Cows Help Sick Children

The Age

Tuesday March 6, 2007

Beverley Head

Computer on wheels are giving nurses more time with small patients, writes Beverley Head.

THE emergency department at the Children's Hospital at Westmead in NSW has freed up about 20 hours a day by using a wireless computer and communications system that allows clinicians to spend more time with patients, not paperwork.

Computers on wheels (COWs) connect to a wireless network and voice-activated communications "badges", worn on cords around clinicians' necks or clipped to their clothes.

Doctors and nurses can access computer-based patient information at the bedside, and also make and receive phone calls or respond to pagers while roaming the department.

Sue Hawes, nurse manager in the department, which sees 26,000 patients a year, says having bedside access to information systems means nurses are "working smarter". "The benefits of real-time information means nurses aren't kept away from the bedside," she says, adding that they also weren't having to stay back after shifts to complete paperwork. "We have more time to spend with the patients."

The system is improving triage results, with more patients being seen sooner, she says. The benefits for children with medical conditions that regularly land them in emergency are particularly significant. According to Ralph Hanson, director of information services at the hospital and a former emergency department head, retrieving a child's record might previously have taken 30 minutes. But the COWs mean a record can be retrieved at the bedside in seconds.

Three COWs (notebooks on specially designed ergonomic trolleys) have been deployed in emergency, with a further seven being used in the hospital's operating theatres and day surgery.

Dr Hanson says 40 Vocera wireless communication badges have been deployed in the hospital - the bulk in emergency, plus four nursing staff in the surgical ward. If more privacy is required, clinicians can wear a head-mounted earpiece and microphone to take and make calls.

Wireless access points have been established in emergency, operating theatres, surgical wards and the hospital cafeteria.

Trials are under way in the United States to allow clinicians wearing a Vocera to interrogate the computer-based patient information system; for example, to determine whether a patient has any known allergies.

Further down the track, Dr Hanson hopes, RFID (radio frequency ID) tags can be used to tag equipment and track patients. "We could process patients better by tracking them better," he says.

All wireless technology was tested for compatibility with the hospital's sensitive equipment. It was found that the diathermy (ultrasonic heating) machines interfered with Vocera, but the machines were not affected by the Vocera units.

Besides allowing faster hands-free communication, Mrs Hawes says, the Voceras allow nurses who are in a threatening situation to discreetly call for help. "If nurses are feeling at risk of abuse, they can push the Vocera button twice and the rest of the team is alerted to a problem and can come to help."

Dr Hanson says the hospital paid $700,000-$1 million for the emergency department wireless revamp, although the total cost of the system was considerably higher and paid for by donations from the vendors in the pilot program.

The new network, which replaces an earlier wireless trial system, has been implemented by Cisco in partnership with Dell, Intel, Cerner, PowerClinical, Vocera and IBM.

A study of the Westmead implementation conducted by the NTF Group and released by Cisco last week identifies savings of 20 hours a day by the emergency department, and suggests that rolling out the system across the hospital could lead to significant savings, perhaps $7 million a year or more.

NEXT LESSONS

? Problem: Paperwork was taking too much time and was a distraction from patient care.

? Process: A wireless network allowed better and faster communication in the emergency department and surgical ward.

? Possibilities: Wireless data and voice systems can be made interoperable, and RFID technology can be brought in to track patients and equipment.