Technology is advancing at lightning speed in all industrial sectors, and healthcare is no exception. Operating theaters (SOPs) have become dominated by Technological innovations that support surgical procedures such as 3D imaging and robotics. Yet despite these advances, the clinical communication technologies that facilitate more effective collaboration among caregivers have yet to fully evolve.
Communication characteristics of care settings
For years the Mixed Commission highlighted the need to improve the effectiveness of communication and information sharing between medical teams to improve patient care. Hospitals and operating theaters are dynamic environments where multidisciplinary clinicians rely on a myriad of information and communication technologies. This layered approach is still common and is compounded by outdated communication systems used in many healthcare facilities. Some are a complicated mix of landline phones, pagers and whiteboards. Others rely on two-way radio systems that are regularly prone to reception problems and poor audio quality. Clinicians often carry too many single-use devices, making it more difficult to share information in a timely manner. As things stand, communication between complex care teams is already a challenge when wearing personal protective equipment (PPE), face shields and masks.
Overhead paging systems have been a mainstay of hospitals and medical centers for ages. However, the constant announcements contribute to a noisy and stressful environment, which may be correlated with poorer outcomes and lower HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) scores.
Healthcare design also plays a role in the quality of communication and workflows. For example, data shows that nurses spend a fifth of their shift coordinating care with team members from other departments and routinely cover up to eight kilometers in 10 hours. Some studies show that nurses waste 10-25% of their time looking for another staff member.
Delays caused by miscommunication contribute to slower response times, workflow inefficiencies, and impact critical decision-making, leading to poorer patient outcomes. When it comes to operating rooms, delays in activities necessary for preoperative preparation, procedures, and postoperative care can cost millions a year. A the average operating room minute costs $130which translates to $1.56 million for 12,000 surgeries performed in a year.
In an environment where patient safety comes first, gaps in communication and misinterpreted information are often responsible for serious medical errors and operational failures, which can lead to avoidable health complications for patients.
To truly improve the quality of care, healthcare organizations need more collaborative and less disruptive communication tools that enable greater workflow efficiency, faster response times, fewer errors and higher levels of higher security.
Transformative mobile clinical technologies
The adoption of mobile platforms for critical clinical communications has begun to proliferate in healthcare. Mobile systems are primarily comprised of software applications and hardware devices that operate over a wireless network.
Wireless-over-cellular (PoC) push-to-talk (PTT) is an example of a mobile communication technology that has transformative potential for medical teams. Essentially, PoC turns mobile devices like smartphones and tablets into walkie-talkies with Wi-Fi or cellular network connectivity. The cellular infrastructure provides a highly reliable network with unlimited coverage that requires no maintenance or operating costs.
The PoC also supports the use of encrypted voicemail applications, which allow clinicians to reach team members both inside the hospital and remotely, while maintaining confidentiality. It allows instant and discreet conversations with an individual or with groups, by channels or even by roles. Voicemail apps offer valuable features, such as record and playback, location tracking, and emergency alerts. They can also include secure text messaging or support for video calling, enabling more effective communications between care teams, with patients and with families.
Since clinicians multi-task while continuously on the move, having to stop to use an app on a handheld device is not always possible and can be intrusive for patients. The emergence of specialized wireless hardware accessories has made access to PoC applications faster and less disruptive. For example, with the touch of a finger, wireless PTT buttons control PoC applications on mobile devices, providing virtually hands-free communications. Plus, because they use Bluetooth Low Energy (BTLE) technologies, the buds run for at least two years on a single coin cell battery.
In recent years, surgeons and anesthesiologists have started using wireless PTT buttons with PoC applications in the operating room during clean procedures while preparing patients. They even found a way to use the system during sterile procedures, simply by asking an OR assistant to press the PTT button to have the doctor speak through the app.
Another emerging hands-free technology is wearable tags that use Voice over Internet Protocol (VoIP) over a wireless network, which allow caregivers to manage calls or receive messages and notifications without using a handset. In an emergency, teams can use voice commands to call by name, role, or group. A caveat is that this technology is often part of a complete solution that includes the mobile app and devices.
Although most PoC apps and accessories are compatible with Android and iOS devices, the iOS platform is known to have more robust security and a user-friendly interface. Consequently, health facilities are more inclined to deploy iPhones as general-purpose devices with clinical iOS apps as a simple and scalable communication solution. Third-party apps on iPhone can extend capabilities to enable VoIP calls, access reference materials, scan barcodes, document patient information, and more. One consideration is whether these devices are rugged enough to withstand the rigors of surgical and hospital environments. Therefore, hardware developers are introducing more sustainable options for clinical collaboration.
Ultimately, software applications are driving the adoption of wireless technologies in healthcare as a way to consolidate caregiver communications. Many mobile clinical platforms integrate with existing systems, such as nurse call, patient records, or monitoring and assistance remote collaboration and telemedicine. The end result is a complete clinical communication solution designed for healthcare professionals.
Responsible use yields better results
As more and more healthcare institutions adopt smartphones, more and more challenges have arisen. Hospitals have differing opinions as to whether it is better to use staff owned (BYOD) or hospital-owned devices. Concerns have also been raised that the devices could become a distraction or cause infections in vulnerable patients.
The Association of Surgical Technologists (AST) provides best practices for using mobile technologies in the operating room. Guidelines for healthcare organizations include establishing policies and procedures for the proper use of mobile devices and ensuring they are cleaned and disinfected before being used in critical care areas.
The AST outlines the reasons supporting the use of mobile devices in medical practices and highlights several efficiency benefits:
- Reduction in medical errors
- Faster access to patient information
- Improved communication with patients
- Higher productivity and work efficiency
- Lower response failure rate
Time is one of the most valuable assets in healthcare, not only for patient care, but also in economic terms. Improving efficiency by doing more in less time can save hospitals millions of dollars and, most importantly, accelerated real-time communications with fewer interruptions can save millions of lives.
However, implementing new technologies inevitably comes with challenges. Practitioners should work with IT professionals and IT staff to ensure goals are aligned and teams are trained to make communications as seamless as possible. Over time, the medical community will embrace enhanced mobile clinical communications as a strategic solution to improve patient care.
Photo: elenabs, Getty Images
