Timebands are visual management tools used by front-line clinicians to keep track of time in hectic, complex, and dynamic cases. After attachment to a patient, Timebands show the elapsed time since its placement. In acute care, every minute matters and simple tools can make a big impact. This patient-bound visual cue supports timely treatment and accurate, repeatable data collection for process improvement. A web-based dashboard makes data collection simple and available to all in the care pathway.
The unique challenges in coordination and communication inherent in the complex processes required of emergency providers can be traced to several junctures that also hold the greatest improvement potential. Emergency response is a highly dynamic process for which, on average, 10-15 spatially distributed team members across multiple geographic locations and many departments are only assembled once a stroke, sepsis, trauma, or other code is called. Once initiated, a finely coordinated and interdependent set of tasks are performed in a transient, role-specific manner, including an array of health measurements, tests, and scans that must occur and be interpreted prior to treatment. As movement of the patient complicates communication, even simple information problems become amplified and remain challenges that digital communication technologies, EHRs, and portable checklists have thus far been unable to address. As face-to-face interactions, telephones, and pagers continue to be the primary method of communication, up to 2/3 of nurses may additionally choose to abandon electronic hand-off forms in favor of older paper forms, stating they instead need information at a glance with only pertinent information from simpler tools that work. Compounding this, 20-60% of ED stroke alerts are also later confirmed to be false alarms, and a reduced sense of urgency in processing a potential victim can emerge when compared with other types of emergencies (such as a patient bleeding out).
The need for new communication technologies that facilitate team-based communication, incorporate lightweight feedback or simple visual cues, provide information transparency designed with patients in mind, and instill a sense of urgency in providers can be readily demonstrated.
The INSIGHT TIMEBAND is designed to address these problems, traveling with the patient as a clinician-oriented tool to help providers manage time-sensitive tasks while providing a patient-centered and patient-located data source, offering further potential to improve care delivery by promoting guidelines already in place. Initiated upon EMS first contact or hospital arrival, the timeband:
(1) presents the time elapsed since placement, providing a rapid communication vector,
(2) provides a constant sense of urgency, and
(3) enables care teams to readily make efficient use of their limited time while the patient traverses different locations, departments, and providers.
Placing 'time' in the line of sight has been proven to improve time to treatment and is recommended by the American Heart Association/American Stroke Association to reduce door-to-needle times in Stroke cases.
Time data from the band can be made available to all providers with a simple NFC scan. Time point annotation, data analysis, and process improvement studies can be preformed in the Dashboard.
Timebands can be kept at admission or EMS drop-off. No software needs to be installed. Android mobile devices on hospital's secure Wi-Fi can be used to scan timebands to collect data. There is no setup fee or capital equipment purchase.
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