The Albert Schweitzer hospital (ASZ) implemented the HiX Mobile app on the COVID department just before the third COVID wave hit the Netherlands. They aim to use this app to better support the nursing staff during their duties. The app arrived just in time, because it reduces the registration burden in all of the chaos. Sjoerd de Boer (project manager I&A) and Esther van Es (nurse and CNIO) were the driving forces behind the implementation. They told us about the implementation and the experiences in the workplace.
Thanks to the app, the COVID nurses at ASZ no longer need to leave the cohort area to access the EHR and register a patient's measurement values on a PC or a COW (Computer on Wheels). This saves them a lot of time, because they no longer have to walk to another department, change their clothes and decontaminate in order to leave the department.
Proper coordination between all parties
In order to benefit from these perks, all parties need to properly coordinate with each other from the very beginning of the implementation process. Project manager Sjoerd de Boer says: 'There are a lot of parties involved. It's not just the EHR supplier, but also the telecom supplier, other IT parties, and mobile device management. A challenging process. During the kick-off of this project, ChipSoft presented their plan for a successful implementation to all parties involved. From that moment on, everyone was on the same page.'
Sjoerd de Boer
The Albert Schweitzer hospital put together a steering group in order to lead the project in the right direction. The steering group consisted of the IT manager, the CMIO, the chair of the Nursing Advisory Council (VAR), and the CNIO. They met weekly to discuss the progress of the implementation. The hospital also put together working groups in order to focus on the technical aspects and the functional configuration of HiX Mobile. De Boer states: 'I would recommend such a project structure to anyone.'
Video calls were the solution
During the implementation, video calls through Microsoft Teams were the solution to not being able to gather in large groups. Sjoerd: 'With video calls, you can easily bring all parties together. The ability to share your screen during the meeting allows all parties to reach the best configuration for the app. In that regard, the COVID measures have actually increased the efficiency of our project.'
The project manager immediately noticed that the implementation of a mobile app affects the entire IT architecture of the hospital. De Boer: 'You have to take HiX into account, but you also have to consider the communication server, the HAS (HiX Application Server), and much more. That means that you will have to involve and inform a lot of people. That has an effect on the existing environments. The implementation of a mobile app also means you start using a type of device you haven't used before in the workplace. It's very important to make the right decisions regarding that mobile device.'
Deciding on devices
The Albert Schweitzer hospital decided on a Samsung smartphone. De Boer: 'The most important thing is that everyone must be able to use it. That's why we took four of the most frequently used phones in healthcare and tested them on speed, performance, battery life, ease of cleaning, and user-friendliness. These tests were done in collaboration with the Nursing Advisory Council. On the basis of those tests, we made our decision. We received the new devices in January.'
That same month, Esther van Es started as the Chief Nursing Information Officer (CNIO), while also maintaining her duties as a nurse. She was actively involved in the project, utilising her two perspectives, that of the nurse and that of the functional application manager. Van Es: 'As functional manager, you want the configuration to be as simple as possible. As a nurse and CNIO, you want the configuration to be as user-friendly as possible. I immediately noticed that the app is very intuitive. It's immediately clear what the possibilities are, which information can be viewed, and where you should enter your measurement values.'
Esther van Es
Registering measurement values and pictures
The nurses of the Albert Schweitzer hospital primarily use the app to register measurement values, but they also use the app to make pictures. Van Es: 'Making pictures, for example from surgical wounds and bedsores, is very easy. Previously, we would make pictures with one device and we would store those pictures on another device. We then had to upload those pictures from that device to HiX. Now, the picture is immediately uploaded to HiX. The physician is able to directly view the image and the picture won't be stored locally on the device.'
The nurses work from a nursing care plan that can be viewed from the app. 'It's easy to see what is on each patient's schedule,' says Van Es. 'All relevant viewing options are directly on hand without needing a PC or a COW (Computer on Wheels).' The app also prevents having to register certain data twice. 'We don't have to write it on paper first and then enter it into the EHR anymore.'
Increasing the number of functionalities
In the future, other departments will also be able to enjoy these benefits, according to the CNIO. 'We started with a limited number of functionalities on three COVID departments and are hoping to increase the number of functionalities in the near future, for example the fluid balance.'
Van Es thinks that it's important to manage the expectations of the nursing staff in order for them to quickly get used to working with the mobile app. 'Per department, you will need to make sure that the app will help the staff in their daily activities. Then it's important to properly explain that the app is an addition to the COWs and PCs. Even though the app offers quick access to the EHR, you'll probably still want to use a keyboard to type the reports.'
Nurses are pleasantly surprised
Van Es says that the first experiences on the floor are very positive. 'Overall, the nurses are pleasantly surprised. They are curious, enthusiastic, and like using the app during their measurements rounds. They are still missing certain functionalities that prevent them from registering all of the data they collect during their rounds in the app, but the next update will add new functionalities, such as the medication administrations. That's great!'
The nurses are picking up on the possibilities of HiX Mobile so quickly, that the Albert Schweitzer hospital has decided to implement the app hospital-wide. Project manager Sjoerd de Boer says: 'Our location in Dordrecht already uses the app. That location has fifteen departments. They will soon be joined by another three departments from our location in Zwijndrecht.'
Implementation of the HiX Mobile Specialist app
The implementation of the HiX Mobile Specialist app will follow the implementation of the HiX Mobile Nurse app. De Boer: 'We want to start implementing the specialist app before summer. HiX Mobile Specialist allows physicians to open patient records remotely from outside of the hospital. We are currently working on that.'
The HiX Mobile apps are intended to play a prominent role in the Albert Schweitzer hospital. De Boer: 'We want to start using mobile devices a lot more. That includes installing more useful apps for our nursing staff. In time, mobile devices should also replace pagers and alert systems for infusion pumps and measurements.'
De Boer and Van Es are eager to start making progress. 'Nurses should be carrying around as little accessories as possible. We hope to make some progress in this area as early as next year. The implementation of HiX Mobile is a great first step! We are still in a very early stage, but we want to expand on it as rapidly and effectively as possible.'
