A Room With A View

Dearborn's Oakwood Hospital & Medical Center used to use index cards to keep track of its patients. Until two summers ago, more than 600 individual cards stood in for each individual patient in one of Oakwood's more than 600 beds. The cards all lived on a 700-slot board. Each card, color-coded for male or female patients, represented the patient and each slot their bed. They were tacked up with paper clips, patient's names scrawled across the top, and little notes explaining what was happening in each room.

The system worked for the most part, according to the nurses. After all it had been standard operating procedure for as long as anyone could remember. Index cards, paper clips, and a board with 700 slots. In many ways it was reminiscent of the long card catalogues that used to dominate libraries across the nation.

Until personal computers came along. Now most library systems boast digital catalogues, electronic tracking and online ordering. In the healthcare setting, however, technological shifts can take a bit longer. After all, lives hang in the balance and so if something is to change, it needs to be done carefully and correctly.

"Technology is evolving the healthcare industry," says Monica Donofrio, senior director of care management and access at Oakwood. "We needed to build new efficiencies within our hospital to enhance our local reputation. We wanted to say, 'Hey, come check us out.' And, frankly, the old system couldn't solve some of those efficiency problems."

For Oakwood, the pile of index cards became "the View." Not only did the Dearborn hospital find an upgrade to their lo-fi bed management system, they also found a cutting edge technology, brand new to Michigan, which would help usher in a new chapter in Oakwood's future as a technological innovator in the local medical industry.

Donofrio, a registered nurse, was well versed in what the hospital needed when it came to bed management procedures and floor staffing. What she didn't know was what was out there in the realm of technology. She went looking for the perfect match between Oakwood's logistical needs and the latest and greatest in gizmos. She also kept an eye out for technology that attracted attention.

What she found was the McKesson Corporation's View System, a sophisticated computerized patient bed tracking system. The Georgia-based company actually prefers to call it Horizon Enterprise Visibility but that doesn't exactly roll of the tongue, does it? Better to follow the lead of Oakwood's nurses who simply refer to it as "the View" (Not to be confused, of course, with Barbara Walter's daytime chat show). 

While McKesson already had a couple dozen of these systems up and running across the nation, none had made it to Michigan. Donofrio liked what she saw and helped Oakwood evolve adopt "The View" to great success.

"Most of the hospitals in Southeast Michigan have come out to see our system," Donofrio says boastfully. In fact, she says, healthcare systems from as far as California (and as close as Royal Oak) have paid a visit to peruse this new technology that Donofrio, the staff, and Oakwood have embraced.

Ah, but what sort of contraption has supplanted Oakwood's tried-and-true index card system?

"The View" is Oakwood's Mission Control, taking real-time inventory on each and every bed in the hospital –all 632 of them.

Presenting each patient as an icon on a wall-mounted flat computer screen, nurses and receptionists in the register's office can track nearly every aspect of the patient's stay at Oakwood. The "View" system notes whether they need to be isolated, are in transit, at radiology, or in surgery. It displays each hospital bed, overlaying an architectural floor plan (complete with doors and windows), and shows if the room is pending discharge, dirty, or if cleaning is in process. There are icons for language barriers, if the patient needs restraints, is at risk of seizure, or has any one of scores of special issues or needs. This comprehensive view of the floor's patients is accessible from computers throughout the hospital --as long as the user has the appropriate password, of course.

"The View's" control room similarly displays each floor's bed situation, allowing nurses to properly staff the unit, assess bed availability, and direct housekeepers to rooms more efficiently. Like a miniature version of NASA's mission control center, a 12-foot by six-foot room boasts seven flat screen computer monitors and a trio of phones.

"The view system has greatly improved our efficiency in many areas," Donofrio says.

Prior to its introduction, nurses had to round on hospital rooms over and over again, using informed guesswork to determine patient flow. Now, Donofrio says, floors can be properly staffed from the control room by glancing at the bed situation on each floor instantly. And because information on the screens is in real time (updated every seven minutes), razor sharp decisions can be made about treatment, what the patient's needs are, where the patient is, has been, and needs to go.

"This makes the nurses' lives a lot easier," Donofrio says. "They aren't running up and down, checking empty rooms three, four times a day. This frees up a lot of time for patient care."

"This system has been a tremendous help for us," says Carol Schimizzi, the Patient Access Center supervisor at Oakwood. Schimizzi works in the control room, watching all the screens like a quarterback looking down field. "We used to do this manually, with cards before this system. This is real time, no guess work, absolutely fantastic."

The system has worked so well, in fact, that other departments have shown interest, Donofrio says.

"This technology isn't specific to bed management," she says. "Other departments want to utilize it, too."

Currently, "the View" is only installed in Oakwood's Dearborn branch. But the goal for Donofrio is to implement the technology in all four Oakwood hospital locations. In fact, she would like to take it one step further.

"In the future I'd like all four of our hospitals hooked up to the view system with one central location," she says. It'd be like a brain for the body. "When that happens, there would be no waiting at any of our hospitals, ER included. I think we're on the forefront of technology here at Oakwood."

And the old system? The 700-slot board, index cards, and paperclips?

"We had a big party to dismantle that old thing," Donofrio says