With so many mobile workstations in the market, the question becomes how does a clinician choose the best cart for the ever-changing workflows in a healthcare setting where the main objective is quality bedside point of care?

Of the many aspects to consider when evaluating mobile workstations, here are 10 of the key areas to focus on:

• Battery. Does it offer long battery life that empowers your workflow rather than hindering it? Does it provide a visual means of indicating battery charge status?  Does it offer a visual or audible alert when the battery requires recharging? What is the charge replenishment time?
• Mobility. Is the cart lightweight? Is it easy to roll on and off carpeting? Does it roll easily on bare floors and on and off elevators? Is it easy to grasp, push and maneuver down hallways and in and out of patient areas?
• Ease of use. Does the cart offer easy access to “on” and “off” computer switches? Is it easy to plug in and unplug equipment residing on the cart? Are adjustment mechanisms user friendly?
• Ergonomics. What height and utilization adjustments are possible? Are they easy to make? Will adjustments made stay in place? How easy are adjustments to change for different users?
• Size of the cart. What are the dimensions? Will it fit easily through doorways? Will it maneuver easily around a patient’s rooms?
• Safety features. Do the wheels lock? Are they easy to lock and unlock? Is the cart sturdy and will it stay in place without continual adjustments? Is the cart stable, minimizing potential for tipping over?  Is there a wire management system on the cart?
• Infection control.  Are the surfaces smooth with minimal crevices to avoid trapping dirt and bacteria? Are they easily cleansable with recommended cleaning agents?  Do they contain an antimicrobial coating to resist bacterial growth and colonization?
• Workspace. Does the cart offer sufficient workspace beyond simply holding the computer client? Is there enough work surface for documentation and clinical supplies? Does it offer extra storage space?  Is the surface well lit for low lighting environments?
• Keyboard. How convenient is its location? Is it adjustable? Are adjustments easy to make? Does the location offer enough space to comfortably enter data? Is the keyboard well lit for low lighting environments?
• Monitor. How convenient is viewing? Does it tilt? Is it adjustable for height? Does it offer an acceptable viewing distance?  Does it feature patient privacy screens?  Is it large enough to accommodate viewing at a distance?

In our next post, we’ll talk about which of these ten aspects may be THE most important element to consider, and why.  Stay tuned!

To provide some more insight, we created a map of a typical hospital floor which illustrates 20 key services and solutions that InfoLogix, HIA, Delta and Stanley provide today.  Together, we’re proud to be serving more than 4,800 healthcare organizations. 

Take a look at the animation

Some nurses report spending as much as an hour per day in their quest to locate equipment.  What’s even more concerning is that even when they find it, it’s not always guaranteed that it will be in proper working order … and so, the search continues.

In an effort to avoid risk, improve clinical outcomes and increase staff productivity, we’re seeing an increasing number of  hospitals take action by instituting asset tracking systems in their facilities.  They are tracking everything from patient throughput in the ED, to smart pumps on the floors, to patient conditions through remotely-transmitted patient health data and emergency alerts.

What’s particularly notable here are the results that are being achieved.  For example, according to a recent Healthcare IT News article, some hospitals have reported a cost savings of as much as $750,000 annually, better equipment utilization, and reduced risk of negative patient outcomes from searching for needed equipment (thus delaying treatment).   At the same time, nurses are reporting more face-time with patients, improved quality of care, increased patient satisfaction, and bolstered staff morale.

Here’s a novel thought:  as technology continues to take the inpatient experience to new levels, wouldn’t  it be great if critical equipment took a note from the family dog, and would just come when called?   Out at HIMSS11 last week, we saw one hospital report that only 53% of their RNs’ time was being spent on direct patient care.   We’d be willing to bet that “chasing equipment” accounts for a significant part of that gap.  In terms of cost / benefit, there’s a very strong case to be made for RTLS here.

1. LOOK AT THE NETWORK
Analyze and make any necessary upgrades to the health and capacity of your network infrastructure to support wireless devices.  Don’t forget to plan for future needs for Point of Care (POC) devices including handhelds and PDAs that physicians and other clinical practices will want to use for not only BMV, but also EHR bedside documentation and CPOE.

2. ESTABLISH UNIT DOSE PACKAGING
Establish unit dose packaging with readable barcode language for your medications.  This can be costly and create significant work for the pharmacy, but is necessary to effectively implement BMV and meet the established guidelines and standards.

3. EXAMINE THE WORKFLOW
Analyze and Map your existing and future nurse workflows to understand how medications are currently administered at the bedside and how those workflows will change with the implementation of BMV.  This should include a risk assessment of the various models for BMV being considered.  Once a thorough risk assessment is completed and the best model is selected for a particular workflow, a thorough training program that includes routine evaluation and possible modifications with scheduled repeat retraining should be documented and implemented to track ongoing progress and outcomes.

4. DETERMINE THE DEVICE RATIOS
Plan for enough mobile devices to adequately support your clinical staff.  This includes nursing, RT, laboratory and blood bank technicians and any area that will be looking to document procedures at the point of care.  It has been found that the number of mobile device required is more than the number of beds on an inpatient unit.  This reduces the wait time clinicians may encounter in gaining access to the EHR, increases real time documentation at the POC, minimizes work arounds and fosters greater adoption of BMV by all parties.

5. NO TWO CULTURES ARE ALIKE
Every organization has their own unique culture.  Taking this into consideration, while recognizing and planning for the significant impact on nursing, will promote the success of BMV implementation in your organization.

6. ENSURE PROPER BUY-IN
Involve Senior Management and gain their fervent support.  This is critical to the successful adoption of any implementation.  Identify key champions across various disciplines that can promote the goal of reducing medication errors and increasing patient safety.

7. PLAN UPFRONT FOR THE TRAINING
Establish purposeful and well planned training for clinical staff.  Nurses view their role as a patient caregiver.  Some may not be strong computer users and will need additional time and training to strengthen this skill.  Highly educated, computer literate nurses minimize end user issues and foster higher adoption rates, ultimately improving the nurse/patient experience.

8. COMMUNICATE, COMMUNICATE, COMMUNICATE
Communicate your results and outcomes with the bedside nursing staff.  Establish venues to share lessons learned among staff.  This will increase ownership of the BMV process and demonstrates better adoption rates with increased nursing and patient satisfaction.

Remember that statistics show that a solidly planned and implemented BMV process avoids medication errors, increases nursing/patient satisfaction and improves patient outcomes.

On May 1, 2010, Hilo Medical Center was the first State hospital to launch the system, named “Health Connect” by employees. InfoLogix and our Healthcare Informatics Associates (HIA) team helped drive the MEDITECH implementation, as well as providing wireless and mobile technology to connect it to the point of care.

View the video clip and news release