Nurses and other staff on the Sanford Health Innovation Unit in Fargo are testing a unique electronic rounding dashboard that displays when each patient had their last hourly visit, or care round, from a nurse.
It’s the brainchild of Heather Perez, MSN, RN-BC, a nursing practice specialist, who looks for ways to use technology to improve patient care and reduce some of the burden on nurses.
“You lose track of time. You don’t realize how fast the time flies by,” she said of patient rounding. “We’re all so busy that sometimes it just doesn’t happen.”
Rounding involves stopping by a patient’s room at least every hour to ask about the four Ps: whether they have pain, if they need to change position, what personal items they need and whether they need to use the restroom (potty).
By doing those regular rounds, patients expect the nurse to stop by and are less apt to push the call light if their need is not urgent. That reduces the alarm fatigue nurses can feel over time, which was one of the problems Perez sought to solve.
“Those alerts are distracting when you’re trying to perform care,” she said. “It was really an idea of a visual tracking system without the audible alerts. Trying to get away from the audible alerts and look more for the visual alerts. So just using the dashboard as a visual in the team station that everyone on the team can be aware of who needs to be rounded on.”
How electronic rounding works
After a nurse performs an intentional care round, they push a doorbell-like button near the head of the bed in the patient’s room. Because all staff members wear real-time location system, or RTLS, badges, the electronic rounding system knows who’s in the room and records the round on a large video display in the nursing station.
When a care round is not due, that patient room shows up as green. The room appears yellow on the dashboard 15 minutes prior to when the next round is due. And it appears red once a round is due. The timing changes between days and nights, per policy.
“The dashboard displays who needs to be rounded on,” Perez said, so other nurses and team members who are free also can jump in. “If I have time and I see my coworker struggling, I can go help them.”
“We actually have seen an improvement in the patient satisfaction as well with this, knowing that we’re there and that we’re going to be back when we say we’re going to be back,” she said.
The button also offers the opportunity to educate family members about the care the nurse is providing, Perez said.
Dashboard is team effort
Perez said that though the idea was hers, numerous other people have contributed to the electronic rounding dashboard becoming reality.
After Fargo leaders identified the potential for the idea to solve a problem in the organization, Sanford Health engineers Jason Thomas, Jordan Mudek and James Engelstad helped design and build it. Merideth Bell, project manager for the innovation unit, helped coordinate its testing by all staff on the unit. She also reached out to Tyler Remund on the company’s innovations team in Sioux Falls. He is evaluating the idea to determine if it has market potential.
“The electronic rounding dashboard proves that Sanford Health can take ideas in from all over the organization, try them out on the innovation unit and identify improvements that help our own patients as well as those at other health care organizations,” Remund said.
“Without their help, we wouldn’t have data and metrics to prove this is successful,” Perez said of the innovation unit staff. “We’ve seen a 50% drop in patient falls. Patient satisfaction is up. We also see zero pressure injuries (from patients confined to a bed). Staff communication has improved, as has knowledge of what an intentional care round is when we push the button.”
Perez began her career as a nurse and has a master’s degree in Nursing and Healthcare Informatics.
“That involves using technology to improve patient care and decrease the burden on the health care workers,” she said. “I love what it’s doing and proving to work because I really want to bring technology to the frontline staff.”
Next steps for dashboard
The next steps for the dashboard are to explore a smartphone app and expand its use, Perez said.
“I really want to get this to other patient units because I see how valuable it is,” she said.
“It’s been great to have an idea and bring it to the innovation unit. Anybody can bring an idea. I really want to encourage people that have ideas to bring them forward. Nurses and other frontline staff have great ideas, but nobody knows them if they don’t pursue them,” Perez said.
Sanford Health values the ideas and problem-solving ability of its physicians, researchers, clinical workers and support staff. Any employee with an idea for a device, therapy, software, tool or other method that helps patients is encouraged to contact the innovations team.
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