1. Innovative Idea Create a Nurse Call system similar to "Hey, Alexa" so patients can call the nurse verbally with detailed information on what they need.
1.1. Some patients have difficulty using their limbs but are able to vocally speak needs. This system removes the requirement of pushing a button to call the nurse.
1.1.1. "Remote control or local control is always useful for those human being who are physically challenged in the world. Such a system always aids them for spending life more easily then without such systems" (Sharma and Gautam, 2015).
1.2. When a patient presses the button on a nurse call, the nurse gets an alert but they do not know what the patient needs. With this new system, the patient will verbally state what they need which will be transcribed. This message can be sent to the unit secretary to triage or directly to the nurse station or both. The secretary or nurse can listen to the audio or go by the transcribed message to help the patient. Due to staffing shortages, this will also allow staff to prioritize patient needs and triage the request.
1.2.1. "Each day, patients and nurses alike frequently activate nurse call systems to request assistance or respond to individuals needing assistance. It is clear that effective patient and staff communication is pivotal to the provision and continuity of quality patient care as well as to patient and staff satis(faction and efficient use of nursing time" (Tilka Miller, 1997).
1.3. Nurse calls from a patient can get entered into the patient's EHR (electronic health record) if beneficial. These can be routed to the Doctor caring for the patient if a sign-off or recommendation is needed.
2. Module 7: Milestone Goal Expectation
2.1. Third quarter 2024: Present idea to stakeholders at team meetings and obtain approval to put together a taskforce and complete a pilot. Fourth quarter 2024: Put together task team of individuals involved in the build, training, and roll-out. Q1-Q3 2025: Build, test, communicate, test more, identify a department to pilot the new system. Train stakeholders in that department Q4 2025: Return to stakeholder team meetings with data from pilot. Obtain approval to move forward with rolling out to the Enterprise. Q1: 2026: Roll out
3. References
3.1. C. Sharma and D. K. Gautam, "Design development and implementation of wired Nurse calling system," 2015 International Conference on Green Computing and Internet of Things (ICGCIoT), Greater Noida, India, 2015, pp. 1258-1262, doi: 10.1109/ICGCIoT.2015.7380657. Khuntia, Jiban; Tanniru, Mohan; Fregoli, Fabian; and Nawrocki, Matthew (2016) "Information Systems Impact on Nurse Call Response – Role of Velocity and Uncertainty," Pacific Asia Journal of the Association for Information Systems: Vol. 8: Iss. 1, Article 3. DOI: 10.17705/1pais.08102 Tilka Miller, Elaine D.N.S., R.N.1; Deets, Carol Ed.D., R.N2; Miller, Robert V. Ph.D3. Nurse Call Systems: Impact on Nursing Performance. Journal of Nursing Care Quality 11(3):p 36-43, February 1997. Womack, D. M., Hribar, M. R., Steege, L. M., Vuckovic, N. H., Eldredge, D. H., & Gorman, P. N. (2020, September 16). Registered nurse strain detection using ambient data: An exploratory study of underutilized operational data streams in the hospital workplace. Applied Clinical Informatics. https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0040-1715829
4. Module 6: Ease/Difficulty of Accomplishing
4.1. Easy
4.1.1. I believe it will be easy to get buy-in from stakeholders. I have a strong argument for the need and can support the idea with data.
4.2. Fairly Easy
4.2.1. Presenting the idea and getting on meeting agendas may take some time but will be low effort and supported due to my knowledge with healthcare, nursing, and IT systems.
4.3. Unsure
4.3.1. At this time I am unsure if the decision to implement an additional nurse call system in conjunction with the existing nurse call button will be supported or if my innovative idea needs to include a nurse call button so there is only one nurse call system. I do not have the knowledge in this area to argue one way or another and will need to expand my knowledge and look to others for help and support on this.
4.3.1.1. *
4.4. Difficult
4.4.1. The training necessary to roll out the new nurse call system will be difficult. It will involve a lot of patient education and education for multiple stakeholders. It will also require a lot of testing which will be difficult.
4.5. Very Difficult
4.5.1. My experience with my current healthcare system causes me to believe it will be very difficult to obtain funding and monetary support for this idea. The current system has been used for many years so changing it will require a monetary investment. I may have to look for funding through a company that would support the idea.
