Signage Streamlines Cincinnati Children’s Hospital, Part 1

When Cincinnati Children’s Hospital Medical Center decided to implement a new, hospital-wide clinical, financial, and patient workflow system, it also seemed the right time to replace the dry-erase 11/11/2008 3:00 AM Eastern

Signage Streamlines Cincinnati Children’s Hospital, Part 1

Nov 11, 2008 8:00 AM, By John W. DeWitt

AVI-SPL integrated Cincinnati Children's Hospital's patient workflow into a realtime digital signage system.

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When Cincinnati Children’s Hospital Medical Center decided to implement a new, hospital-wide clinical, financial, and patient workflow system, it also seemed the right time to replace the dry-erase boards that tracked patients’ progress through operating rooms and other treatment processes. SVC talked to Brian Hicks, a systems analyst with the hospital’s information services department, about how AVI-SPL integrated its patient workflow into a realtime digital signage system. The network of 46in. NEC LCD screens not only streamlines processes for hospital staff, Hicks says, but they also give worried parents the up-to-the-minute status of their children.

SVC: How did replacement of Cincinnati Children’s Hospital’s financial and clinical systems lead you to implement digital signage?
One piece of our new system was a patient workflow system that replaced systems and processes in critical areas, such as the operating room, same-day surgeries, and the PACU, the post-anesthesia care unit. The new system actually tracks patients as they go through areas. Staff previously used dry-erase boards, which they would update as patients went through, so this project integrated LCD digital signs to do this in realtime as a patient goes through. For example, the patient gets an exam for surgery, then moves to the operating room and his or her information is updated in realtime, and at the same time the information is changed on a screen in the family waiting room.

Obviously you are implementing signage in a mission-critical application. What were some of the challenges you faced in this project?
The main challenges were the physical aspects of the design—the text and clarity of screens, placing screens at the right height to ensure safety, and installing them in high-traffic areas with lots of equipment getting moved around. The screens needed to be out of the way and still usable and viewable.

The ability for information services to support the screens also was crucial. They are running 24/7 because they’re in operating rooms. To ensure these screens and systems were always available, we designed them to run a continuous health check; they even try to fix themselves. And if screens are cut off, we can remotely log in and power the screens on. We can do that centrally from the IT department, which is a few blocks down the street from the main campus. Taking a shuttle to the hospital can take us an hour, but as soon as a doctor or nurse calls, we can log in and turn it on.

How are the screens configured and controlled? Was it a challenge install wiring for the network in operating rooms?
Five areas have multiple 46-inch screens in a matrix display. One is a 1x4 matrix, another 1x6, and another 1x3. For control, we use an individual thin client PC per screen, which gave us the support to see each screen individually. Originally, we looked at having one PC with a video card supporting multiple screens, but that raised issues of resolution and clarity. There are many areas we can’t run wires through—for example, the operating rooms—but luckily we already were wired for network connectivity, so we could just plug the thin client PC right behind the screen, then plug into the network and power. There were some areas without connections nearby, so we ended up running standard VGA tables no more than 25ft. over to a locked cabinet where we could put the PC and connect to the network.

How is the information entered, stored, and displayed on the signage? What happens, for instance, if there’s a sudden change in the schedule? How do you protect confidential information?
The application is held in our data center—and that’s where all the data is held. There’s a client piece on any workstation in the hospital for doctors and nurses, so when they enter information, that’s reflected in the central servers; there’s a terminal services connection back to our server, and then the system formats that information on the displays.

If someone is running late, or there’s an add-on or walk-in for that day—for example, a major trauma case—then the staff can change the schedule live as it’s happening. Depending on the area, certain pieces of information are displayed. We have to ensure compliance with HIPAA [Health Information Portability and Accountability Act]. For example, in the parents’ waiting room, we couldn’t display the patient name and surgery, so each patient is assigned a unique number that’s given to the family, and they can track status changes on the screen. The screens in the operating room area show the doctor, patient last name, along with the nurses on duty in the OR. This helps with teamwork and workflow, resulting in faster and safer response time.

Part Two of SVC’s interview with Hicks will discuss the deployment of signage, kiosks, and teleconferencing systems at Cincinnati Children’s Hospital’s main campus and new Liberty campus.

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