7 innovations transforming emergency care

Technology has revolutionized the way medical professionals work, communicate, and process information.

Nowhere is this more apparent than in the emergency department. Digital communication tools allow nurses and clinicians to uncover and track data in real time and adjust the course of treatment. As healthcare architects, we strive to incorporate creative and cost-effective technologies into ED spaces to help improve patient outcomes and the delivery of care.

The following is a list of innovations transforming the way emergency care is provided.

Miniaturization of imaging and diagnostic equipment
Point of care ultrasound machines allow emergency doctors to make diagnosis easier by identifying injuries and illnesses such as bleeding in the abdomen, gallstones, kidney obstructions, or acute heart failure. While Medical Imaging is required to perform comprehensive scans, POCUS allows emergency physicians to answer binary questions that may influence the course of care and dramatically improve outcomes. Physicians are able to travel with a dedicated imaging machine, eliminating the waste of learning how to operate a different machine or having machines sit idle. Miniaturization is also starting to extend into the fields of endoscopy and laryngoscopy, where a handheld device is replacing a bedside cart.

Non-invasive bedside laboratory testing is also changing the delivery of care model. The I-STAT blood testing system delivers laboratory-quality test results through a handheld device and then wirelessly transmits results to a patient's EMR. This bedside technology eliminates the waste of transporting samples to and from a laboratory and frees up highly coveted ED real estate.

Research has shown that immediate access to imagining is vital to the diagnosis and outcome of stroke and head trauma patients. However, because CT scanners have traditionally been large and expensive, they are not always immediately accessible to the ED. New miniaturized CT scanners are portable and wireless, able to be brought directly to a patient's bedside. These portable CT scanners are revolutionizing the standard of care by eliminating the dangers associated with both the transportation and wait times traditionally required to move a critical patient to a Medical Imaging suite.

Telemedicine
Equipping ED treatment rooms with cameras, monitors, and high speed internet invites new opportunities for remote consultation with specialists around the world. This technology empowers small rural hospitals to partner with sophisticated centers of excellence, no matter how far from the facility, to provide patients with a higher standard of care. Some EDs incorporate smart TVs in the exam rooms connected to the facility picture archiving and communication system so that imaging data can be pulled up in a patient room as an aid for discussions. In the future, touch screen tablets outside every exam room door will function as both a room sign as well as a tool for medical staff to bring up patient data prior to entering the room - similar to having a paper chart mounted next to the door but more secure and capable of generating additional information.

Additionally, WiFi connected equipment, both in and outside of the hospital, allows for patient data to be securely collected and transmitted to physicians for evaluation and tracking. For example, systems currently exist in which a patient may upload glucometer readings or stethoscope sounds directly to their EMR for physicians to review.

Handheld devices
As with the rest of society, over the past several years EDs have become more computerized. Tablet computers and smart phones are increasingly common in daily use by practitioners and patients alike. Physicians can now review EMR data (like glucometer readings or stethoscope sounds) from anywhere on their smart phones. Given the prevalence of handheld devices, it is inevitable that more decision support, charting, and patient record management will be performed on these devices. Moving forward, all horizontal surfaces in an ED should be adaptable into a touch-down work station with data connectivity and power (including the incorporation of wireless inductive charging surfaces to eliminate unnecessary wires).

Online Check In
Several Emergency Departments across the country allow for patients to check-in online via a mobile device – entering personal information such as insurance and point of contact data. Registration can occur at home, in the car, in the waiting room or bedside in a treatment room. This elevates the paperwork burden on already stressed triage and reception staff and expedites the check-in process for patients.

Patient Flow Software
Gone are the days of nurses walking up and down hallways documenting empty beds. Today patient flow software manages where patients are (and are not) within the hospital. It can identify available beds by specialty, thereby streamlining registration and decreasing wait times. These systems have been said to improve communication across departments and expedite both admissions and discharge procedures.

Real-time Locating Systems
Similar to Patient Flow Software, real-time locating systems digitize information regarding where a patient is, or is not, during their course of treatment. This technology can also be adapted to track all movement in the hospital by applying location transmission tags to patients, beds, staff, and equipment alike. With this information practitioners are able to more accurately track movements to efficiently manage time and care. Additionally, hospital administrators may utilize movement data to analyze work flow, standardize care, identify best-practices, and eliminate waste.

Utilizing Technology to foster Lean Principles
As pressures mount for EDs to do more with less, many healthcare systems have turned to Lean principles borne out of the manufacturing industry to cut waste and improve efficiency. Lean planning tools rely heavily on data analytics - both collection and management software. By tracking analytical data (such as movement times collected with RTLS), administrators are able to identify optimal registration procedures, treatment process times, and staffing schedules. From a patient care perspective, Lean principles seek to standardize work processes to ensure outcomes are reproducible and predictable – improving patient outcome and departmental satisfaction scores.

It is an exciting time to be a healthcare architect. Technological innovation, and its incorporation into emergency department design, has improved both the patient experience and care outcomes. We look forward to witnessing how technology continues to improve the delivery of healthcare and being a part of its evolution.

Regan Henry, PhD, AIA, LEED AP, LSSBB, is a Healthcare Architect and Research Director at E4H Environments for Health Architecture, an architecture and design firm exclusively focused on healthcare and health innovation.

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