4.5.1.1. *
5. Major Stakeholders
5.1. Departments
5.1.1. Critical Care Unit(s)
5.1.2. Emergency Department
5.1.3. Medical Telemetry Unit(s)
5.1.4. Surgery Unit(s)
5.1.5. All other Inpatient Units
5.2. People
5.2.1. Nurses
5.2.2. Doctors
5.2.3. Unit Secretaries
5.2.4. Housekeeping (for messages that request housekeeping)
5.2.5. Food Service (for messages that request food)
5.2.6. Hospital Administration - to approve the project and up front costs.
5.2.7. Patients
5.2.8. Me! The innovative idea generator
6. Module 4 Evaluation and Outcomes Expected
6.1. Evaluate and document current practice
6.1.1. 2. Evaluate the timeliness of response to nurse calls
6.1.2. 1. Evaluate the average number of times the nurse enters the patient's room because of a nurse call per shift.
6.1.3. 3. Rate patient satisfaction
6.1.4. 4. Record data from nurse's self-evaluation of burnout/strain
6.2. Outcomes expected
6.2.1. 1. The number of times a nurse enters a patient room per shift because of a nurse call will be lower than baseline.
6.2.2. 2. The time between receiving a call and responding will be lower by at least 20%
6.2.3. 3. Patient satisfaction will improve by at least 5%
6.2.4. 4. Data on nurse's self-evaluated burnout/stress will improve by at least 10%
7. Continue to use/implement the current nurse call system and add this new system to it. OR Add a button to the new nurse call system so a patient can call verbally or with a button
8. Module 5: Barriers, Forces, Relationship Linkages
8.1. Which organizational forces impact the success of your project?
8.1.1. The resistance to change is the strongest organizational force I will face with this innovation. Traditional nurse call systems have been in place for many years, and this would implement a big change.
8.2. Which barriers have you identified, and how might you approach them?
8.2.1. 1. Some patients are unable to use their voice so will still need a button they can push to call the nurse.
8.2.2. 2. Some patients will be resistant to use the verbal requests and continue to press the button for a generic nurse call.
9. Module 3 Making a Case
9.1. Introduction: Traditional nurse call systems consist of a button in a patient's room. This innovative idea provides additional options for patients needing assistance. Instead of pressing a button, patients are able to verbally call a nurse. They can also include information on what they need (i.e. medication question) and this information will be transcribed for the nurse or unit coordinator to triage prior to entering the patient's room
9.2. Problem or Opportunity: Traditional nurse call systems do not support patients who are unable to use their limbs. They also do not allow patients to explain what they need prior to the nurse entering the patient's room. These nurse calls can be quite cumbersome for nurses to keep up with and can cause exhaustion/strain especially when short staffed.
9.3. Supporting Evidence: "The nurse call system is the lifeline for a patient in a hospital room" (Khuntia et al, 2016). Almost all requests from patients admitted to the hospital are initiated by a call to the nurse. Some of these requests would be more appropriate for other healthcare individuals such as housekeeping, food service, or an MD. Traditional nurse call systems are one-faceted. They consist of a button and send a generic message to the nurses station.
9.3.1. Khuntia et al go on in their article to state that the nurse call is a way for patients to control their own situation and how the promptness of response from the nurse creates a patient perception that their needs are being met (Khuntia et al, 2016). Regardless of what nurse call system is used at a hospital, they are extremely important. Unfortunately, data shows that traditional nurse call systems are not always effective and can cause strain to nurses when overused (Womack et al, 2020). While these are a necessary tool, innovation can make them more useful.
9.4. Benefit Analysis: The new innovative nurse call system will have many benefits.
9.4.1. -Patients are not required to press a button to call the nurse -Patients can verbally explain what they need to the nurse and/or other professional -Nurses will receive clear information about what a patient needs rather than a generic "call" -Unit coordinators can triage nurse calls for nurses and involve other professionals if needed -Lower priority calls can be triaged and organized into a nurses workload -Calls that need a provider can be entered into the EHR and the provider can be paged/apprised of this information