Evaluation of an Integrated Hands- Free Communications System in Residential Aged Care

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Nickolas Bishop
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1 Evaluation of an Integrated Hands- Free Communications System in Residential Aged Care Based on Research for Samarinda Aged Services, Melbourne, Australia David Brous - IFA 11th Global Conference on Ageing May 2012

2 Project Objectives To evaluate the benefits of an integrated hands-free communications system in a residential aged care environment Co-funded by Samarinda Lodge and IBM Australia Limited The views expressed in this study are not necessarily those held by Samarinda Lodge nor IBM Australia Limited, IBM Corporation, Vocera Communications Inc or affiliates. 2

3 Approach to the workplace environment Identify the current communications system and its component features Assess the direct and indirect changes in workforce practice & procedures resident satisfaction quality of service outcomes Specify required capital investment and the return Analyse recurrent costs and benefits Identify potential financial and reputational benefits to Samarinda 3

4 The Samarinda Context Samarinda Lodge is a not-for-profit residential facility in Melbourne 40 residents 75 permanent, part time and casual staff Clinical and auxiliary staff contribute to resident care Many messages pass between staff during a working day Residents can wait for 5-10 minutes for care staff to respond to their calls Resulting anxiety, particularly for dementia residents, can lead staff to waiting additional time settling the resident 4

5 Vocera Vocera is a wireless voice-activated communications device, worn as a badge, supported by Cisco communications infrastructure Qu ic k Tim e and a d ec o m pres s or are needed to see this picture. 5

6 Implementation at Samarinda Three stage implementation over a year installing a wireless network, with a server to support the communications software and carry data to laptops on mobile trolleys used by nurses, doctors and allied health professionals to record and access all resident clinical information integrating an Internet Protocol (IP) based telephony system for residents and staff, transmitting voice and other information over a data network integration of the nurse call system into the wireless communications badge and the telephone system 6

7 Communication Seamless & hands free, enabling every staff member to speak to anyone at any time without interrupting care tasks Resident telephones are hands free automatic answering on the speaker, from calls on a Vocera badge a resident a few metres from the phone can be heard and given reassurance and instruction before support arrives Resident locations are identified on the Vocera screen 3 fixed wireless call points in rooms and throughout common areas residents wear a call bell on a lanyard medical and other equipment are tagged for quick access monitoring of fire panels, door alarms and resident restraint beams and pressure mats 7

8 Time and Motion at Samarinda Time-and-motion studies were conducted by the Centre for Health Innovation to analyse staff workflow patterns the time spent by staff upon various tasks communication lines between individual staff members and groups how staff members interacted with each other In total, staff spent more than two hours per shift communicating with other staff and residents 8

9 Resident Perceptions at Samarinda Residents supported the system it met their immediate needs for personal and social support familiarity with call by buttons by cognitive residents use of hand free phones was readily adopted 9

10 Staff Perceptions at Samarinda Staff supported the system increases staff retention, with greater feelings of achievement in outcomes for residents lessens the need to recruit new staff to take up expanded functions due to productivity savings preferred to the traditional methods of walking the corridors in search of assistance and equipment 10

11 Samarinda s Investment Expenditure totalled $225,300 (2009 $A) or c.166,000 euros server and rack wireless access Vocera hardware telephony nurse call system 11

12 Operational Return to Samarinda Rostering total weekly hours increased due to increased administration and service requirements changes in rostered hours cannot be attributed to he introduction of Vocera Tasking communication between staff reduced 16 per cent of total minutes (147) to 6 per cent (56) walking between tasks reduced 10 per cent of total minutes (89) to 4 per cent (43) time spent on resident care increased 51 per cent of total minutes (476) to 68 per cent (634) Increase in direct time devoted to care of residents of 33.2 per cent 12

13 Financial Return to Samarinda Average costs of staff include penalty payments and overtime but not superannuation or worker s compensation insurance Estimated annual return was $298,000 (c.220,000 euros) compared to a capital outlay of $225,300 (A$ 2009) (c.166,000 euros) Qu ic k Tim e and a d eco mpress or are ne ede d to s e e th is p ic tu re. 13

14 Samarinda Outcomes 1 Substantial savings in daily clinical hours redirected into resident care Improved documentation accuracy through immediate message transfer and data recording Reduced staff frustration in waiting and searching for people or resources Improved staff morale Potential improvements in staff productivity Reduced resident anxiety and resulting behaviours Triaging of nurse calls and improved responses to resident care needs 14

15 Samarinda Outcomes 2 More appropriate and timely responses and management of emergencies Improved resident security through the ability to locate individuals Increased accurate monitoring and reporting of resident behaviours and production of documentation to improve funding from the Australian Government appropriate to the resident care need profile A potential return on investment arising from the facility becoming a telephone service provider 15

16 Lessons for the Future The optimal path for communications technology is integrate during the building phase rather than retrofitting infrastructure Prospects to achieve strong efficiencies in the delivery of direct and indirect care services in larger and more complex care environments are enticing, but need to be tested Elimination of non productive activities enhances productivity improves effectiveness of staff improves care outcomes for residents Articulation of Vocera with clinical, financial staffing, security systems can support greater automation of operations digital transcription of clinical records 16

17 Download the Evaluation www-935.ibm.com/services/au/igs/vocera/index.html 17

18 In 2007, Samarinda received the ITAC award for the implementation of the year and the Aged Care Association of Australia national management award for the facility/team of the year Suite 102E, Collins Street Melbourne

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