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Evaluation of an Integrated Hands-Free Communications System in
Residential Aged Care
Based on Research for Samarinda Aged Services, Melbourne, Australia
David Brous - Impact Consulting Group
IFA 11th Global Conference on Ageing May 2012
Impact Consulting Group 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.
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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
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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
Impact Consulting Group 5
Vocera
Vocera is a wireless voice-activated communications device, worn as a badge, supported by Cisco communications infrastructure
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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
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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
Impact Consulting Group 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
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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
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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
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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
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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
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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)
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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
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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
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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
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Download the Evaluation
www-935.ibm.com/services/au/igs/vocera/index.html
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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
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