ER / ICU Management
Delivering solutions outside the box
For Children's Medical Center in Dallas, using a combination of more than 100 strategically positioned, customized workstations has resulted in positive feedback from the hospital's doctors and nurses.
By Tracy Morris, December 2012
PHOTO OF TRACY MORRIS BY MAXIM LAVROV. For more on Proximity Systems: Proximity Systems
The state of Texas is well known for its pioneering spirit, geographical variety and wide open spaces. But the state’s overall business climate of conservative pragmatism requires a different kind of creativity from the decision makers in healthcare design. Visionary plans for bold innovation in layout and furnishings run the risk of clashing with conservative resource management. It’s a scenario that points to the usefulness of long-term planning and developing key relationships, rather than brash overhauls, whether faced with new construction or redesign needs.
For Tracy Morrison, senior IT infrastructure designer for Children’s Medical Center (CMC), updating various departments within a 2.2 million-square-foot pediatric hospital required not only thinking outside the box, but pinpointing the specific connections out there that could facilitate CMC’s continual expansion into a future enriched by high-level information technology.
As the only academic healthcare facility in North Texas dedicated exclusively to the comprehensive care of pediatric patients, CMC must rely on top-level products and professionals in its two full-service campuses in and around Dallas. A 24-year veteran of communications and information systems, Morrison knew of the different solutions available to choose from for modifications in existing patient rooms, a new infusion unit and the emergency department (ED). Besides superior functionality to facilitate both written and electronic documentation by staff, solutions were required to be aesthetically in tune with CMC’s pediatric mission.
“Whenever we’re designing a space,” Morrison says, “the first questions we ask our people are, ‘Where do they want the computer in the room, and how are they going to chart?’ One of our main concerns here is we don’t ever want to have our back turned to the patient.”
Photo of Tracy Morrison by Louis Curtis of Children’s Medical Center.
Among the options Morrison reviewed, generic premade solutions – such as wall-mounted arms or carts – were found to be inferior when measured against the expressed needs of the two most important people in a hospital room: the patient and the nurse.
Arms could address some purposes, such as being able to perform charting and then re-folding the work surface back against the wall. But for a child-focused environment, the overly robotic appearance (along with sharp metal edges and visible wiring) was deemed unsuitable. Carts, too, were found lacking in comparison, primarily due to the potential for obstructing mobility.
Proximity Systems’ wall-mounted workspaces house computer equipment, sensitive documents, medication and supplies.
Space issues were of special significance in Children’s Center for Cancer and Blood Disorders, a new infusion clinic setting where architects utilized evidence-based design principles and ergonomic planning in order to waste little to no space.
“Since the kids are there for extended periods of time, a lot of space is taken up by couches, chairs and things to make the room comfortable for the parents, as well as for the children,” Morrison explains.
Timeliness, in particular, became a factor in solution selection when Morrison’s team found themselves with an urgent need to complete the creation of a new start care facility for the ED, the first pediatric Level 1 trauma center in Dallas.
Morrison recalls, “We had a target date for completion and were working hard to meet it.” The combination of user needs, deadlines and Americans with Disabilities Act (ADA) requirements made choosing a from-the-box option unacceptable.
The differences between ready-made and custom-built solutions were made clear when CMC made the choice to team with Proximity Systems’ design specialists. Utilizing a combination of more than 100 strategically positioned, customized workstations designed and built by Proximity has resulted in positive feedback from the hospital’s doctors and nurses. And since the units were manufactured and delivered directly by the company, there were no middle agents to dilute the connection between customer and service, and Morrison’s ED deadline was met within less than a month.
Houston-based Proximity’s C-ARM series of workstations are now located in CMC’s patient rooms and the infusion unit, taking up minimal space while allowing staff to conduct charting tasks at the point of care. Each station is designed to conceal, protect and ventilate computing equipment, while providing a workspace that is customizable by each staff person with easily accessible height adjustments, plus extendable, swiveling arms that retract fully.
“The monitor and keyboard section swivels away from the unit to a position where you’re actually standing in front of the patient; yet the way it’s designed, you really are taking up the same amount of footprint in the room whether you are using it or not,” Morrison says, calling the C-ARM workstation design “really ingenious.”
Strategically positioned workstations in patient rooms, exam rooms, ERs, ICUs, ORs, hallways and other areas move information near the point of care, reducing the effort and time to get data, and can improve workflow and reduce FTEs.
Initial cost, the downside of choosing a custom-designed-and-built workstation solution, was shown in a study to be offset by the benefits, especially in terms of walking distance traveled by hospital staff. Proximity Systems’ workstations were featured in the study conducted by Rapid Modeling Corporation, which looked at four different scenarios of nursing stations and meds dispensaries:
- Centralized nursing station and pharmacy;
- Conservative use of computer carts;
- Liberal use of computer carts; and
- In-room workstations that include charting equipment, meds and supplies storage.
The study concluded that placing IT equipment and patient medications in secure, wall-mounted workstations, strategically positioned in or near patient rooms, reduced the distance nurses walked per day by between 50 and 80 percent. The overall result in terms of cost is increased efficiency and productivity, not to mention a boost in staff job satisfaction.
Proximity Systems' custom design process brings together the functional needs of users, such as doctors and nurses. Workstations look more like elegant furniture than bulky equipment.
Morrison concurs, describing how the hospital’s ongoing relationship with Proximity Systems helped facilitate a re-cabling project in the ED. In this case, the company’s multi-compartment workstations were designed and installed according to ADA requirements for placement in pathways.
“We’ve created touch-down locations in the corridors where the doctors can do their charting away from the other work areas,” Morrison says. “It gives the doctors access to a computer without needing to interrupt work in the nurse’s station. It’s a win-win for both groups.”
For CMC in Dallas, Proximity Systems has become part of the expansion team, as their ADA-approved multi-compartment workstations are now the standard, a move that adds efficiency to the hospital’s continued expansion. All new construction will be free of issues with the Joint Commission and life safety inspections, since the units already meet all ADA requirements.
Establishing a constructive relationship with product providers who can deliver solutions from outside the box was a key decision for Children’s Medical Center.
Tags: ER / ICU Management