Wireless Marge eases task of bed management

Joint MediaLab research project with Hawkes' Bay DHB computerises a complex manual task

MediaLab South Pacific has set out to ease the working life of one of the hard-pressed but worst technologically served members of hospital staff, the bed manager.

There is normally only one main bed manager in a hospital, in charge of ensuring that beds are efficiently used and resourced and that patients are traceable and occupying a bed for a good reason in line with the “flow” of their treatment.

Yet the management records are typically kept manually in a large book that the manager carries around. While patient management has been extensively automated, bed management is one of those tasks that seems to be on the periphery of health systems and perpetually marked for possible inclusion in the next upgrade, says Don Christie of Catalyst IT. Catalyst is co-developer of the software and a member of Wellington R&D consortium MediaLab.

One person with a book represents an obvious potential single point of failure. Retrieving information from the managers of the various wards is a matter of walking about or phoning, and statistics to guide efficiency improvement can be difficult to collate over time.

Working in collaboration with Catalyst IT, wireless specialist Link IT and the Hawke’s Bay District Health Board, MediaLab has replaced the book with a record-keeping system on a tablet PC of similar size. This interfaces with a wireless LAN which was newly installed in the Hawke's Bay hospital.

The project began last year. MediaLab chief Michael Gregg was acquainted with a bed manager who could tell him about the issues of maintaining the bed management database manually. It was an attractive project for the lab, with its emphasis on researching new uses of wireless and mobile technology.

The tablet system has a graphical interface which to some extent mimics the book (without the scrawled arrows and alterations) with an overall chart of the bed situation and “pages” for each ward. But it is a live system and adds significant features such as colour-coded green-amber-red indications of efficient, unsatisfactory or urgent situations and alarms and bring-up notes alerting the bed manager when, for example, a patient should be moved on to the next phase of their treatment.

Statistics on efficient treatment flow are continuously accumulated, allowing the bed manager and other management staff to measure efficiency against key performance indicators. It’s not a simple matter of bed occupancy that a hotel would measure. MediaLab project manager, Graham Scown, says a hospital bed is only useful if it has sufficient “resource” in the form of nursing support.

Ease of use is another priority, with graphic screens able to pop up and close down with a tap of a stylus. A technophobic bed manager used to working with a book doesn’t want to be bothered with fiddly menus, Scown says. The bed management system naturally interfaces with the standard patient management software in use at DHBs around the country.

Hawke’s Bay uses the IBA system but since one of the most widely used systems is Homer, the bed management application was christened Marge after the cartoon character Marge (Mrs Homer) Simpson.

The tablet is a relatively expensive platform, Scown concedes, but only one or two need to be supplied per hospital and alternatives such as a PDA or a PC on a trolley would be harder to read or more cumbersome than the book.

Installing a wireless network in a hospital presents its own problems. Critical equipment had to be exhaustively checked to ensure the radio transmissions would not interfere with its function.

The future life of Marge is unclear as yet. It may never become more than a successful research project, says Scown; but there are a number of options for licensing arrangements with existing health software companies, a joint venture or a new spin-off venture run by one of the companies that are members of the lab.

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