Pediatric Informatics: Computer Applications in Child Health (Health ...

8 Complexity in Healthcare Information Technology Systems 113
Table 8.5 Planning new information systems for pediatric critical care
Existing Bedside Medical Devices
Inventory
Technical specs (ports, models, fixed or portable…)
Driver protocols needed?
Space
Consider optimal install configurations for decreasing the frequent ICU crowding concerns
Single room, pod, or other bed space arrangements
Configuration of physical bed spaces: (photographs needed)
Electrical
Current data management strategies – how are flowsheets or COWs (computers on
wheels) used?
Wireless management – data ports location?
Staff expectations for wireless?
Bandwidth considerations?
Workflow: (stopwatch, observation check list)
Informal brief observations by a clinical informaticist
Formal study, conducted by workflow management engineers
Walk through mockups by clinical staff, all shifts
Target unit team structure
How do nurses work in the environment?
How does the nursing staff cover for each other?
How do they deal with “offsite” needs (supplies, feeds, medications?)
Do they use a formal team structure for care, for coverage, for parent communication,
for emergencies’ management?
What are nursing concerns about new technology?
How do the doctor teams gather their daily data? Who does the “Daily Note” and how are
data obtained?
Does the unit use nurse practitioners or physician assistants? Will they interact with the
new system? How? Where?
Consider other staff “visitors” and team members (e.g. consultants, social work,
pharmacists, others) their roles and likely interactions with the new system
Remember HIPAA and the “80 hour rule”
Consider parents roles and physical spaces
Education
Does the Unit have a nurse educator?
Does the hospital have a nurse educator?
How is education and “in service” for new things usually managed? Is staff paid for
educational hours?
If the data are never to be printed, how will providers be notified of data?
How much provider time and attention does the system take from (or add to) rounds?
Installation setup: evaluate the target ICU’s needs for Hardware
Note existing terminals and lab links, are wires and data ports
Inventory bedside lab devices and their data output methods
Note existing servers for other vendors’ systems (e.g. partial vital signs automated
systems, doctor note systems, computerized provider order entry systems (CPOE), nurse
charting systems)
Check location, number, speed, and maintenance considerations of printers
(continued)