“Aruba’s 802.11n solutions deliver assured access to latency-sensitive communications services, regardless of where the clinician is working. That makes possible a wide range of new opportunities to improve patient care and reduce staff workload.”

“Unlike general data access services, point-of-care voice and video communications are latency-sensitive and require special handling,” said Manav Khurana, Aruba’s Head of Industry Marketing. “Our high-speed 802.11n wireless LANs are application-aware, and automatically adapt themselves to deliver the bandwidth, airtime, and quality-of-service required by unified communication applications at the point-of-care. The resulting wire-like performance enables Motion’s platforms to take clinical productivity to a new level.”

The Motion C5 is a hospital-grade slate tablet PC and the healthcare industry’s first Mobile Clinical Assistant,MCA. The tool improves clinical productivity, optimizes electronic medical record (EMR) utilization, and enhances clinician efficiency by enabling the use of technology directly at the point of care. The flexible MCW-200 workstation improves communication and collaboration involving complex work-flows and information-rich content, delivers up to 15 hours of battery life, and is available with integrated voice and video support. Aruba’s Adaptive Radio Management (ARM) technology improves the wireless performance of both devices by automatically optimizing Wi-Fi band selection, load balancing, and power levels in real-time, an important function in a healthcare facility’s dynamically changing RF environment.

“Providing unified communications and automated patient data management at the point-of-care requires that the Wi-Fi network follow in lock-step as clinicians with C5 or MCW-200 devices roam through a hospital campus or satellite clinic,” said Mike Stinson, Motion Computing’s Vice President of Marketing. “Aruba’s 802.11n solutions deliver assured access to latency-sensitive communications services, regardless of where the clinician is working. That makes possible a wide range of new opportunities to improve patient care and reduce staff workload.”

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Pia Andersen¹, BSc; Anne-Mette Lindgaard¹, BSc; Mirela Prgomet², BAppSc(HIM); Nerida Creswick², PhD; Johanna I Westbrook², PhD

¹Medical Informatics Group, Department of Health Science and Technology, Aalborg University, Denmark
²Health Informatics Research and Evaluation Unit, University of Sydney, Australia

Corresponding Author:

ABSTRACT

Background: Selecting the right mix of stationary and mobile computing devices is a significant challenge for system planners and implementers. There is very limited research evidence upon which to base such decisions.
Objective: We aimed to investigate the relationships between clinician role, clinical task, and selection of a computer hardware device in hospital wards.
Methods: Twenty-seven nurses and eight doctors were observed for a total of 80 hours as they used a range of computing devices to access a computerized provider order entry system on two wards at a major Sydney teaching hospital. Observers used a checklist to record the clinical tasks completed, devices used, and location of the activities. Field notes were also documented during observations. Semi-structured interviews were conducted after observation sessions. Assessment of the physical attributes of three devices—stationary PCs, computers on wheels (COWs) and tablet PCs—was made. Two types of COWs were available on the wards: generic COWs (laptops mounted on trolleys) and ergonomic COWs (an integrated computer and cart device). Heuristic evaluation of the user interfaces was also carried out.
Results: The majority (93.1%) of observed nursing tasks were conducted using generic COWs. Most nursing tasks were performed in patients’ rooms (57%) or in the corridors (36%), with a small percentage at a patient’s bedside (5%). Most nursing tasks related to the preparation and administration of drugs. Doctors on ward rounds conducted 57.3% of observed clinical tasks on generic COWs and 35.9% on tablet PCs. On rounds, 56% of doctors’ tasks were performed in the corridors, 29% in patients’ rooms, and 3% at the bedside. Doctors not on a ward round conducted 93.6% of tasks using stationary PCs, most often within the doctors’ office. Nurses and doctors were observed performing workarounds, such as transcribing medication orders from the computer to paper.
Conclusions: The choice of device was related to clinical role, nature of the clinical task, degree of mobility required, including where task completion occurs, and device design. Nurses’ work, and clinical tasks performed by doctors during ward rounds, require highly mobile computer devices. Nurses and doctors on ward rounds showed a strong preference for generic COWs over all other devices. Tablet PCs were selected by doctors for only a small proportion of clinical tasks. Even when using mobile devices clinicians completed a very low proportion of observed tasks at the bedside. The design of the devices and ward space configurations place limitations on how and where devices are used and on the mobility of clinical work. In such circumstances, clinicians will initiate workarounds to compensate. In selecting hardware devices, consideration should be given to who will be using the devices, the nature of their work, and the physical layout of the ward.

(J Med Internet Res 2009;11(3):e32)
doi:10.2196/jmir.1221

KEYWORDS

Study; multi-method study; observational study; mobility; mobile computers; computers; computer hardware; medical order entry systems; computerized physician order entry system; computerized provider order entry (CPOE)

Read more about Mobile and Fixed Computer Use by Doctors and Nurses on Hospital Wards

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Mobile point of care technology is key to improving both workflow and patient outcomes. If your organisation is identifying critical components and determining plans find out fromthree industry thought leaders on how other hospitals and healthcare organisations are approaching this task.

There was information on three key practices for deploying mobile point of care technology:

• How to identify the right form factors or hardware solutions
• How to choose the right wireless deployment for the needs of all in the facility
• The Big Picture – from planning to implementation—the critical task of transforming clinical workflow

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