Revised: February 24, 2015

Intelligent Hospital™ LDRP Script 2015

Please send all comments/updates to Heather.Ruchalski@obix.com

Revised: February 24, 2015

MRN:

Status: Delivering

Welcome to the Labor Delivery Recovery and Postpartum (LDRP) Suite of the Intelligent Hospital.

The overall Intelligent Hospital supports a distributed network designed to facilitate the delivery of high-bandwidth mobile data and voice service serving a broad variety of users, devices, and applications found in the LDR and across the hospital. The robust network utilizes and integrates multiple technologies to deliver a quality experience for the user and related mobile device: smartphone, tablet, laptop, IP softphone, or machine. The distributed network consists of a an integrated blend of Carrier based Distributed Antenna Systems (DAS) and Small Cells that provide facility wide high bandwidth 3G/4G-LTE services, coupled with , integrated carrier class Wi-Fi solutions,  architected to be both cost effective and as a long term solution that can change with the evolving needs of the facility. (LDRP0 Extreme Network).

The LDRP room is equipped to handle patient care associated with labor, delivery and post mother and baby care.

Our patient, Ava Adair, is 27 years old with a due date of 4/18/15 that presented to the ED complaining of contractions that began when she first woke up and are now occurring every 5 minutes. After the initial patient assessment in triage, Ava was quickly registered, wrist banded (LDRP1 Zebra) [Hold up patient wrist] and transferred and admitted to LDRP Suite.

As you can see, Ava was placed into the OB bed (LDRP2 Hill-Rom), admitted into the perinatal system (LDRP3 OBIX) [actor turns to the OBIX system to admit the patient into the system], and the fetal monitor initiated [actor points to the fetal monitor]. The perinatal system allows continuous visibility of the patient’s electronic fetal monitor trace as well as audible and visual alerts.

Once Ava is oriented to the LDRP, the nurse instructs her on how to use the nurse call system (LDRP4 ASCOM) [actor places the nurse call light within reach of the patient in the bed]. The nurse performs an assessment of the patient and enters the assessment notes into the patient’s electronic medical record in the perinatal system (LDRP5 OBIX), [the actor turns to the OBIX system to chart assessment]. The system’s specialty charting options provide efficient charting reducing the need to navigate through multiple screens. Ava's entire assessment is documented never having to leave the Intrapartum notes entry screen. Ava's assessment is entered in the notes entry screen and populates the fetal monitor strip, flowsheets, care plans, graphs, and notes logs are sent via interface to the EMR [SCREEN SHOTS: OBIX_LDRP01 & OBIX_LDRP02 & OBIX_LDRP03 & OBIX_LDRP04]. Ava is in active labor, her vital signs are stable, the fetal heart rate is within normal limits, with contractions are occurring every 3-5 minutes. [Actor looks at FM strip to review on OBIX System].

Ava’s pain is increasing and she requests medication by pressing the pain button on her pillow speaker [Actor points to the speaker pillow] (LDRP6 Ascom). The assigned nurse receives the request directly on her wireless device [Actor points to a wireless device]. The nurse is able to immediately speak to the patient from the wireless device and informs her she will be in shortly. The nurse then sets a reminder for herself on the handset before disconnecting so that the system can gently remind her to come to the room in case she gets tied up with other requests [Actor “sets” a reminder on the wireless device]. This reminder will automatically clear when she enters the room via her RTLS tag. The nurse arrives to administer pain medication. Upon administering the medication, the nurse sets a Pain reassess timer on the workflow station that will alert her when to return to reassess patient pain levels [Actor “sets” a reminder on the wireless device]. All of these events are recorded in a database for reporting staff performance and patient satisfaction.

The medication administration is then documented in the perinatal system and populates the notes log, fetal monitor trace, Medication Administration flowsheet, and sent to the EMR (OBIX). [The nurse actor turns to enter medication into the OBIX system & points to the screen for screen shots – OBIX_LDRP05 & OBIX_LDRP06 & OBIX_LDRP07]

After the baby is born, the Nurse places the infant in the infant bed for stabilization and assessment. [The actor takes the baby and places in the infant bed/bassinet]. A small, tamper-detecting security tag is then applied to the baby [The actor nurse points to the security tag on infant]; this infant security system provides hospital-wide protection that can extend to multiple buildings and sites providing continual visibility of the infant’s location (LDRP7 Stanley). After completion of the initial bedside assessment, the baby is placed in the bassinet and transferred safely to the nursery for a comprehensive newborn assessment and screening. [The actor moves the baby to the bassinet and walks the bassinet to the door]. If an infant approaches the exit of the secured area without authorization, the infant security system immediately locks the doors and sends a critical alert to the nursing station desktop, staff mobile devices and hospital security desk of the unauthorized exist. [Actor 2 points to the shared monitor with iPhone screenshot] This alert includes complete event information – infant, type, and location – as well as security surveillance video feed to show what happened at the exit starting a few moments before the alarm [Actor 1 points to the monitor with live video image]. Equipped with a visual of the suspected individual and exactly what happened, staff members are able to rapidly respond leading to increased security and greater efficiency.

