The Future World of Health Care
September 1st, 2007 by adminby Kate Christmas, RN
Vice President, Health Care Division
The year is 2020 and much has improved in the United States health system. Government sponsored health coverage is available for everyone and, although there are waiting periods for elective procedures, no one has to go without.
Focus has shifted to a prevention-based system; now, many health issues are dealt with before they become diseases, and Emergency Departments are not full to the brim with exhausted, sick, angry people waiting to be seen by physicians.
Let’s take a walk around Future General Health System and see what is going on at the unit level.
The corridors are bright and cheerful, and the personal entertainment systems can be programmed to play whatever the listener wishes to hear, ranging from music to educational programs for patients and their families to audio books and movies in 23 languages.
It’s astonishing just how quiet the environment is – HEALING, some would describe it – without constant overhead pages, phones ringing, or the buzz and alarm of medical equipment. RNs and allied health professionals get direct feedback to the uniform shield devices (a cross between a clipboard and a BlackBerry) built into their lab coats that notify them of changes in patient condition, and convey physician messages. These devices are voice activated so staff members do not spend any time typing text when sending or retrieving messages.
Since time with patients and families is highly valued, nurse-to-patient ratios never exceed 1:4, allowing staff the time to interact more often with patients and their families.
The robot assistants paired with the nurses and allied health professionals have dramatically expanded the role of the professionals. They are programmed to perform MRI-type assessments on each patient at prescribed times during each shift, and notify RNs immediately of problems or changes.
Each RN has bedside interaction with each patient every 20 minutes on the med surg unit, and every 8 minutes in critical care areas. This enables the RNs and their allied health counterparts to do more teaching and provide emotional support to patients and families. Janie, who has been a nurse since 1990 says it reminds her of the ‘good old days’ when nurses had time to talk with patients.
Some units are language immersion areas where caregivers can perfect and maintain their bilingual abilities, and where the culture of the patient population being served is reflected in everything from the décor, and entertainment selections to how care is provided and food choices.
The robots (and the personal moving walkways) cut down the amount of walking staff members must do during each shift. Robots assume tasks such as performing labs and producing results at the bedside and getting extra linen. If specialized equipment is needed, the RN or allied health professional gives the robot a voice message. The robot in turn identifies the code and location of that piece of equipment and retrieves it.
The food service robotic team manages tray-delivery and pick up, assistance with meals, and can produce virtually any type of cuisine within 15 minutes around the clock.
Environmental services technological innovations have effectively eliminated hospital acquired infections, as no caregiver or family member is permitted within five feet of any patient without thorough hand scrubbing.
As professionals make rounds to provide care and to interact with patients and their families, a voice chip attached to their badges records and documents all of their observations to the electronic medical record in real time. No one ever needs to stay behind to finish charting, and the medical records have an accuracy and value that has never previously been experienced.
Flat interaction screens in the patient rooms can connect the RN or allied caregiver with a hospitalist instantly if there is a change in condition that the professional wants the doctor to observe, or needs immediate feedback on.
Patient pod units are what the patient is admitted to, and the entire unit (just slightly larger than the beds of 2007) goes everywhere with the patient. As the patient moves through the system – from ED to OR to ICU to Telemetry, they remain within the same pod unit.
On each home pod screen there are holograms of the physicians, RNs, and allied professionals in charge of each patient, along with their contact codes.
The pod units are self-propelled and self-guided, using GPS technology. Care givers program the patient destination with a wireless wand, and indicate if a robot, transporter, therapist, RN, or family member will accompany the patient.
Meds are dispensed directly to each patient’s pod and distributed at the bedside using a bar-coded system. All equipment needed to dispense the medication is included in the pod. Each RN presses her thumbprint on the screen. This pulls up the ID of the RN and preferences entered by each nurse. The computer dispenser moves up or down to be at eye level, and the computer screen uses the nurse’s font of choice to display information. The talking bar code double checks every aspect of medication administration to avoid errors.
