Tuesday, April 13, 2010

Patient Communication & Technology Part One

People ask me all the time why Sphere3 addresses Nurse Call first when we look at Alarm Automation. Quite Simply - it is the hub of all patient interaction at a hospital. If you want to see immediate change then address the way caregivers are interacting with patients. Nurse Call is the only Patient controlled device in the room that is related to their care. (Yes, interactive TV people may disagree) It is a life line for patients to interact with people who know how to help no matter what the request.

This is a medical device that is required to be in every hospital for notification of patient need. However, if you are just using it for that type of interaction then you are not fully leveraging the investment. For example, if you can purchase a button that can be used for bed management as opposed to a bed management system then isn’t it leveraging that base platform more efficiently? The key word above is “required” but the key idea is how do you leverage a required piece of equipment for innovative workflow processes that are outside the basic scope. Nurse Call purist will disagree with this point by saying that adding extra workflow processes decreases safety. By not using the system for its intended use you actually increase risk that a peripheral function would disrupt a critical one. However, most platforms are designed so that you can’t disrupt a critical process unless it’s not implemented correctly.

Further, when evaluating the system it’s important to define how it will be used. I have found that a majority of the time the system is being evaluated on a few key features – not necessarily on how the system will be used. Don’t follow the Shiny Ball folks!

To put it in other words – a hospital knows they need a nurse call system for communication but rarely has its uses or additional workflows been pre-defined. Many rely on vendors to provide outlines and designs on how the system set up, but that’s how it is looked at as “system setup” not workflow. There may be some base anecdotal type information about wanting to “send it to a phone” but not a true plan.   Having a plan of how each aspect of the nurse call is to be used prior to making a purchase decision is crucial.

Important: System design is how the components and cabling are put into the hospital. Workflow design is how the caregivers use the system. Workflow design overlaps system design because there are specific component needs that enable the workflow.

Stay Tuned for the next post: Top 5 things a hospital should look at when evaluating a Nurse Call System


  1. Glad to see this series started - thanks for posting. Agree on nurse call being critical. Was interested to see the stat you tweeted today that the average patient produces 1.5 nurse call alarms per hour. Given an average nurse's workload that comes out to about 1 call that they are responding to every 10 minutes. Considerably more than I would have thought.

    One question...

    "For example, if you can purchase a button that can be used for bed management as opposed to a bed management system then isn’t it leveraging that base platform more efficiently?"

    Would be interested to see more context on this - sounds interesting, but I'm not sure I'm understanding the use case.

  2. That's a great observation and on average "normal" calls it is 1.5/ patient which if you are familiar with nurse call you know that means that there has to be a verbal interaction. Jst consider that is an average so they may come in clusters and a majority do not require an "RN" to respond to them. So the RN may have 5 patients and on average they may have 1.5 requests per hour which is 7.5 "normal calls" per hour but her workload is balanced out by the type of request made.
    That being said - this is why workflow design is soooo critical. The devil is in the details and often the details that need to be assessed are over looked.

    You would be amazed if you dug into the numbers the number of calls that are generated by patients - and it varies by unit type, acuity, etc Understanding the mix and the requests (etc) is what we do best. We have actually developed software that assesses the situation for us.

    On your second question about systems....Hospitals often purchase systems, such as bed management, to solve an issue. However, what we find is that instead of purchasing a new technology they can simply leverage an existing platform.

    For example, IF you have paid $500K for a nurse call system and for an additional $25K can add a button for bed management - then why would you purchase another system (yes, I know the information is displayed differently) You actually decrease the time it takes to have a positive ROI on your purchase by finding additional applications for that platform.

    We believe that leveraging existing platforms is as important as exploring new. That the most efficient way to map out decisions is to first understand your workflow then approach the marketplace or find a more effective way to use what you have.

    Thanks for the comment! Keep them coming!


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Kourtney Govro