Magazine Article | January 29, 2013

Mobile Carts Move Staff Workflows Right Along

Source: Health IT Outcomes

By Health IT Outcomes staff

St. Peter’s Health Partners benefits from the improved patient engagement and real-time charting made possible by a new mobile computing cart investment.

Mobile carts don’t carry quite the cachet their brethren in the mobile health space hold. Tablets, smartphones, and apps are certainly in demand when it comes to healthcare, but it’s important to remember that mobile carts helped pave the way for mobile, point-of-care IT resources and still underpin much of today’s bedside care within hospitals. According to HIMSS Analytics, mobile cart adoption increased by 19% between 2008 and 2011, reaching an almost 50% adoption rate at the point of care amongst those surveyed. While patients and visitors might not give them a second glance, hospital staff — especially nurses — recognize the valuable (and still growing) role mobile carts play in efficient care and quality outcomes.

St. Peter’s Health Partners, an Albany, NY-based health system formed in 2011 through the merger of St. Peter’s Health Care Services, Northeast Health, and Seton Health, had a love/hate relationship with an older generation of mobile carts that, according to CIO Jonathan Goldberg, were past the point of repair. “It was a constant case of trying to find a Band-Aid solution to keep the devices working,” he explains. The carts, used at the time only in St. Peter’s registration department, were necessary for day-today operations, but became increasingly burdensome to staff due to battery problems and other equipment issues. “They weren’t used in patient care so much, but they were affecting employee workflow,” Goldberg adds.

Goldberg and his team made the decision to purchase new mobile carts in 2009, coinciding with (and likely necessitated by) the decision to implement Siemens’ Soarian Clinicals online patient care database.

“We were at a point where we were going to go live with Soarian Clinicals — the nurses and staff were also going to use Med Admin Check (MAK) barcode administration. We were just not going to be able to do that with the present devices we had,” Goldberg relates. “So we had to find another device that would enable those new technologies to be utilized properly.”

Goldberg realized that nurse buy-in would be essential to maximum utilization of the carts, especially in relation to how the carts would be implemented alongside the new patient care database.

“We had several meetings with the nursing staff and presented them with a couple of equipment choices,” he says. “They wanted to keep the carts as simple as possible — not heavy, not clunky. Not only did we conduct trials with the nurses using several different carts,” Goldberg adds, “but we also mocked up a patient room with a wall-mounted PC. The carts were chosen over this setup.”

Ultimately, St. Peter’s purchased 180 mobile carts from Capsa Solutions. Since the initial purchase, though, the hospital has periodically expanded its number of carts to 323 to facilitate the need that arose from new building construction and increased demand from staff. Carts are used throughout the hospital by nursing, physicians, respiratory therapists, the registration department, and case managers.

Once St. Peter’s nurses became accustomed to the new carts and all their features, workflow benefits were quickly realized. “The first and foremost benefit is the mobility,” Goldberg explains. “The staff seemed to like the ability to take the device anywhere, sit down and do their work, and not be confined to a certain workspace as they would be with a desktop computer. Subsequently, they’ve also enjoyed being able to roll the cart right up to the patient bedside for real-time charting. The patient’s data stays with the patient at the time of engagement.”

In an attempt to maximize use of the carts and to make them as user-friendly as possible, Goldberg also decided to implement, in conjunction with the new MAK application, wireless Bluetooth bar code scanners to scan medications and patient wristbands.

In an era of alert fatigue, impending staffing shortages, and an increasing level of scrutiny placed on PHI, the point-of-care data entry that the mobile carts enable may help to eliminate further complications down the road. As most people in the healthcare industry realize, efficiency tends to foster quality, and it seems providers would be wise to consider the workflow benefits mobile carts bring to healthcare delivery.