Redesigning Patient Identification
Reviewing patient identification experience for nurses to ensure patient safety.
Center for Social Design at Maryland Institute College of Art(MICA)
Client: John Hopkins Medicine
2016, Baltimore
Skills: Design Research, Interview, In-situ Observation, Prototyping
Summary
John Hopkins hospitals had recently switched to the EPIC software which led to some changes in the workflow of registered nurses (RN). For some units, despite the added steps of scanning the patient, it made the workflow more efficient. For other units, these extra scanning steps caused some limitations, which were uncovered in our research.
We conducted interviews and in-situ observation of the EPIC software working with the patient ID wristband at Johns Hopkins Hospital. Then we redesigned the system to ensure patient safety and showcased prototypes to the John Hopkins Armstrong Institute through role playing activity.
Problem
RN needs to scan every medication or fluid bags, and also the patient with a loud scan noise.
To avoid disturbing the patient and ensuring efficiency in patient care, the RN generated a workaround by printing multiple wristbands and placing them on the computer to reduce the extra moving back and forth to the patient.
In doing this, an issue arises when there are multiple armbands in the room, which can easily lead to patient misidentification.
How might we rethink patient identification to discourage multiple band reprinting while ensuring patient safety?
User Research: We got in two groups to initiate two research methods, one group for doing the observation and the other group sat down with nurses and asked questions.
Synthesize: We regrouped to exchange and combine our observations and findings. Then we identified common themes of the causes of this workaround.
Ideate: Building upon the problems, we came up with potential strategies for the corresponding problems.
Themes | Insights | Interventions
Nurses do workarounds to make the work quicker, easier, and more efficient while avoiding to disrupt patients. We got inspired by the causes and proposed other opportunities for patient identification that prioritizes patient care and efficiency without sacrificing patient safety. These interventions includes EPIC ON THE GO, a portable scanner and fitbit-like wristbands with a proximity sensor that provides additional patient information like blood pressure and heart Rate.
Room Setup
Scanner, computer, and patient are not within close proximity.
Rearrange room setup plus using a portable scanner; EPIC on the go.
Wristband
Inaccessible for scanning if the patient is asleep or at a different angle.
Wristbands to have a proximity sensor and a barcode.
Hardware/Software
The scanner has a disruptive noise and software multiple steps made it complicated.
Use light or vibration to notify plus fingerprint scanner for nurse’s login.
Reprinting
There is no limit for the number of prints of the wristband.
Minimize access and limit the number of printable wristband per patient.
Patient
Patients are not aware of the importance of band and refuse to wear it.
Patient education through visuals like posters or on TV to create a behavior change.