Why reinvent the wheel? This was the approach adopted by University Hospitals Leuven when developing a Patient Data Management System (PDMS) using MetaVision software to provide a critical information system for the intensive care unit (ICU) and coronary care unit (CCU) of OLV Hospital in Aalst, Belgium.
Christof Van Den Steen, an IT professional and former ICU nurse, was responsible for implementing this system in the ICU and CCU of OLV Hospital. This necessitated adjusting the existing legacy system to suit the workflow of both units, as well as integrating new hardware that enabled the system to be accessible from bedside terminals. Mr. Van Den Steen stated, “The differences between the ICU and CCU became apparent during the initial implementation stage. The CCU is a modern facility located in the new wing of the hospital, and patient rooms have sufficient space to install beside terminals. By contrast,the ICU is somewhat outdated and the patient rooms are smaller. The space around the bed is sometimes insufficient for the equipment. Thus, we needed a compact bedside system with limited space requirements. We began our investigation in Leuven and Antwerp. Although the most obvious solution was a wall mount, the feedback from other hospitals was that wall mounts have a tendency to wobble and be unstable. So we had to look further. We approached various companies for assistance with determining a solution. Alphatron Medical was one of them.”
Considering the appropriateness for small spaces and installation flexibility, Alphatron had a more than suitable solution— the AMiS medical cart. This handy, mobile care workstation equipped with a thin client is specifically designed to support the provision of bedside care. “At our first meeting, it became clear that OLV Hospital in Aalst was looking for something that differed from what we typically provide,” said Alphatron. “Most hospitals in the Netherlands use a wireless system. However, their ICU is situated in the old part of the hospital, where no wireless network is available. So we devised a unique solution for OLV Hospital that involved attaching a flexible mounting pole to the ceiling for the system wiring.” Mr. Van Den Steen was quite impressed by Alphatron’s rapid service. “They immediately provided us with an AMiS device to test in the hospital,” he reported. “The workstation was very stable and easy to use, both when sitting and standing. After consulting bedside personnel, we decided to have a drawer added for storing files.”
Based on this positive experience, OLV Hospital purchased 25 carts for its ICU - 24 for bedside use and 1 as reserve. “Although the AMiS units are comparatively higher cost, they seem durable. These systems must be able to withstand rough treatment because patient beds are frequently moved around. However, the portability of these units means that we can take them with us if the ICU is relocated. Following a discussion with the head nurses and doctors, we concluded that the AMiS units were a financially justified investment,” said Mr. Van Den Steen. Alphatron also asserted that these units were truly a long-term investment, because they are optimized for the future. The main advantage of AMiS workstations is their modular design. With only a few small adjustments, the system can be easily updated. Additionally, for wireless operation, all that is required is the installation of a battery unit.
For certain applications, the AMiS cart can also be installed as a stationary wired unit. Because of their stability and reliably,wired work stations have attracted market interest in the Netherlands. Alphatron reported, “We recently received requests from two hospitals for identical AMiS units, with data connections and power supplied directly from the ceiling. This is considered a very stable solution. If the required radius is not more than 2 meters to the left and to the right, it is an excellent solution. Our service focuses on the customer’s
wishes.” Nonetheless, the ceiling installation proved to be fairly challenging. Mr. Van Den Steen said, “In an ICU, the ceiling cannot be directly demolished, because care must continue. Instead, we dismantled the ceiling in sections in order to install the network wiring and electricity. A cleaning crew was sent in afterwards to clear the area, and Alphatron handled the subsequent ceiling cable installation and AMiS connection.”
Following the hardware installation and software integration, implementation of the PDMS was initiated. “IteMedical (distributor of MetaVision in the Benelux) had drafted a project plan with a tight schedule, which generated a fair amount of pressure. First, all technical issues had to be resolved. We then scheduled training for super users and end users. In total, 170 users were trained in three weeks!” By mid-December, the system finally went live. Mr. Van Den Steen continued, “For the first two weeks, people were somewhat confused by the system. It was a particularly busy time for the ICU and on top of that, everything had to be performed on a computer. Several issues arose as the adoption progressed. However, by now, staff have successfully completed all the relevant processes associated with admitting and discharging
patients, and are gradually gaining more confidence in using the system. Based on our experience, we are currently making a few adjustments in order to better manage workflows.”
Currently, doctors and nurses recognize the benefit of using the PDMS. According to Mr. Van Den Steen, “They see the advantages of the system. Specifically, it ensures a uniform method of registration. Just consider the simple value of being able to read everyone’s notes! Nonetheless, the underlying purpose was not specifically to save resources and staff time. Searching for and filling out forms still takes time, especially since all the fields must be complete before the form can be saved and closed. In the past, patients would be given pain medication and that would be it. Now, the system also requires staff to complete a paper evaluation of the patient’s pain score. Presently, paperless operation is not viable or even necessary. In the future, however, our goal is to limit the use of paper; but that will take time.”
Sufficient foundations have now been established at OLV Hospital. “By working with University Hospitals Leuven, we were able to enhance a number of key elements, which is why the system comprised several items initially. They provided plenty of valuable advice, which was enormous beneficial for us. We still consult them regularly regarding support and administration. Communication is very important. Organizations and people must connect with each other for good cooperation. Fortunately, our collaboration with Alphatron was very positive. The feedback received from the nurses has been fairly positive. The only problems still encountered are hardware-related, such as the occasional blue screen. From an end user perspective, this is not ideal. However, we are confident that this issue will be resolved quickly.” For Mr. Van Den Steen, certain challenges still remain. “The departments are only in the initial adoption phase. Plus, the system can never be truly “finished” due to its ongoing development.” Nonetheless, the AMiS units are not expected to pose any obstacles because they are proofed for the future!
This project was realized by Alphatron Medical Systems and customized specifically for OLV Hospital in 2012.