By Suzi Birz, principal, HiQ Analytics, LLC
In December 2008, the California HealthCare Foundation published Equipped for Efficiency: Improving Nursing Care Through Technology—a report that examined hospitals’ experiences with a variety of technologies that enhance nursing care delivery.
A recent report shows that new technologies that enhance nursing care delivery have helped create a better workplace for nurses and raised their job satisfaction levels.
The focus of the report centered on the following technology applications that have demonstrated their value—some of which are in early use and some already in the mainstream.
* Wireless communications (with alarm/event messaging)
* Real-time location systems
* Delivery robots
* Workflow management systems
* Wireless patient monitoring
* Electronic medication administration with bar coding
* Electronic clinical documentation with clinical decision support (including biomedical device integration)
* Interactive patient systems
The results indicated that these systems have helped to create a better workplace for inpatient nurses, raising their job satisfaction while also contributing to improvements in care.
“The purpose of the research report was to identify and describe technologies that positively impacted a nurse’s work day as well as improved patient and nurse safety,” stated Fran Turisco, research principal at Computer Sciences Corporation and co-author of the report.
“We interviewed practicing nurses at hospitals to understand the problem that initiated implementing the technology, why a specific technology was selected and how it has helped to improve nursing care,” said Turisco.
Although difficult, unraveling the care process is a necessary first step to identify specific workflow and efficiency issues.
“Hospitals that spent time understanding and measuring the problem, charting the workflow and the information hand-offs, and then using this knowledge to put together their desired solution had high success rates,” Turisco said.
Another important factor was having a multi-disciplinary team that included nurses and that was willing to openly discuss problems and options that involved changes to roles and responsibilities.
For example, one hospital implemented delivery robots to free up nurses and pharmaceutical technicians and redesigned the workflow to include the technicians as part of the care team.
“These changes improved nurse satisfaction with pharmacy services and job satisfaction for both nurses and pharmacy techs,” noted Turisco.
For each technology, the report included a description of the problem, the solution and the resulting improvements categorized in four areas:
* Increasing efficiency by removing nurses from tasks that do not require their attention
* Improving patient safety and quality of care
* Helping to deliver care by empowering patients and others to assume new delivery roles, thereby making nurses more efficient
* Enhancing collaboration and communication
“Our findings indicate that many of the technologies we examined demonstrated improvement in more than one area,” said Turisco. “For instance, wireless communications solutions including alarm/event messaging improved nursing care delivery in three areas: efficiency, safety and quality, and collaboration/communication.”
When asked about which technology had surprising results, Turisco identified workflow management systems as both relatively quick to install and having a number of different uses and benefits. These applications collect information from multiple sources and integrate it into a single display that highlights key information such as available beds, patients awaiting discharge, patients at risk, new patient order and results. They also can be combined with radio frequency identification systems to track the location of patients and equipment.
For example, a three-hospital system evened out the census among the facilities by consolidating bed availability display across the hospitals and then offering patients a choice.
“By providing a choice to the patients to wait for a bed at one hospital or to be admitted immediately at another, the health system improved census and bed turns and increased patient satisfaction,” noted Turisco
The California HealthCare Foundation publication is available at Equipped for Efficiency: Improving Nursing Care Through Technology - CHCF.org
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