‘Middleware First’ is not the Best Alternative
October 24, 2007
Although I have tremendous respect for my colleague Kenny, I cannot totally accept a strategy of looking at band-aiding existing systems to take the place of a Vocera solution. I see two primary reasons. One is another middle-ground alternative. The other is what’s being overlooked with an alarm management solution without Vocera.
Let me address the middle-ground approach first. I have had the personal experience of a customer who was faced with all the odds against them that Kenny describes:
- Existing paging infrastructure that needs augmenting (and may not be going to go away anytime soon)
- Antiquated nursecall system that’s begging to be part of an integrated framework, and slated to be fork lifted
- Major wireless infrastructure build out that may be many months from production
- Vocera is an enticing option, but may be too stressful on resources to implement full blown right away
- Need for process and workflow improvements
This customer had all these issues in front of them and still went ahead with the Vocera implementation. However, the strategy we took was much different than looking at middleware first.
Instead of trying to justify a house-wide deployment of Vocera, this customer took a look at the area of greatest need for workflow process improvement and focused there. This happened to be the Emergency Department. They formed a task group that looked at workflow first and technology second. Given the project was limited to a small user and geographic space, the resource commitment was minimized. This provided some limits on the arguments against going forward. Meanwhile, the remainder of the hospital had the opportunity to sit back and evaluate the returns on the investment before going further.
To my other point about what is being overlooked; when you band-aid these existing technologies you fail to achieve on of the greatest benefits Vocera has to offer in a dynamic clinical environment- instant voice communication. There’s no substitute for connecting to co-workers in seconds to get critical information via voice. The alarm management can tell you an alarm went off, but you can’t quickly interact with your coworkers or patients to get the level of response needed.
It’s understandable that hospitals are reluctant to introduce and justify new technologies. However, with careful planning and step-wise approach, making these bold steps are the best way to achieve performance and safety improvements.
I am happy to say that the customer that started in the Emergency Department is now budgeted further roll-out of Vocera to the rest of the hospital. The only kind of band-aids they have are for the patients!