Introducing apps to clinical workflows
Until now doctors and nurses at the Hôpital du Valais have worked exclusively with desktop computers or laptops on trolleys. But recently it had been decided that mobile phones should be included in the workflow.
Understanding nurses’ workflows
I had the chance to spend a full week with nurses. Observing them performe daily tasks and having insightful chats during the coffee break, I learned a lot about the obstacles that make their challenging jobs even more difficult.
Nurses constantly switch between digital and non-digital tasks – If they lack the time or all computers are taken, they might store information temporarily on paper and transfer them to the electronic health record (EHR) when they have more time.
Hardware is not suitable for workflows – The closest thing to a mobile device that nurses have at their disposition are laptops on trolleys. Since those trolleys are not adapted for transporting medical materials nurses often find themselves dragging a caravan of different trolleys and additional monitoring machines into the patients’ room.
Workdays are organized by tasks rather than patients – Many tasks, like taking blood pressure and handing out medication, are completed for one patient after the other rather than completing all tasks for one patient and then moving to the next.
Nurses have created their own workarounds – The nurses bypass the lack of suitable technology by printing a table of all patients on the ward and taking notes on these sheets throughout the day.
Defining an implementation strategy
Are mobile phones just gadgets or can they improve workflows?
Since mobile devices were completely new in the hospital, it was important for us to start a pilot project from which we could learn as soon as possible. Therefore, we decided to develop separate applications tailored to specific workflows rather than a complete medical record. This would allow us to gradually release new applications and improve them over time.
To define use cases I explored the benefits of using a mobile phone over a computer.
Use case 01
Speed up blood transfusions through barcode scanning
While writing on small smartphone screens is not exactly efficient, mobile devices offer other interesting input methods such as taking photographs and scanning barcodes. The latter is especially useful when it comes to controlling identities.
As this is one of the key tasks in registering blood transfusions, we decided to design the first app for this workflow.