Implementation of the Vocera Communication System in a Quaternary Perioperative Environment

Abstract

In the hospital, fast and efficient communication among clinicians and other employees is paramount to ensure optimal patient care, workflow efficiency, patient safety and patient comfort. The implementation of the wireless Vocera® Badge, a hands-free wearable device distributed to perioperative team members, has increased communication efficiency across the perioperative environment at Massachusetts General Hospital (MGH). This quality improvement project, based upon identical pre- and post-implementation surveys, used qualitative and quantitative analysis to determine if and how the Vocera system affected the timeliness of information flow, ease of communication, and operating room noise levels throughout the perioperative environment. Overall, the system increased the speed of information flow and eased communication between coworkers yet was perceived to have raised the overall noise level in and around the operating rooms (ORs). The perceived increase in noise was outweighed by the closed-loop communication between clinicians. Further education of the system's features in regard to speech recognition and privacy along with expected conversation protocol are necessary to ensure hassle-free communication for all staff.

Outcomes of Communication, Workflow Efficiency, & Patient Care Quality Resulting from a Hands-free, Wireless Communication Device

“…Future Study ................................................................................................ 34 Conclusion ................................................................................................... 35 REFERENCES ................................................................................................... 37 APPENDICES .................................................................................................... 45 Table 3 Frequencies of Staff Perceptions on Improved Communication,Workflow Efficiency,and Patient Care Quality ..................................................... 26 Table 4 Descriptive statistics for Perceptions on Communication,Workflow Efficiency,and Patient Care Quality ..................................................... 28 Breslin, Greskovich, & Turisco, 2004;Cooney, Banbury, & Plunkett, 2018;De Grood et al, 2012;Dunphy, Finlay, Lemaire, MacNairn, & Wallace, 2011;Ernst, Weiss, & Reitsema, 2013;Fang et al, 2018;Friend, Jennings, Copenhaver, & Levine, 2017;Vandenkerkhof, Hall, Wilson, Gay, & Duhn, 2009;Wilson et al, 2014). To deliver quality care, effective communication must transpire between healthcare team members (Propp et al, 2010).…”

AORN Position Statement on Managing Distractions and Noise During Perioperative Patient Care

“…o heating, ventilation, and air conditioning systems o metal equipment (eg, instruments, basins, rigid containers) 23,40 o powered surgical instruments 40,51,52 o moveable equipment o equipment operations and troubleshooting 14,19 o acoustic surfaces on floors, walls, and ceilings 41,53 o pneumatic tube systems 22,47 • technology: o telephones (eg, smart phones, cell phones, 54,55 land lines) 43,48,56 o wireless devices (eg, tablet computers, personal digital assistants, personal gaming devices) 20 o wireless communication systems 20,57 o paging systems (eg, personal pagers, 48,56 intercoms, overhead paging systems) 20,43 o computers o music devices (eg, radios, subscription music services) 48,51,52 • electronic activities:…”

Electronic Health Record Interactions through Voice: A Review

“…Users speak preprogrammed commands to evoke the desired action. While the system has good user acceptance, for some users the system has difficulty recognizing the person that the user is trying to contact 79,80 resulting in calls to the wrong individual. Challenges with Vocera and similar communication devices generally involved SR accuracy and concerns about privacy.…”

“…Challenges with Vocera and similar communication devices generally involved SR accuracy and concerns about privacy. [79][80][81][82] A participant in a study evaluating Vocera for health care communication remarked, "The technology works about as well as the voice recognition on my smartphoneabout 75% of the time. This is not… an effectiveness level sufficient for critical care."…”

“…Recognition improved to 91% on first attempt in 2016. 80 To further increase firsttime SR, users can train the system using the "Learn a Name" feature, which is helpful especially to those with strong accents, by creating custom voice copies of the pronunciation and intonation of other users' names. 79 The ability to call team names or roles instead of persons (e.g., "Team A Intern 1" or "Nursing Supervisor"), improved accuracy and recall and prevented failure when the name of the specific individual was unknown-a common occurrence in hospital settings with multiple daily hand-offs.…”