Each time an alarm would go off, signaling a possible problem with a patient, the notification would go to a central telemetry station. Technicians would then page the nurse on duty, but the nurse might be busy or otherwise unable to respond to the page.
It took a wireless solution to ensure the timely and consistent delivery of alarms to the caregivers best placed to respond.
“We spent some time ripping apart our process and systematically looking at where the failures in that process were occurring,” says Bonzheim, director of noninvasive cardiology. “The tech would page the nurse and it would give very little information: the room number, the level of the alarm and a number to call back. But a nurse is trying to do a lot of different things, and it was just taking too long.”
The solution came from Vocera Communications. Each nurse now wears a communications badge into which Vocera has integrated a Wi-Fi chipset. Voice traffic is turned into IP data, sent to the nearest access point, routed through the LAN and delivered to its destination.
Nurses are assigned numbers, with each number associated with a patient room. If an alarm sounds in a given room, the nurse is notified through her badge. If the nurse fails to respond, the message is bumped up automatically through the chain of command until someone answers the call.
At Vocera, vice president of marketing Brent Lang says the system almost had a Bluetooth foundation in the early days. In fact, the company had already made Bluetooth headway in 2001 when it decided to re-engineer into Wi-Fi mode. “We realized that Wi-Fi was about to explode and that there was going to be Wi-Fi infrastructure already in place,” he says.
The resulting system has been a hit at Beaumont Hospitals, where alarms are generated by transceivers attached to cardiac patients. Since the system was put in place, response times have dropped from 9.5 minutes to an average of 39 seconds, according to Vocera.
Bonzheim says she is especially pleased with the handsfree, voice-activated nature of the Vocera badges, which make it easier for nurses to respond to alarms without interrupting their ongoing tasks.
In addition, it helps that badges are identified by number rather than by name. That allows dispatchers to easily reference the caretaker associated with any given room.
The number system also helps ensure the hospital’s wireless transmissions stay within the HIPAA privacy regulations. “The alarm information that is communicated to the nurse is fairly short and can be done by room number, so you don’t have to communicate patient information per se,” Bonzheim says. Since the badges are wireless, a wearer also can step into an empty room for further privacy if needed.
Transition to the new system has sometimes been a little bumpy because of the human factor. “We have quite a mixture of people on our nursing staff, and some are not as excited about technology as others,” Bonzheim admits.
On a more practical level, trouble can arise when members of the nursing staff speak in a variety of accents. Vocera can manage this to some extent, as each badge is capable of “learning” its user’s intonations. For the 10 staff members who performed especially low on the voice recognition side, the hospital has provided additional training.
Beaumont Hospitals ran a pilot test of the system in August 2005, and started rolling out a full deployment in the spring of 2006. So far, the system covers about 200 people in three of the hospital’s 14 nursing units at a price of roughly $300 per badge, Bonzheim says. Eventually, the system should cover all 14 units.
Ultimately, the wireless badges have helped deliver a new level of teamwork in the hospital, where better communications have made nurses better able to respond to evolving situations in a timely fashion. This in turn drives better care all around.
“If the team works well together, the patients are going to be safer,” Bonzheim says.