Beds that can reposition a patient without the assistance of a nurse, collect vital signs and alert staff if a patient is at risk for falling or attempts to leave their bed; robots that could deliver water to patients or specimens to laboratories; and technologies that enable care delivery through virtual nursing and can guide visitors to parking or the front door and let hospital staff know the moment they arrive — these are among the many features patients and their family members will experience at the new UT Health San Antonio Multispecialty and Research Hospital.
Two goals of hospital staff are to make patients and their families more comfortable and to help hospital employees and providers do what they love: caring for patients and improving satisfaction within their work environment.
“There is not a single piece of technology in this hospital that someone said, ‘it would be really cool if we had this,’” said Jeremy Viles, DNP, MBA, RN, NE-BC, chief operation officer for the hospital. “Every piece of technology was reviewed and selected with the intent of trying to solve challenges of our care teams that they’ve experienced over their careers. Every aspect of care delivery and consideration of those working in this environment is crucial to what we are building.”
Focused on patients and staff
The hospital is expected to open in December with a focus on treating cancer patients and those who need to undergo complex surgical interventions. With 144 beds and 12 surgical suites, the hospital is poised to be technologically innovative while remaining patient-, family- and care team-focused.
Yeman Collier, vice president and chief information officer for The University of Texas Health Science Center at San Antonio, said the average stay for bone marrow transplant patients at the new hospital could be 28 days or more. With a length of stay higher than average, having beds that offer more than simple comfort was important. For example, the hospital’s beds collect pressure data to sense if a patient who is a high fall risk attempts to get out of bed, and then immediately alerts nursing staff.
“I came from a time where hospital beds were barely electronic. We used to have all these creative workarounds such as aftermarket bed alarms,” Viles said. “When I was a floor nurse, we always had to find several people to help position patients and turn them every two hours. Now, the beds can rotate the patients and prevent pressure injuries by maintaining a consistent positioning schedule. It will also help to protect nurses and care team members and prevent back injuries from lifting and manually positioning patients.”
Nursing assistance
Virtual nursing is another key feature of each patient room. Each large-screen monitor serves not only as a television, but also has a microphone and camera so the patient can interact with a nurse, physician or even family members who are not physically present. The screen displays the patient’s care team, schedule for the day, options for movies and music and even provides the ability to order from the cafeteria in alignment with specific diet and nutrition guidelines.
“Early discussions about virtual nursing really perplexed folks, almost as if they had an image in their mind of a nurse hologram,” Collier said. “Virtual care models allow nurses to perform many of their caregiving activities from locations other than at the patient’s bedside.
“We asked ourselves, how do we create an environment whereby nurses are enabled to operate at the top of their licenses and certifications and not running water bottles back and forth?” he said. “If we have 400 nurses spending 10% of their shift performing repetitive tasks, that’s not an insignificant amount of time that could otherwise be spent at the patient bedside. As much as possible, we are seeking to automate those repetitive time-consuming tasks.”
Collier said nurses can log in to computer stations with a simple tap of their badge to reduce the time it takes to log in with username and password. Three robots resembling “Rosey” — the futuristic family robot on the animated television show, “The Jetsons” —will roam the hospital’s halls, delivering bottled water, specimens to labs or medications from the pharmacy to the nursing units.
“Not only does a nurse not have to run back and forth between the cafeteria and patient rooms, for example, but the patient’s face will light up the first time they see the robot round the corner,” he said. “That’s just one example of a positive patient experience while they are in our care that we didn’t initially think of when deciding to deploy the robots.”
Beyond the technology, Collier and Viles said much thought was put into making the hospital as efficient as possible for the staff. According to Viles, team stations are designed for an easy workflow, including something as minor as the placement of supply rooms.
“If you go to any unit, the supply rooms are in the exact same place, and they are centrally located, so the areas where the nurse needs to go the most are in the middle of the unit, and the care delivery happens around the outside of the unit,” he said. “It is the shortest possible distance between the supplies, medications and the patient for the nurse to travel, which saves the nurse time between caring for each patient.”
Technology for visitors and family members
While the needs of patients and staff were a major part of the hospital’s planning process, the needs of the patients’ family members were also a big consideration. Collier said that making the space useful for family members was necessary since some patients could spend close to a month or more in the hospital.
“You’re talking about family members who still have commitments to fulfill, like work and school,” he said. “We did a simple study and found that the average person has nearly five Wi-Fi-connected devices, such as a watch, tablet, PC, or phone. The new hospital will be saturated with Wi-Fi, with the knowledge that not only will patients and families use it, but the medical devices in the hospital will rely on it as well.”
Additionally, visitors to the hospital can be guided with timely text messages, directions or instructions that ease wayfinding. Kiosks, not unlike those used in airports, will make check-in easier. Through the electronic records system used by the hospital, communication between caregivers and hospital staff will ease the transition from hospital to home care.
“From beginning to end, we are really trying to make the process easier,” Viles said.
The hospital will also be a training ground for students attending all six of the university’s schools. However, Viles and Collier said it will not be as easy as going from the graduation stage to working in the hospital.
“In the absence of training and time to acclimate within a highly technology-enabled clinical setting,” Collier said.
New procedures offered
The hospital will also offer some new procedures for the first time in this region, including magnetic resonance-guided focused ultrasound ablations for essential tremors. MRI-guided focused ultrasound uses an MRI scanner to target ultrasound waves within the thalamus, an egg-shaped structure found in the middle of the brain above the brainstem.
The procedure is incisionless, unlike deep brain stimulation (DBS), which requires open surgery to implant the DBS device. Alexander Papanastassiou, MD, a UT Health San Antonio neurosurgeon, said many essential tremor patients prefer MR-guided focused ultrasound.
“There are a lot of patients who say, ‘yes, I’d like to have this tremor treated, but I don’t want surgery,’” he said.
Viles said procedures like focused ultrasound and programs that match patients to clinical trials are part of building a hospital from the ground up.
“You get to build these things — the culture, technology, teams and relationships — from the very beginning,” Viles said. “Most places are adding something to an existing building or a new program or location. That’s what’s unique about this opportunity for us. We started with essentially a green field, and now we are opening a facility to provide services and clinical options that do not exist in our region.”
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