Seven Steps to Improve Efficiency and Workflow in Healthcare

Healthcare technology delivers the most value when it fits naturally into clinical work. Equipment that is difficult to reach, cumbersome to move or poorly positioned can create extra steps and pull attention away from the patient. A well-planned point-of-care workstation can place documentation tools, supplies and technology where staff actually use them.

The following seven steps provide a framework for planning a more efficient healthcare environment. Examples from Children’s Medical Center in Dallas, Texas, and Centerpoint Medical Center in Independence, Missouri, illustrate how wall-mounted workstations can be incorporated into patient-care settings.

1. Embed technology in the clinical workflow

Place technology at the user’s fingertips and near the point of care. The objective is to make access to the clinical information system part of the normal workflow rather than a separate trip or task.

Children’s Medical Center selected wall-mounted Proximity workstations as an alternative to mobile carts. The reported benefit was straightforward access: nurses could approach the workstation, chart and fold the unit closed when finished.

Questions for the project team include:

• Where does documentation actually occur?
• Which information must be available in the room?
• How many users need simultaneous access?
• What equipment, peripherals and supplies must the workstation support?
• Should the unit be wired, wireless or capable of either configuration?

2. Design around the patient and the caregiver

The patient and the caregiver are the two most important people in the room. Technology should support their interaction rather than become the focus of it.

At Centerpoint Medical Center, computer positioning was planned to preserve face-to-face communication. When the screen and work surface are placed correctly, the caregiver can document while maintaining a natural conversation with the patient.

Consider sight lines, screen privacy, reach, seated and standing positions, bed placement, visitor space and the location of other medical equipment. A workstation should help the computer recede into the background of the encounter.

3. Involve the right stakeholders

Healthcare workstation projects affect clinical care, information technology, facilities, infection prevention, safety and interior design. Include representatives from the relevant areas and appoint a strong project leader who can coordinate requirements and resolve conflicts.

The technology or workstation vendor should also participate early. At Children’s Medical Center, the design process included reviewing plans and brainstorming with the department, information-technology staff and other project groups.

A representative project team may include:

• Nurses and other frontline users.
• Clinical leadership.
• Information technology.
• Facilities and construction.
• Infection prevention.
• Safety, risk management and compliance.
• Pharmacy when medication storage is involved.
• Interior design or architecture.
• Biomedical engineering when applicable.
• The workstation manufacturer or integrator.

4. Customize the workstation to the environment

Wall-mounted workstations are not a one-size-fits-all product. The design should account for workflow, room dimensions, wall construction, technology, supplies, medications and user needs.

The original white paper states that 90% of Proximity Systems production was a variation of an existing model, illustrating the role of configuration and customization in its offering.

Configuration decisions may include:

• Overall cabinet dimensions.
• Recessed or surface-mounted installation.
• Monitor size and mounting method.
• Keyboard, mouse and work-surface layout.
• CPU or thin-client storage.
• Ventilation and cable routing.
• Medication and supply compartments.
• Locking and access-control options.
• Arm, swivel and height-adjustment features.
• Finish, color and coordination with the room.

5. Make ergonomics part of the design

Efficiency and comfort depend on the relationship between the user, the workstation and the patient. Poor placement can create awkward reaches, uncomfortable postures and repeated walking.

At Centerpoint, in-room computers and workstations reduced the need to return to a central nursing station to chart, retrieve information or collect certain supplies. The original account associates those shorter routes with greater efficiency and less staff fatigue.

An ergonomic review should consider:

• Work-surface and monitor height.
• Seated and standing users.
• Reach distances.
• Keyboard and pointing-device position.
• Screen angle and glare.
• Swivel requirements.
• Clearance for wheelchairs and mobility equipment.
• The full sequence of tasks performed at the workstation.

6. Address appearance and the patient experience

Hospitals increasingly consider interior appearance part of the patient experience. Clinical technology should work with the design of the room instead of appearing added as an afterthought.

Centerpoint selected wood construction and a custom workstation finish that coordinated with furniture throughout the hospital. The result supported a consistent visual environment while keeping technology available at the point of care.

Aesthetic planning can include finish samples, hardware, proportions, cable concealment, the workstation’s closed appearance and its relationship to casework and furniture.

7. Replace cumbersome mobile workflows where appropriate

Mobile equipment can be valuable, but it may not be the best answer for every room or workflow. Heavy or frequently moved devices can experience wear, occupy circulation space and add physical effort to the workday.

Centerpoint had experience with mobile units that sustained wear while moving through hospital corridors. The facility chose stationary workstations for the relevant applications instead.

The original white paper also states that an independent study found Proximity workstations reduced nurses’ walking distance by as much as 80%.

Turning the seven steps into a project plan

The seven principles can be translated into a practical planning sequence:

1. Observe and map the existing workflow.
2. Identify the points where information, equipment or supplies are needed.
3. Gather requirements from frontline users and supporting departments.
4. Measure the rooms and document physical constraints.
5. Select or configure a workstation around the actual task sequence.
6. Review ergonomics, safety, privacy, cleaning and accessibility.
7. Pilot the design with representative users.
8. Adjust the configuration before a full deployment.
9. Train users and document maintenance procedures.
10. Measure results such as walking distance, task time, user satisfaction, equipment downtime and patient interaction.

Better workflow starts with the care environment

Healthcare efficiency is not created by technology alone. It comes from aligning people, processes, equipment and space. A point-of-care workstation can support that alignment when it is placed correctly, configured for the real workflow and developed with input from the people who will use and maintain it.

Proximity Systems offers configurable wall-mounted workstation solutions for healthcare environments. The planning conversation should begin with the room, the equipment and the work that must happen there.