Vol. 8 Issue 5
Implementing Lifelike Animation
Boston Medical Center implements computerized workstation to converse with patients
With the premise that something wasn't right with its discharge process, Boston Medical Center set out to make the procedure more efficient. After multiple grant cycles over the course of 3 years researchers most recently received a $1.2 million grant the hospital piloted "Louise," a computerized workstation that electronically prepares discharge plans for patients.
Last month the hospital implemented a small-scale program on two of its inpatient units and eventually plans to roll out the workstation to all units.
"We're putting theory into action it's not ready for prime time yet," said Lisa O'Connor, MS, RN, CNAA, vice president of nursing.
Conversing With Patients
Louise determines patients' understanding of self-care, medication use and the transition from hospital to ambulatory care. "She" also converses with patients at the point of discharge on a kiosk wheeled into the patient's room.
"Our intent is to develop the technology and content to make it possible for Louise to interact with patients after discharge on a hand-held device, and on a kiosk in their primary care physician's office," said Brian Jack, MD, vice chair of family medicine.
Will Ease Nurses' Workload
"While the program was created to primarily help patients, by implementing the program on our floors we'll be able to better gauge how Louise will also help our nurses," O'Connor said, adding that Louise interacts with patients on a basic reading and understanding level.
The workstation tests patient knowledge through test screens and documents their understanding. In addition, patients are able to ask detailed questions about their medications, which is where patients fail most often at home.
"We know the program will help nurses because it gives patients the in-depth opportunity to learn and it documents their comprehension. It also allows patients to spend time at their own pace not the nurses' pace to learn, and the animation is very lifelike," O'Connor said.
In addition to Louise, the grant Boston Medical Center researchers received will benefit the ReEngineering hospital Discharge (RED) program. RED is a checklist with 11 components that confirms patients are ready to be discharged. The objective, Jack said, is to reduce inappropriate readmissions, increase patient satisfaction and promote primary care services in the community after a hospital stay.
"Our goal is to decrease medical errors and adverse events after a hospital discharge, and ensure patients are well-prepared when they leave the hospital," he wrote in a recent issue of the Journal of Patient Safety.
According to the medical center, the research funded will improve delivery, monitoring and updating of patient-centered health information to ensure patients have the information needed to make better healthcare decisions. Preliminary research shows patients who received these interventions are more likely to see a primary care doctor within 30 days of discharge, are prepared for discharge and their follow-up appointments, are more likely to understand their medications, and are less likely to visit an emergency department.
Both projects are supported by the Agency for Healthcare Research and Quality as well as the National Heart, Lung and Blood Institute, part of the National Institute of Health.
Emily Marchesani is a frequent contributor to ADVANCE.