The Emergency, Maternity, Oncology and Surgery & Anesthesia teams are designing electronic tracking boards that will be integrated with the new clinical information system to make providing patient care more efficient and effective. Once the tracking boards are implemented, the days of relying on a whiteboard to manually track patients on a unit will be over.
There will be tracking lists for small screens, and tracking boards visible on large LCD screens. No full patient name is displayed on the large screen, but it shows all the details staff members need to do their work. The smaller tracking list has different views: an ‘all beds’ view, which any care team member can see, and role-specific views for providers, nurses, registration clerks, nursing unit coordinators and so on.
The board makes it clear who needs to do what for a patient. You can send alerts to it, so everyone in the department can see them without looking at the patient’s chart, which is good for patient and staff safety. There could be alerts for isolation status, allergies, violent patients and care plans.
The electronic boards will be interactive – you can click through to the patient chart or go directly to test results. If a test result has a critical value it will show up as an alert. The tracking board won’t show the actual result; just that it has a critical value and needs attention.
Tracking boards make it easier to find patients too. For example, if a patient has gone for an X-ray, the board shows where they are. It therefore decreases the time spent tracking down patients.
Emergency tracking boards
A tracking board enables staff to see all of the patients in every area of an emergency department and understand who’s providing care, what care is required and what stage of their visit a patient is at. In addition, it shows how long they’ve been there, whether or not their test results have come back, what consults have or haven’t been done, whether or not they’re ready for discharge, and so on.
Access leaders can see any hold-ups and what might be causing them.
“You can see from the board if someone has a lot going on, and offer help where it’s needed,” adds Melissa Pearson, (former) Associate Lead for the Emergency Design Team and an experienced Emergency nurse.
Download a printable version of the article A clear view of the Emergency Department (PDF).
Maternity tracking boards
In maternity departments, tracking boards will include pertinent information such as membrane status and Group B streptococcus status, as well as the usual alerts about allergies etc.
There will also be a free-text comments section, so that staff can include important up-front information such as “No visitors”, or “This person is hypno-birthing and should not be disturbed”.
The tracking board will also display triage information, showing a patient’s stage of labour or whether they are undergoing ante-natal testing.
“This should help us to utilize beds more effectively, because we can anticipate how long the patients will need them for,” says Shardae Brown, Maternity team manager. “It also helps with managing staff time – if you can see that you have two patients in dilation and one pushing, you wouldn’t put two nurses on a break.”
Oncology tracking boards
Oncology tracking boards will be implemented at various oncology clinics. All care providers will be able to view relevant information at the same time, without having to look through a paper chart.
Oncology tracking boards will make it easier to know what’s going on with a patient. Care providers will see up-front: when a patient’s drugs are ready for pick-up at the pharmacy; when to call a porter; whether an interpreter is needed; and other useful, relevant pieces of information. Some examples include: provisional evaluation is needed; the patient’s chair is ready; treatment is on hold; a child life specialist is needed; a blood product has been ordered; patient is receiving procedural sedation; and more.
“It should speed up appointments,” says Kerrie Cino, clinical team associate for pediatric oncology at CST. “It doesn’t seem like it takes long to make a quick call but it adds up across the day. Patients will be able to spend less time in the chair and more time doing other things. If we know a patient has arrived early we may be able to get them in early and that information will be face-up on the screen. If they’re late we’ll know that too. It will be much more helpful than the way we do things now.”
Clinical trial patients, who are currently tracked separately, will be included in the tracking board. An icon can be used to indicate that the patient is on a clinical trial, and the comments section will allow research staff to communicate with clinical teams. This enhances safety by providing a flag that the patient is on a clinical trial and increases efficiency in communication between research teams, nursing and pharmacy. Using tracking boards will ensure timely communication, meaning that critical clinical trial information is less likely to be missed.
Surgery tracking boards
Electronic surgery tracking boards will perform a function very similar to the current OR slate but with more information available to staff. The paper slates that are used at the moment are usually printed on the afternoon of the previous day and information often changes in the interim. (There will still be a printed version of the tracking board information available, which will be updated once a day and provided to the blood bank, the lab and anyone else who needs the information but does not have access to the clinical information system.)
As well as showing which patients are scheduled for what surgeries, the board will show real-time status updates, such as whether surgery has started or stopped. Each area will be able to see, for example, if a patient has arrived, has been worked up, is ready for surgery and so on – without all the phone calls they currently have to make.
- Staff and physicians will be able to see a patient’s pre-op status and PACU status
- Medical device reprocessing staff will know how many carts they need to send, which is particularly useful since they are often located far from the operating room
- Anesthesiologists will know whether the patient has been seen by a nurse and is ready for follow-up
- Unit staff will know when their surgical patients are due back