While Ava’s daughter is in the nursery for her complete assessment, she asks the staff for an update of procedures and when the baby will be returned to the family. [Actor goes to workflow station @ headwall and points to the “Call Nursery” touch point]. The nurse is able to call the nursery from the workflow station within the room for an immediate infant status update and estimated time of arrival; providing the family with immediate answers to the information requested (LDRP8 Ascom).

The baby is returned to the LDRP so that mom can start breastfeeding. [Actor moves the baby out of the bassinet and hands the infant to the mother]. Common with all first time mothers, Ava is having difficulty nursing. The nurse asks if Ava would like assistance from a Lactation Coach. The nurse requests assistance from the Lactation Coach from the workflow station at the touch point (Ascom). [Actor goes to workflow station @ headwall and points to the “Lactation Coach” touch point]. The request is dispatched directly to the Coach’s wireless device with the room number. The coach has the option to open an intercom path into the patient room to communicate with the new mother and nurse prior to arrival.

The nurse orients mom and dad to the hospital’s Interactive Patient System Using the pillow speaker, the new parents can navigate the menu on the TV, which includes personalized health education, services and entertainment. The nurse shows the new parents the list of health education videos that have been prescribed by her care team including caring for a newborn and breastfeeding. Videos are displayed through integration with the hospital’s order system. Once mom and dad watch a video, viewing is automatically documented into the patient’s medical record through integration with the hospital’s EMR system.

The nurse then explains that there will soon be a shift change and shows mom and dad that they can view a snapshot of their care team on the electronic whiteboard. The personalized whiteboard also provides pain management tools and other information the patient may find helpful during their stay. [Actor points to the screen to show screen shots for the interactive patient system capabilities.]

The nurse discusses some of the other features on the system showing mom and dad that they can request services such as housekeeping, meal ordering, and fill prescriptions. Requests are sent directly to the appropriate department saving nurse time. The interactive patient system engages Ava in her care, empowering and connecting her to her care team.

Ava and her husband are ready to enjoy a celebratory meal together. Ava orders dinner for them through the Interactive Patient System’s meal ordering. [Actor places order through the Skylight module.] This module is integrated with the hospital dining provider allowing patients to order at their own convenience and within the provider prescribed nutritional requirements and dietary recommendations (LDRP9 CBORD). This software integration ensures that patients receives approved foods and in compliance with any food allergies. Many hospitals are discovering that serving guest trays not only improves patient satisfaction scores but provides an excellent source of revenue. Communication is key in achieving high patient satisfaction, especially when it comes to coordinating meal delivery with medication administration in a room service hospital. [Actor takes two trays and brings them to the bedside and tracks tray deliver with a hand held device]. Using the tray tracking application, visible at the nurse’s station, everyone can see who has ordered and when their food tray is expected to arrive on the floor.

After the trays are delivered, the host tracks the delivery on a handheld device. This is how the department knows it is meeting their 45-minute delivery goal. (CBORD). The tray monitor system will signal the host to pick up the tray 30 minutes after delivery preventing dirty trays being left in the room. Along with tray delivery and pick-up, the host can also quickly record what food the patient has eaten. When the host picks up the trays, she uses her mobile device to record what food the patient has eaten. This Intelligent Hospital’s program is aimed at identifying and caring for malnutrition, helping to reduce length of stay and readmission rates. [Actor uses hand-held device to track food Mom ate].

When Ava is ready for discharge, the nurse performs and records the discharge process in the perinatal system providing complete customized discharged instructions. [Actor turns to the OBIX system to discharge the patient & points to screen shot OBIX_LDRP10]. Once the patient is discharged all documentation from the perinatal system is automatically sent to the EMR system via COLD Feed for archival, long term storage, and enterprise record retrieval (LDRP10 OBIX). [Actor points to screen shot OBIX_LDRP11].

This concludes the demonstration within the fully networked LDRP, which I hope highlighted how the smart integration of these different technologies and applications, enhance patient care and safety, optimize staff workflow, and assist the inventory and supply management. Please visit the other rooms in the Intelligent Hospital™ to find out how the other patients fair, pick-up the LDRP Tour Handout and visit our sponsors in the Pavilion kiosks to learn more about these dynamic technologies.