Advisor available across the entire health system. Installed in April 2012, the product has become a popular go-to resource for clinicians looking to get specialized information to bolster their knowledge about diseases, signs and symptoms, treatments, diagnostic tests, nursing care plans, drugs, and more. It provides 24/7 online access to this information and is optimized for most mobile devices.

“I don’t have to second guess where I’m going to go for information, I just automatically go to Lippincott and know that what I’m looking for is going to be there,” added Cottrell. “It’s a single source so it doesn’t matter what hospital a clinician is in. Now that we have Lippincott Advisor, all of our employees have access to the same up-to-date, evidence-based resource.”

Good Planning Led to Success

Cottrell and Dippel staged a remarkably well-orchestrated launch for Lippincott Advisor, which they simply call Advisor, by first building a cross-functional design team to determine how it was going to be rolled out. Approximately 200 clinical educators were selected to be product advocates and quickly became experts on its content and use. Shortly afterward, Advisor was rolled out to the rest of the organization.

“Lippincott Advisor has become hardwired with our clinician population,” added Cottrell. “We’re always hearing comments like, ‘Have you checked Advisor? What does Advisor say?’ It’s pretty great.”

Now with the integration complete, Tenet has become the largest single-customer implementation for Lippincott Advisor with immediate online access available to nearly 60,000 Tenet employees.

‘Bread and Butter’ Staff Development in South Carolina

Lippincott Advisor is solving a lot of problems for nurses and nurse educators across the Tenet network. Hilton Head Hospital, a 93-bed community hospital in South Carolina, is using the product for staff development, policy development and as an everyday knowledge resource.

“Lippincott Advisor is my bread and butter. I look at it every day. For me it’s vital,” says Andrea McCleary, RN, BSN, MAOM, Director of Education at Hilton Head Hospital.

McCleary builds education modules and does needs assessments for staff to keep them up to date. “Advisor has been my best friend for this,” she said. “I use it all the time for policy development because you need the research and evidence behind it.” The product has also been invaluable to McCleary as her main resource when building professional development modules. “Whenever there is a new problem,” she continued, “I go straight to Advisor and everything I need is there.”

One of the biggest challenges, according to McCleary, is keeping things fresh.

“Our new nurses have taken to Advisor quickly and they use it regularly because they’re still learning and don’t have the experience of a seasoned nurse,” said McCleary. “On the other hand, some staff has been doing things the same way for many years. But things change in healthcare and many of them are using Advisor to learn about these changes.

“Frequently, this occurs when a student nurse is shadowing them or they are precepting a new hire nurse,” continued McCleary. “They’ll get a question, check Advisor for the answer, realize that their current knowledge may be out of date.”

Before Lippincott Advisor, when a question arose, clinicians either tried to find a book or did a search on Google, often finding questionable resources in the process or wasting time sifting through all the aggregated search results to find the right answer. “We’ve all been trained on textbooks and journals but books become dated pretty quickly and when you need one you can’t find it,” said McCleary. “So, what happens is people may not look it up at all.

“We needed something we could trust to be there every day,” added McCleary. “Lippincott Advisor solved our problem because it’s evidence-based and constantly updated.”

Improving Policy Development and Mobile Access in Texas

Another Tenet hospital, Cypress Fairbanks Medical Center in Houston, is using Lippincott Advisor as an evidencebased resource for developing its policies. When creating a new policy or reviewing or updating an existing one, Cyndie Salmons, BSN, RN, and Director of Staff Development, goes to Lippincott Advisor first to see if there is content she needs.

“By having really good policies and procedures that are up-to-date and evidence-based, we can improve the quality of care that we give to the patient,” said Salmons. “Advisor is helping us get there.” In terms of usage relative to total headcount, the 400 nurses employed at Cypress Fairbanks are among the top users in the Tenet network. “I know our nurses are using it. If they didn’t see value in it they wouldn’t keep going back to it,” she added. “So, for us it’s been a real success.”

More and more Cypress Fairbanks nurses are choosing to use the mobile-optimized version as a way to get answers straight from a smartphone or tablet. The hospital allows clinicians to use them, which in turn gives the clinicians the ability to always have access to the answers they need.

According to Salmons, staff members also are very excited about the Health Library, a collection of approximately 30 health-related books that nurses can access directly from Advisor. The library allows the nurses to review more in-depth information, giving them a way to “self-learn” and remediate gaps in their knowledge.

In her post, Salmons regularly monitors Lippincott Advisor usage across the hospital and looks for clusters of certain terms. Using these metrics, she determines areas that may be in need of remediation and uses content from the product to develop learning modules for staff on those topics.

“We made it clear to staff that we wanted to do evidence-based practice and that Advisor should be their first stop,” said Salmons. “It’s a great program for our hospital.”

A Gold Standard in California

At Twin Cities Hospital in Templeton, California, Education Manager Janet Tiffin manages Lippincott Advisor across the Tenet facility.

“We are a 124-bed community hospital with a wide variety of patients and the busiest ER in our county,” said Tiffin. “It’s so wonderful to have access to a real-time reference library instead of needing to do an Internet search for an opinion.”

Lippincott Advisor has over 3,500 original entries in which a team of nurses and subject-matter experts have uncovered the latest evidence-based research and synthesized the information into concise abstracts of information. It’s this dedication to detail that enables the product to provide immediate answers to nurses’ questions at the bedside.

“Advisor is a gold standard resource that eliminates the need to have nursing manuals scattered throughout the facility,” said Tiffin. “There is such a large volume of information in Advisor. It is 100 percent better than an Internet search that may or may not be vetted. And the Health Library is a tremendous asset.”

Staff at Twin Cities use the product regularly to understand disease pathology and recently are getting huge value from the new medication identifier feature. “Patients come in with their baggie of medications and we use Advisor to quickly identify them,” said Tiffin. “It’s so easy to use and with very little info we can make an accurate identification.”

Not Just For Nurses

After using it for a year, Tenet is extracting value from Lippincott Advisor in ways that go well beyond its core purpose.

Although the product was originally intended for nurses, Tenet is using it more broadly across the organization. Clinicians such as hospital pharmacists, radiology technicians, and clinical informaticists have jumped on the Lippincott bandwagon and are customizing the product to meet their specialized needs. Other non-clinical groups including medical coders and billing specialists are tapping into it as a resource to help them understand medical terminology and do their jobs better.

“When we designed the customized training for the product we specifically called out the broad clinician population, not just nurses,” said Tenet’s Cottrell. “In addition to the cross-functional disciplines that are using it, we are trying to get it in front of every clinical initiative that is taking place so that the leaders of other functions are aligning whatever language, teaching and training that they are doing by leveraging Advisor.”

“We’re working to keep raising the bar on quality and Lippincott Advisor is right there with us,” says Kathy Cottrell, Sr. Director of Organization Learning and Development at Tenet Healthcare.