When it comes to getting optimal use from carts, Philadelphia’s Main Line Health finds it’s all about battery lifespan and charge time.

Charlie Riccardi knew something needed to change when he realized that his staff was spending an extensive amount of time, sometimes hours, changing the sealed lead acid (SLA) batteries in his hospital’s mobile carts. And it wasn’t just the utilization of his resources that concerned him; it was that when the carts were in for maintenance they were not available for clinicians to meet their workflow requirements and ultimately provide care to patients.

Riccardi, system director of the biomedical-engineering department at Main Line Health in suburban Philadelphia, purchased top-of-the-line carts in 2005, and by doing so, also changed productivity and accountability of the healthcare staff. Before the carts, Main Line Health, along with healthcare systems across the country, were still utilizing non-mobile medicine administration carts, or MACS, to deliver medicine to patients. But, beginning around 2004, the healthcare industry experienced a change in medicine delivery with the advent of mobile technologies in the healthcare space. When the need for a more efficient method of delivering medicine to patients arose, along with the increased requirements for electronic documentation at the point of care, the need for a new technology solution to meet these new demands became evident.

“The purpose of electronic carts has changed significantly over the last several years,” says Riccardi. “They’re no longer solely used for doling out medications to patients. Nurses, doctors and all other medical staff are now required to document everything, and the purpose of mobile carts has now shifted from a vehicle for distribution to a recorder of every single daily task completed by a healthcare professional.”

This increase in usage meant that the battery life of Riccardi’s mobile carts no longer met the clinical workflow demand. Previously, the carts were used just a handful of times during a given shift. But, as the carts became a requirement for all patient interactions and additional mobile technologies were added to the mix, including barcode scanners and printers, the battery could no longer support what was essentially a full-blown PC on wheels.

When Riccardi began his search for a solution, he didn’t have to look very far. Just 15 miles from Main Line Health’s Bryn Mawr Hospital resides the corporate headquarters of Futura Mobility, a leading mobile solutions provider that supports more than 250,000 devices worldwide. Futura Mobility, formerly Futura Healthcare Technology, has supported Main Line Health’s fleet of mobile carts via help desk support and an extended warranty program since 2005, and had just introduced their new lithium-based power solution called the Continuum Power System. Continuum utilizes lithium iron phosphate (LiFePO4) battery technology and an advanced electronics system that recharges the battery to full capacity in just two hours with a lifespan of five years.

The new battery seemed like the right solution, but before making the decision to switch over, Riccardi wanted to ensure that the investment would address all of the needs of his healthcare staff, not just the need for increased battery life.

“Everything the hospital staff does today must be electronically documented. Every interaction now requires notes and a way to keep track of information,” says Riccardi.
To address the needs of his staff, Riccardi solicited feedback from nurses and clinicians, who all agreed that the displays on the current carts were too small. A larger screen size would allow them to include patient input into the documentation process, instead of having to scroll through various screens, allowing them to be more productive. In addition, nurses also needed a larger work surface, much of which was currently being taken up by printers and scanners that sat on top of the carts.
Riccardi and Futura Mobility worked closely together to find a solution and then customized it to meet all of the needs of Main Line Health’s staff. To ensure the cart’s work surface would not be inhibited, Futura developed a custom technology tray that fits within the contours of the cart and allows for easy access of the specimen label printer and barcode scanner. This solution also allows for options to add ancillary devices on the cart if needed in the future. Futura also replaced the standard 19-inch LCD monitors with 22-inch, white-display, height-adjustable monitors to give the nurses and clinicians the larger screen size they desired. In addition, new barcode scanners and electronic locking drawers with customized dividers were incorporated to meet their medication administration workflow.
Once all parties were satisfied, the carts were integrated with the Continuum Power System and deployed to various Main Line Health locations. Although the process was a smooth one, the upgrade to the new carts wasn’t without its challenges. In order to maximize daily runtime and ensure the battery reaches its expected five-year lifespan, the power system had to be configured to draw power from the connecting computing equipment. To work through this potential challenge, Riccardi and his team worked closely with Futura Mobility to create a detailed instruction sheet that now accompanies all carts, stored safely in the computer tray, which lists the necessary steps needed to configure the power system.
The carts have now been in use for about six months, and the feedback from the clinicians has been extremely positive. Service calls have been drastically reduced, and the uptime on the carts has allowed the clinicians to perform their task without disruptions due to battery performance issues. The hospital system is appreciative for the improved efficiency and reduced cost of ownership, and the healthcare staff is thankful for their new workstation, that not only is available every time they need it, but also lighter and easier to maneuver.
“Our upgraded carts allow us to effectively document all interactions with patients right at the point of care, and in a manner that is efficient and effective. Most importantly, they provide validation from an error-prevention point, which is essential,” Riccardi says.  
While the new carts were a replacement for the original 2005 carts, Riccardi and his staff continue to closely monitor the entire fleet of carts throughout the health system. As equipment ages, Riccardi and his staff will plan additional replacements with the same careful consideration for battery performance, workspace needs, screen size and mobility. To aid in this process, Riccardi is beginning a pilot of Futura Mobility’s MobileForce Fleet Management software, which will provide an enterprise-level view of their entire fleet of carts and their current power state, regardless of where in the five locations that cart resides.
As the needs of nurses and clinicians change and demands of mobile carts continue to evolve, Futura Mobility will continue to work with Riccardi to provide innovative solutions that meet the ever-changing requirements of the healthcare sector.

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