Healthcare Design - June 2015 - 22

C THE CENTER | 07.15
The name game
Technology has a way of making commonplace concepts and terminology suddenly antiquated.
Is that the case with "nurses' stations"?
By Rosalyn Cama
Look down at your wrist. Are you still wearing a
watch? I'm not sure when, but some time ago I
gave up my beloved Movado for my smart phone,
or what I affectionately refer to as my "rememberer." It prods me on to my next task and reminds
me of key dates, although these are just some of
its myriad uses. That's why I can't call it a phone:
a very small percentage of my time using it is
spent on audible communications. So when Apple
introduced the iWatch recently, I pondered why
the term "watch" was chosen. Is it because it's
intended for use on our wrists? Is it because that's
what a consumer understands?
I began to wonder about what else in my world
has evolved but still holds on to a past nomenclature. What struck me as still quite rooted in
nostalgia is "nurses' station." Once upon a time,
a nurses' station was centrally located in a nursing unit, serving as a location where nurses and
other clinicians would gather together, report
patient information, and pool resources. Twenty
minutes per shift per patient was the reported
hands-on time a nurse spent with patients, while
a unit clerk would keep track of patient charts
and man the station.
During the most active period of inpatient
building projects in the early 2000s, Ann Hendrich, the senior vice president and chief quality/
safety and nursing officer at Ascension Health,
and Marilyn P. Chow, vice president of national
patient care services, program office at Kaiser
Permanente, conducted notable time and motion studies. A nurse time-motion study in 2008
exposed the inefficiencies of nursing care and
in many ways ushered in a new approach to the
design of nurse workstations. Much was revealed
about the inefficiencies of clinicians chasing
down charts. But a solution was on the horizon:
the electronic medical record (EMR). While the
paper record was still being used during this
time, many projects were built with the necessary
infrastructure included to support a later transition to EMRs.
Since then, many providers have now adopted
EMRs and nurses are spending much more
time at the bedside. The paper chart has now
become several computer stations. Although few
health systems access information wirelessly,
22

HCDmagazine.com 07.15

I've heard that adoption is slowly coming.
And once wearable devices take off in care
delivery, the game of accessing vital patient
information will likely change once again for all
clinicians-the Fitbit will seem so last century.
And meanwhile, the nurses' station may evolve
once again to provide the wireless signal,
record every clinical move, and transmit justin-time information.

Once wearable devices take off in care delivery,
the game of accessing vital patient information
will likely change once again for all clinicians.
The human need to pause and/or huddle
has been answered over the years even as
technology allows more mobility. The latest
incarnations of the nurses' station include
"perches" or workstations directly outside
patient rooms that keep caregivers close while
also allowing patient and family privacy. In the
future, will those solutions continue to be stations or something even more deconstructed?
For example, supplies are more and more
frequently delivered robotically via just-in-time
systems to in-room nurse servers, eliminating
the need for more centralized unit resources.
We are in a vortex of change and, as such,
need an evidence-based design way to approach these shifts in the design of facilities for
care management and delivery. The Center for
Health Design has access to the most recent
research that builds on the original Hendrich
and Chow studies to help us all imagine the
realm of possibilities.
If a phone is more than a communications
device and a watch tells you more than time,
then has a nurses' station become a mobile
data set that enables patient-centered care?
Share with me your best new examples of
dynamic clinical work environments. HCD
Rosalyn Cama, FASID, EDAC, is president and
principal interior designer of Cama Inc. (New
Haven, Conn.). She is the board of directors
chair for The Center for Health Design. She can
be reached at rcama@camainc.com.

Rosalyn Cama

http://www.HCDmagazine.com

Healthcare Design - June 2015

Table of Contents for the Digital Edition of Healthcare Design - June 2015