When designing and activating a new healthcare facility, there is tremendous opportunity to rethink clinical workflows as you address the specific challenges of moving into a different environment. After nearly eight years of construction and planning, in December 2011, our patients were moved into the new C.S. Mott Children's and Von Voigtlander Women's Hospital.
The experience taught us the value of collaborating across the continuum--from the clinicians, IT, biomedical engineering, nursing informatics, and project leadership--and that vendor relationships are key to successfully designing workflows and implementing new technology.
Our original facility's neonatal intensive care unit cared for up to 10 patients in a single, large nursery, but the new, much larger facility was designed with all single patient rooms. University of Michigan Health System (UMHS) needed to have nursing staff connected with their patients similar to how they were in the old building. We also recognized that communication among nurses and with other clinicians was going to be significantly impacted by moving to the new facility.
With the support of Senior Project Leadership, we were tasked with the analysis, redesign and implementation of both workflow design and new technology implementation.
We were able to redesign nursing workflow and create situational awareness with a collaborative approach to the technology implementation. It is critical that the technology implementation be deployed by a cross-functional team, involving leadership, IT, the clinicians, biomedical engineering, project stakeholders, risk management and the vendor.
We looked at our caregivers and their activities from a clinical perspective. We got down in the gemba with the nurses to better understand how they work. We had clinicians walk us through the various events that could occur in their environment so we could pinpoint what the caregivers truly need, and optimize the technology to meet those needs. This is an ongoing, operational process that we've been refining since the go-live date last December.
We also opted to work with vendors that were willing and able to play an integral role in the process, working with both IT and clinicians to plan, implement and teach the new technologies. We relied on our vendors to understand workflow patterns and identify additional opportunities for improvement across departments and disciplines.
With this approach, our vendor became a partner in the planning process and also provided the required continuing support after implementation, which is especially important with new facilities that have interoperating systems.
Part of what was learned from that process was the need for a holistic, systemic approach to IT in the new facilities. We looked at the individual systems independently, but it was really about how everything tied together and how each system affected each other across the ecosystem.
We deployed an integration engine to offer clinicians access to critical data from virtually any vendor, including our patient monitors and nurse call system today and looking forward, our EHRs, smartbeds, and RFID chips in the future, so they could better use alarms and alerts to improve performance and safety. It was important that the integration be customized for our facilities and that the specific workflow needs we identified by working directly with the clinicians were addressed appropriately.
Since we opened the doors of our new facility, staff, patients and families have all noticed a positive impact in our caregivers' responses to our customers' needs. Patients are afforded more privacy and quiet, since alarms and alerts are routed to caregivers' devices rather than announced overhead. Through our shared clinical and IT implementation, we were able to achieve a more peaceful and healing environment while addressing the key clinical workflow challenges of the new facilities.
Craig Margin is senior business systems analyst of the University of Michigan Health System. Kathrynn Thompson BSN, RN is the iterim nursing operations administrator of the University of Michigan Health System.