In 2015, Saratoga Hospital in Saratoga Springs, New York, unveiled a new, state-of-the-art intensive care unit that, at 20,000 square feet, is more than triple the size of the previous ICU.

THE PROBLEM

All rooms are private, enhancing the patient experience and reducing the risk of spreading infection. At the same time, caring for patients in a much larger space presented a communications challenge. Saratoga needed a solution that would enable staff to quickly and safely share information and request support, when needed.

PROPOSAL

During the planning stages, leadership at Saratoga Hospital realized that they would need an enterprise clinical communication solution to connect team members and maintain the patient surveillance and safety that are essential to delivering high-quality care.

“Given the high-risk environment of the ICU, our nurses wanted a system that would work seamlessly under isolation gowns and allow team members to summon help quickly,” said Diane Bartos, RN, director of critical care at Saratoga Hospital. “After assessing several systems, we selected the Vocera Badge, a wearable, hands-free, voice-controlled device that streamlines communication.”

"If a patient needed to be put on a ventilator, only the intubation team entered the room. The charge nurse stood outside, observing the procedure and communicating via the badge to guide the team as needed and help prevent cross-contamination."

Diane Bartos, RN, Saratoga Hospital

There’s no need to remember phone numbers or who is on call; instead, clinicians simply say the name, role, or group of the person or team they want to call, and they are connected, she explained.

MARKETPLACE

On the clinical communications technology front, vendors include Avaya, Halo, HipLink Software, Mobile Heartbeat, PatientSafe Solutions, PerfectServe, Spok, Telmediq and Vocera.

MEETING THE CHALLENGE

Shortly after deploying the communication badges in the ICU, Saratoga rolled the technology out across the hospital. Team members who often need to be hands-free – nurses, respiratory therapists, security personnel, EKG technicians and others – wear the badges.

The badges are integrated with the organization’s Rauland Nurse Call system and Philips Patient Monitors, enabling patient requests and notifications to go directly to the assigned nurse or care team. Physicians primarily use the secure Vocera smartphone app to communicate and collaborate.

“Before the first wave of COVID-19 hit Saratoga Hospital, staff already were equipped with a hands-free communication solution that can be worn and used under PPE,” Bartos said. “As part of our pandemic preparation, we focused on educating frontline staff on the proper way to put on and remove PPE to avoid self-contamination. The Vocera Badge played a significant role in these education efforts.”

During the safety training, which took place inside and outside an anteroom, the educator would observe and guide team members as they donned and doffed their protective equipment. The educator and staff members wore the badges to communicate during the training, a practice that helped nurses, doctors, respiratory therapists and other care team members reduce the risk of self-contamination.

“At the peak of the pandemic, care teams in the ICU used hands-free communication to reduce staff exposure and improve safety by keeping the number of team members in a patient room to a minimum,” Bartos recalled. “For example, if a patient needed to be put on a ventilator, only the intubation team entered the room. The charge nurse stood outside, observing the procedure and communicating via the badge to guide the team as needed and help prevent cross-contamination.”

Without the communication badges, Saratoga would not have been able to limit the number of clinicians in the isolation room and help nurses, doctors, respiratory therapists and other care team members stay safe, she said. Staff members who intubate COVID-19-positive patients say they take comfort in having that extra set of eyes focused on identifying and preventing opportunities for cross-contamination, she added.

RESULTS

The communication badges have improved care team communication and safety, saved time, and helped conserve valuable PPE resources, Bartos said.

“One of our COVID-19-related adaptations is to appoint staff members as runners who bring supplies to team members working in isolation rooms,” she explained. “Clinicians and runners all wear the badges. If a clinician dons PPE, goes into a patient room, and suddenly realizes he or she forgot something, the clinician can easily communicate with a runner.”

The runner then quickly gathers and delivers the forgotten item. This process minimizes the number of times a clinician must leave and re-enter a room, and in turn, don and doff PPE. That saves time and precious resources.

ADVICE FOR OTHERS

“In emergency situations and isolation environments, care teams need hands-free, voice-controlled communication solutions that can be worn under PPE,” Bartos contended. “This technology enables immediate consultation, helps protect patients and providers, and facilitates hands-on care. In situations with increased risk for contamination, hands-free solutions offer significant advantages over smartphones and other options.”

Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
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