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Instrumented In-room sensing devices authenticate nursing staff and trigger the
retrieval and display of relevant patient information.
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Bringing intelligence to the bedside
Solution components UPMC’s SmartRoom solution is supported by real-time linkages back
into key clinical systems such as pharmacy and lab services. At any
Software
● IBM WebSphere® Message Broker
given time, the underlying workflow module compiles a list of required
● IBM WebSphere Application Server tasks from various backend systems, using algorithms derived from
UPMC nursing staff activities that indicate the order in which tasks
Servers
should be done. To control access to this information, SmartRoom
● IBM BladeCenter® HS21
employs indoor positioning technology from IBM Business Partner,
Services Sonitor Technologies, which uses in-room ultrasound sensing devices
● IBM Global Business Services® to identify the nurse—or any other hospital staff member—entering
● IBM Global Technology Services
the room. Once authenticated, the nurse calls up the task list on the
IBM Business Partner display screen within the room. Upon performing the task, the nurse
● Sonitor Technologies can easily confirm on the touch screen that it was completed, and this
triggers the automatic updating of the appropriate electronic records.
Additional clinical information can be pulled up in the room with the
patient’s permission.
“SmartRoom improves
the quality of care by Importantly, UPMC designers realized that the true test of
providing information SmartRoom’s effectiveness is its ability to adapt to the decidedly non-
linear nature of the average nurse’s task sequence. Interruptions in the
directly to the bedside— core workflow can range from brief (getting a blanket for a patient or
where it’s needed most— new physician orders) to prolonged (an extended discussion with a
patient’s family). In either case, time lapses and priorities change. The
not to a computer in the
intelligence of the UPMC solution is seen in its ability to dynamically
hallway or to a worksta- adapt the task list based on the comparative time sensitivity of the
tion at the nursing different tasks on the list. This means, for instance, that a task initially
placed fourth on the priority list could be escalated to the number one
desk.” priority, if not performed within a specific timeframe. This rules- and
intelligence-based adaptability ensures that UPMC patients receive the
—David Sharbaugh, senior director of
UPMC’s Center for Quality Improvement and
Innovation
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right treatment at the right time. While technology enables this intelli-
gence in the form of algorithms, the logic that guides it comes directly
from the clinical knowledge of UPMC nurses and physicians. Rather
than trying to industrialize nursing or deploy a new gadget, this tech-
nology is making routine tasks easier and allowing nurses more time to
do what they are trained for—critical thinking and spending time with
patients at the bedside.
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directly to the bedside—where it’s needed most—not to a computer in
the hallway or to a workstation at the nursing desk,” says Sharbaugh.
“The less nurses have to focus on mundane, predictable tasks, the more
they can focus on the human, compassionate side of patient care.” The
same dynamic holds true for the time spent documenting completed
tasks. By sharply reducing this part of the nursing workload—the
reduction was 57 percent in the initial 22-bed evaluation unit—
SmartRoom enables nursing staff to spend more time at the bedside
and less walking to and from a computer terminal. Finally, SmartRoom
is also expected to improve patient safety by providing nursing staff
with bedside access to detailed, up-to-the-minute information on not
only prescriptions and doses, but also allergies and risk factors such as
patient falls—all of which give caregivers the tools they need to make
the right clinical decisions.
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