The ergonomic design of pod beds enables patients to remain in bed for all testing except surgery. In the OR, the beds’ built-in lift mechanism can be configured to move the patient to the OR table safely and without human effort.
Nurses schedule team huddles that include physicians, allied health professionals, the patient and family members twice a day, happening at the times requested as most convenient by the patient. Everyone is brought up to speed on the patient’s progress, and questions can be answered efficiently.
Staff RNs partner with college instructors to provide clinical mentorship for nursing students, who pair directly with the nurses as patient care progresses. Despite the fast-paced high tech environment, students are able to complete a BSN program within three years due to the intensity of the mentorship programs.
Health care leaders and recruiters meet with students once a week to answer questions and to see how things are going since the competition for new graduates is fierce. But Future General has an edge over their competitors, because the work environment for nurses and allied professionals is above average, and physician respect for them is superb. (One of the key reasons for such high levels of physician respect is that the Worklife Committee at Future General has final approval of which physicians are allowed privileges at the health system.)
Experienced RNs and allied professionals also vie for positions here, due the high level of supportive technology and the excellent care provided to patients.
The fact that nurses’ stations have been reduced in size and augmented by nurse comfort stations is another plus. Breaks and lunch are mandatory for all staff. During breaks, any caregiver can enter a privacy pod for a free 15-minute rejuvenating spa treatment. The menu includes services from mini facials to oxygen therapy to body massage to acupuncture – all done by robots in a calming, relaxing environment. Since schedules are extremely flexible (as short as thirty minutes) and job sharing is the norm, there are adequate RNs to cover mealtimes and breaks.
Staff members enter their scheduling preferences into a smart computer that tallies requests and produces the working document. The robots that compile budget information to be reviewed and approved or corrected by unit managers also do the ordering of supplies and capital equipment.
The need for meetings and committees has been virtually abolished since everyone can communicate in real time using virtual technology. This frees managers to spend most of their time on their units of responsibility, discussing care with the professional teams and physicians, and interacting with patients and their families. Turnover is tiny at just 4%.
Future General requires one manager for every 100 employees, so managers have a reasonable span of influence. Screens in each room allow them to check in with their units any time of the day or night using a password.
And how have these changes impacted HR and Recruitment? Well, the role of the recruiter has changed, and the technology available keeps them in frequent touch with candidates. Recruiters keep in contact with passive candidates by sending holograph messages on a bi-weekly basis, tailored to each candidate’s interests and lifestyle.
Travel companies pay Future General to allow ten each of their nurses, PTs, OTs and Pharmacists to come every year for mentoring and training in their unique environment. Recruiters oversee these partnerships as well as those with colleges and universities, since they have so little physical recruitment to attend to.
In addition, Future General’s recruiters function like talent scouts. They do a tremendous amount of relationship marketing with potential hires, and guide those who cannot get positions into programs that will increase their skills. Thus, the pipeline of great candidates is always primed!
Fantasy or Reality?
While the robots and holograms may be a bit out of the everyday, most of the technology mentioned in this article is available today. Many companies are working on some of the other innovations mentioned, so that they, too, could be in use by 2020.
But what is NOT out of reach today is promotion of a healing work environment, where people are treated respectfully. And the kind of processes that allow recruiters and health care leaders to use relationship marketing to convert passive candidates into hires is also available, even if holographic messages are not. Career counseling and steering good candidates toward programs to increase their skill sets exists in some of the best companies of today. So while all the bells and whistles would be nice, the BEST work environment certainly does not require rocket science. The BEST environment is not a vision of the future. It can be reality TODAY!
Kate Christmas is an RN and Vice President of the Health Care Division at Bernard Hodes Group. She can be reached at kchristmas@hodes.com.
To contact a Hodes Health Care team member, call us at 800-582-4668 or email us at healthcare@hodes.com