Researchers Create Better Hospitals

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RUC researchers are helping to implement a system which could lead to patients getting more time with doctors and nurses. This article is brought to you in collaboration with RUBRIK.

Datalog Morten Herzum er en del af den digitale revolution på Danmarks sygehuse. Foto: Uffe Weng.

Computer scientist Morten Hertzum is a part of the digital revolution at Danish Hospitals. Photo: Uffe Weng.

The Danish hospital service is in the middle of a digital revolution which will free the hospital staff from a number of time-demanding and time-consuming tasks. Researchers from RUC are deeply involved in one of the most promising projects which could ensure patients significantly more time with doctors and nurses.

Instead of trudging through hospital hallways to get an overview of the work days and be delayed by unanswered telephones in other departments, doctors and nurses can from now on get this overview and coordinate their rounds anywhere in the hospital. So far, the experiences with the system from emergency department at a hospital in Region Zealand are very promising.

»Experience shows that nurses spend significantly more time with the patients than previously. Patients have requested more contact with doctors and nurses. Often, you can feel a little bit neglected and we are pretty certain that patients will have a better experience now that doctors and nurses stay with them longer, « says lector Morten Hertzum from the Department of Communication, Business and Information Technologies (CBIT).

Overview for Everybody

The special basic term for hospitals is that all personnel are constantly in motion. It is only a handful of doctors and nurses who have an office or a personal computer. Instead, they move around from ward to ward, patient to patient, department to department. Thus, all information has previously only been accessible from one central location, but now all that information will be spread to monitors around the entire hospital.

»Previously, information was only found in written form with the coordinating nurse. For this reason, the staff rushed to finish with each patient to be ready to receive new patients. But with the overview the monitors provide, nurses and doctors can spend more time with each patient, because they themselves have the overview of how pressured the department is, « says Morten Hertzum.

The monitors show, among other things, when the patients were checked in, where they are, what is wrong with them and what treatment they receive. Morten Hertzum has many years of experience from similar projects, and his job is, together with colleagues at RUC , to evaluate and optimise both the way the hospital has to reorganise to get the maximum benefit from the system, and how the system has to be optimised in order to function in the everyday lives of the staff.

The researchers from RUC also have to observe how the system changes the working habits of the staff. Among other things, the system has had the effect of making the staff more thorough with the registration. Instead of pushing cartloads of patient journals around, the nurses fill them out in the wards with the patient. Apart from getting more time for the patient, it also means that they can ask clarifying questions immediately. The same positive effect has not been observed in doctors yet, but Morten Hertzum believes that this can be due to the fact that the emergency department has many young, inexperienced doctors who simply have a need to consult with an experienced doctor before they write the journal..

But with the overview the monitors provide, nurses and doctors can spend more time with each patient, because they themselves have the overview of how pressured the department is.

Now the system is being tested at all the departments at Nykøbing Falster Hospital. One of the more time-consuming processes today is the coordination between departments. When a patient has to move on in the system, an appointment has to be made with the recipient department, an orderly has to be booked, and a nurse has to follow.  But if, for instance, the phone goes unanswered at the recipient department, or they do not believe that they have room for the patient, the entire process comes to a halt. This leads to wasted time.

»With this system all the departments can see what is going on at the other departments. If the emergency department can see that there are available beds at the department the patient has to be transferred to, it is more difficult to reject the patient. The boundaries between the departments are opened, and the staff have to adjust to this rebalancing. This is, among other things, the process which we have to investigate« says Morten Hertzum.

Fewer Readmissions

The system can be used for a wide variety of things. One of the first initiatives at Nykøbing Falster Hospital is an attempt to reduce the number of patients who are readmitted immediately after they have been checked out. It is typically elders who have difficulties walking and have no family or friends to help them when they get home. For instance, they have a lot trouble going grocery shopping and getting something to eat when the fridge is empty. Thus, the staff have identified an array of parameters such as age, network, mobility and residence which indicate whether a patient belongs in the risk group who are liable to be readmitted.

»If a sufficient number of parameters are checked off, the patient becomes visible on the monitor in a special “follow home office” which can then follow the patient all the way home and make sure that there is food in the fridge, and that the patient arrives home safely. It already works really well across all departments, « Morten Hertzum explains.

The expectation is that the system overall will increase the collaboration across departments and increase patient safety by creating more coherent stay with a less stressed staff. When it is fully implemented, the entire stay will be far more automated for all patients. For instance, paramedics will get an overview of the position of the nearest hospital, retirement homes will be able to see that one of their residents has been discharged from the hospital and the general practitioner will able to follow the patient’s admission on the monitor.

»In the long run general practitioners, retirement homes and ambulances will be wired into the system so that the borders of the hospital are expanded to cover the entire health system. In this way all relevant information will be available to all relevant persons in a visually convenient manner, « says Morten Hertzum.

Patienterne kan takke en computer for, at de får mere tid med læger og sygeplejersker. Foto: Uffe Weng.

The patients have a computer to thank for getting more time with doctors and nurses. Photo: Uffe Weng.

Facts

Designing Human Technologies

Morten Hertzum´s research is part of the target area Designing Human Technologies with its three dimensions in respectively design, human science and technology. The area focuses on technological design and problem solving in close interplay with citizens and users.

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