Staff Workflow and Nurse Call Automation at Mater Health

Mater and CenTrak collaborate to enhance technology at a cutting edge new hospital

Mater comprises a network of hospitals, health centres, a world-class medical research institute, a nationally accredited registered training organisation, and pathology and pharmacy businesses. Mater has a strong focus on cancer and neurosciences, women’s health and newborn services, and the care of young adults and adolescents.

Mater Private Hospital Springfield is a newly built $85 million hospital equipped with cutting-edge technology. Stage one has 80 beds with services offered to medical and surgical patients and a dedicated day oncology service.

As an innovative greenfield site, Mater wanted to deliver proven technology in order to enhance the safety of patients and efficiency of work practices at the new site. To support this goal, Mater worked with CenTrak to implement a Real-Time Location System (RTLS). Based in the United States, CenTrak is identified as an industry leader in developing accurate and speedy real-time locating systems (RTLS) for healthcare facilities

What Is RTLS?

In healthcare, RTLS is a system used to provide real-time management of medical equipment, staff and patients. RTLS solutions typically use location sensors with unique IDs embedded on tags. Using infrared technology, the system can locate the tags and display real-time location information within the hospital. Clinical-Grade Locating™ systems are able to achieve room, bed, bay and even shelf-level tracking.

Nurse Call

At Mater, CenTrak’s RTLS system has been integrated with the Rauland Australia Responder 5 solution. The integration of these two industry-leading products allows clinical staff to perform a variety of tasks automatically simply by wearing a purpose-built staff tag. These tags are similar in size and weight to the hospital's staff ID badges and are worn together, preventing staff from having to carry another piece of equipment.

Practical Functionality

When a patient presses the ‘nurse call’ button in the room the following automatically occurs:

1. A bright white ‘nurse call’ light illuminates outside the patient's room in the corridor.
2. The system sends a message to the assigned nurse via their wireless phone.
3. An annunciating monitor displays all of the current nurse calls and relevant waiting times in the corridor.
4. If the assigned nurse is with another patient and unable to respond, the system alerts the (second responder) assigned nurse and becomes audible providing the entire team the ability to respond.

Nurse Presence and Automatic Cancellation

Practical Functionality

When a nurse enters a patient’s room, the following automatically occurs:

1. The system automatically detects and records their presence.
2. The nurse's presence in the room is indicated in the corridor by a green light
3. If a call has been made, the call is canceled – it does not have to be manually overridden by the nurse
4. The green corridor light remains on whilst the nurse is present in the room
5. When the nurse leaves the room, the green lights turn off

The Benefits

Integrating RTLS into Mater Private Hospital Springfield processes primary benefit is targeted patient safety, efficiency of workflows, and the ultimate benefit being enhanced, patient experience.

Practical Functionality

A key foundation of patient safety is an effective and responsive system for responding to nurse calls. CenTrak supports the ability to:

• Promptly respond to patient needs
• Set KPI’s for response times and report against these KPI’s
• Document the exact amount of time a nurse was present in a patient room
• Avoid touching the cancel call button which enhances hand hygiene

Efficiency of Workflows

Since the implementation of CenTrak, with integration to Responder 5 solution:

• Nurses on duty are assigned to patient beds, allowing for visibility of case/patient load during each shift
• Nurses are quickly alerted about calls from their patients
• A quick glance down the hospital corridor quickly shows which patients have made a call (white light) and which rooms have a nurse presence (green light)
• Nurses do not have to manually press the call button to cancel the call after entering the room
• Detailed and customisable reports enable managers and administrators to review actual and historical nurse response times

The Data Perspective

• CenTrak, with integration to Responder5 solution, provides the ability to measure and report accurate, precise call bell response times for all disciplines
• Reportable response time to calls was reduced from 5 mins to 3 mins to comply with statutory reporting
• Equipped with new reporting capability, the business saw the opportunity to drive improvement to call bell response times and hold teams to account with the below outcomes:
  • Ward Level Response time for calls at 3 mins increased from 53% to 94%
  • Overall Response time for calls at 3 mins facility-wide increased from 76% to a consistent 95%
• Improved workload management via visual staff assignment in Rauland Responder5 solution
• Improved call vs. response time reporting capabilities capturing daily, weekly, monthly statistics presented at both Bed Management and Board level

Safety Focus – Managing nurse calls for isolated patients at Springfield

During 2016, there were 7,878 episodes of care provided at Springfield. Approximately 30% of patients had isolation precautions in place. When patients are isolated at Springfield, standard procedures include hand hygiene and gown, glove, and mask. These precautions are taken to protect patients, families, and healthcare workers from infectious agents.

Before CenTrak, when an isolated patient made a nurse call, a nurse was required to gown, glove and mask before communicating with the patient and canceling the nurse call button located beside the patient’s bed.

With the implementation of Nurse Presence, the RTLS tag is recognised by the system when the nurse is in the doorway of the room, the call is canceled and the nurse presence light in the corridor is illuminated. At the threshold, the nurse engages with the patient without touching anything in the room. After communication, approximately 25% of patients will require direct nurse assistance – for example, help being moved into a comfortable position, which will require full isolation procedures. The remaining 75% do not require direct nurse assistance avoiding the need to gown, glove, and mask and enter the room. This has been estimated to save 1,007 nursing hours per annum.

Patient Experience

Ultimately, patients at Mater Private Hospital Springfield expect to receive exceptional care. Most nurse calls made by patients relate to questions about their care and requests for help with water, toileting, mobility and pain management. Quick staff responsiveness to these needs enhances the healing process and patient experience.

Should a complaint arise about the responsiveness of staff, detailed reports about nurse presence and rounding can be reviewed. By enhancing safety and supporting the evaluation of patient feedback CenTrak has enabled Mater to enhance the patient experience.

Potential Future Rollout

Hand Hygiene - Electronic monitoring systems proactively increase compliance, reduce the number of Hospital Acquired Infections (HAIs) along with the treatment costs and length of stays associated with HAIs. Electronic monitoring of hand hygiene could assist in identifying additional interventions and improve clinical workflows.

Contact Tracing - If a patient contracts an infectious agent, the system can be used to identify the Nursing Staff who have been in contact with particular patients.

Asset Tracking- In the future, RTLS tags could be added to medical device assets such as infusion pumps, blood pressure monitors, and equipment that circulates in the ward environment and can be required quickly for patient care. This functionality allows for the tracking per item and does not require linking to on-duty staff.

Mater allocated an RTLS tag to the key to the drug cupboard. Due to the critical nature of key visibility, connected with on-duty staff assignment, Mater Private Hospital Springfield opted for a sophisticated paging system using DD Finder that functions via a central button at the Nursing Station, when pressed, activates the pager attached to the drug key sending an immediate page to the nurse staff carrier that the keys are required at the medication room which has proven to save staff time and expedites medication administration.

Staff Duress - RTLS tags can be programmed to have a duress button. Pressing this button would immediately alert security and enhance the safety of staff at Springfield in emergency situations.