The opening of MetroHealth’s state-of-the-art Glick Center coincided with the turbulence of Autumn 2022. Health care systems across the country were trying to get their post-pandemic footing. Hospitals were struggling with economic pressures, staff shortages, and increased violence against staff. Care teams confronted the complexity of managing patients coming back into facilities after an extended period of virtual or deferred care. “This was a chaotic time. The pandemic was still lingering. Our staff was also dealing with a multitude of issues and concerns coming into the hospital. So, looking at our team, it was important to do all we could to reduce cognitive load,” shared Julia Mason, DNP, MBA, RN, CENP, SVP Patient Care Services and Chief Nursing Officer Hospital Division.
Fortunately, the new Glick Center implemented Digital Whiteboards and Door Signs that improved care collaboration amongst patients, families, and staff while helping to reduce that cognitive load. “It starts with the Door Sign. If I can get visual cues at room entry about specific precautions, language preferences, and/or diet associated with a patient, it’s one less thing me, as a nurse, needs to worry about tracking down. It’s easy, it’s accurate and I’m ready to focus on the patient,” explained Dr. Mason. And because the information was being updated from the medical record, staff were confident they could trust the accuracy and currency of the information.
Digital whiteboards are also a great staff satisfier. With the best of intentions, the information on dry erase boards tends to fall out of sync. It’s difficult to have team members update their name and role let alone write out information that patients want to see from the medical record. The result is increased calls to the nurses’ station for updated information and frustration for all parties. The integrated digital whiteboard presents up-to-date information from multiple hospital systems which, like the digital door signs, improves trust and confidence in the information and supports a superior experience for all parties.
The benefits also extend to patients by providing a sense of control. “We take their clothes, tell them when they can eat, insist they call for help to go the bathroom, and interrupt them to check vitals and dispense meds,” Dr. Mason explained. “So proactively sharing information using our RTLS system to present a staff member’s name and role goes a long way to easing a patient’s mind and helps reduce their cognitive load that is impacted by all that is going on around them in an unfamiliar environment surrounding by intimidating equipment that keeps making noises.” Family members also benefit. Knowing who is on the care team and what is on the patient’s daily schedule allows care partners to support their loved one in a manner that aligns with staff efforts. For example, post-surgery, patients are often very hungry because they had been on NPO orders. Real-time dietary updates on the whiteboard confirming it is OK to eat improves the post-op experience.
The Glick Center has been open for about six months. MetroHealth has discovered that the technology provided by the digital door signs and whiteboards has been a great adjunct to the training the staff receives. Ongoing efforts to improve nurse communication is a focus area for staff and the efforts have been paying off as reflected in improved HCAHPS scores. The new technology enhances those programs.
Tips and Tricks
Julia Mason along with Sandi Duke, Manager of Inpatient Informatics, and Tim Patterson, Technology Product Manager, shared the following tips when looking to implement this and other technology.
1. Be sure to involve multiple stakeholders. For a project like this one, beyond front line staff including nurses, attending physicians, therapists, be sure to get input from anyone whose data will be used on the system. For the Whiteboards and Door signs, this included dietary, facilities, pharmacy, to name a few.
2. Get patient feedback on the design. MetroHealth solicited input from their PFAC (Patient and Family Advisory Council) as part of the process.
3. Monitor, adjust and make sure shared data is patient friendly. For example, MetroHealth translates 2gm NA to Low Salt Diet reducing patient confusion and questions.
4, Be flexible. “The pCare system and team were both flexible,” Ms. Duke shared. “One size does not fit all and fortunately the pCare system allows for individualization based on preferences. We were not locked into what and how we presented information. And the pCare staff has been very responsive each step along the way.” As we go to press, MetroHealth is working on special whiteboard configurations for Labor & Delivery and the NICU.