In the hospital environment, technology is becoming an ever more central element in the drive to improve care standards, in line with guidance from Government and independent institutions, such as at the National Institute for Care Excellence (NICE).
Health Technical Memorandums (HTMs), for example are published by the UK Government’s Department of Health to give advice and guidance on the design, installation and operation of specialised building and engineering technology used in the delivery of healthcare.
HTM 08-03 governs all hospital bedhead services, including nurse call systems, so all nurse call products marketed in the UK need to be compliant with this. “HTM 08-03 was developed to show what good working practice looks like with regards to the installation, design and implementation of nurse call systems,” explained Terry Boarer, iPiN technical manager at The Wandsworth Group.
Although the HTM guidelines are a huge help for designers and specifiers it is important to consider that HTM 08-03 was originally produced over a decade ago and that technology has advanced at a rapid pace in the intervening period. In many areas, however the guidance does recognise this and a section focusing on the need for a flexible design states that: ‘Owing to the improving and evolving nature of healthcare facilities, it is important to have in-built flexibility of service provision at the bedhead. Where a room undergoes a change of use, the system should be capable of seamlessly changing the nurse-call facility within that room both from a software and from a hardware point of view.’
Meeting this HTM requirement calls for the selection of a flexible nurse call system. A modular solution will have this required flexibility – giving the ability to be expanded and adapted as needs change. Having a core engine that remains the same, with the ability to add on other elements to meet changing requirements will ensure a flexible and future-proofed solution. “Such a system helps protect the original investment too,” said Terry Boarer. “New systems can be added with just a small additional cost, enabling users to evolve their systems at their own pace.” To achieve this it is vital that the core system is flexible enough to adapt to technology evolutions, and so needs to be based on a standard, open system protocol.
Flexibility
Choosing a system that is able to communicate over a standard IP-based platform will also go a long way to helping achieve the necessary flexibility.
IP-based systems use a standard network protocol and topology and allow data from different systems to be centrally managed and controlled. “An IP-based nurse call system makes good sense,” said Terry Boarer. “Working with a platform that is used by most developers means that it will be possible for the system to ‘talk’ to many other hospital systems, using a standard level platform. It will also be possible to link all the individual IP-based systems together and control them from a single server, bringing together a variety of traditionally disparate systems – such as paging, wireless panic systems, and environment and entertainment control systems – and enabling them to be managed in a more cost-effective way.
“You still need to add a server between the different elements to translate them all into the same language. However, once this is in place it will allow for a much higher level of integration between IP-based systems.”
IP-based solutions are becoming even more valuable today as they come an integrated part of wider hospital based systems which can provide a much simpler audit trail and enables data collection relating to response times for quality-control purposes.
Maintenance
Centralised control and administration of the nurse call system and other services also allows the system to be maintained to a higher level, from a central point in a cost-effective way, allowing maintenance teams to make simple changes without the use of high levels of staff resource.
With the biggest cost in any hospital being attributable to labour, this allows more efficient and effective use of maintenance manpower. Terry Boarer offers a good example of this: “Imagine a fault going up on screen – a lamp going out of service, for example – this fault will be logged in less than a second and the on-call engineer can be messaged to alert them to the problem, wherever they may be in the hospital.”
The HTM guidance also includes a requirement for routine maintenance to ensure equipment is functioning correctly. Again, the use of an IP-based nurse call system can offer HTM compliance, as it will allow system faults to be highlighted to the maintenance department automatically – via a number of different methods to suit individual working practices – allowing for much faster fault diagnosis and a more focused and efficient hospital maintenance process.
The use of an IP-based nurse call system also ensures that the system is future-proofed. “There are a host of yet unknown enhancements that could be introduced in the future, as technology advances,” said Terry Boarer. “Employing an open-system today will ensure that it is able to fully integrate with any system developments to meet future healthcare needs.”
Improved patient experience
Another key driver facing those responsible for designing, building and running healthcare institutions today, in addition to the need to deliver value for money and the best use of available resources is the need to offer improved patient care.
An important consideration for nurse call systems is how they are able to contribute to an improved patient experience. Having the ability to integrate with third-party systems in the patient environment can, therefore, offer huge benefits.
Evidence shows that the patient will have a better hospital experience if they are able to take more control of their immediate environment. The 2010 NHS Confederation report ‘Feeling better? Improving patient experience in hospital1 offers evidence to show that organisations with a strong emphasis on providing a high-quality patient experience have found that it is linked to better health outcomes. Further, Cole-King and Harding2 and Weinman et al3 also offer good evidence to show that when a patient feels less stressed, that recovery time is significantly decreased.
Allowing patients to have more control of their environment also removes the need for nursing staff to respond to many of the non-clinical activities they are currently required to undertake – such as adjusting lighting, opening or closing curtains or windows and adjusting entertainment centres.
The hospital of the future is expected to become more hotel-like – with an increase in single-room wards – designed to make patients feel more relaxed and helping prevent the spread of infection. Enhanced communication between patients and nursing staff and other service providers in the hospital will become a more essential component of the new future hospital environment. So, it is important that any nurse call system installed today is able to meet these demands…and others that we are not yet able to forsee.
The Wandsworth Group has recently lent its support to The Nurse Call Charter (www.nursecallcharter.com) which offers advice, recommendations and food-for-thought on some of the main issues to consider today when specifying a nurse call system. Not only do today’s buyers and specifers need to ensure any system is HTM 08-03 compliant but also understand just what nurse call systems can now achieve to help the NHS deliver outstanding patient care.
References
1 NHS Confederation (2011). Feeling better? Improving patient experience in hospital. http://www.nhsconfed.org/publications/reports/pages/feeling-better-improving-patient-experience-in-hospital.aspx
2. Cole-King A, Harding KG. Psychological factors and delayed healing in chronic wounds. Psychosom Med. 2001 Mar-Apr;63(2):216-20.
3. Weinman J, Ebrecht M, Scott S, Walburn J, Dyson M. Enhanced wound healing after emotional disclosure intervention. Br J Health Psychol. 2008 Feb;13(Pt 1):95-102.
