hese days, most would agree that time is of
the essence. Often, there aren’t enough hours in the day to accomplish every
task, and even if there were, we’d likely find ourselves scrambling to cram
even more into that already narrow time slot.
Perhaps no other industry is more keenly aware of time limitations and
the need to do more with less than healthcare. Each minute — or even second
— that passes can mean the difference between good outcomes and bad, and
even life or death. And while providing quality patient care remains the
primary focus, as it should, it would be a bit naïve to believe that time
doesn’t factor into the bottom line. Although the "time is money" mantra is
one that may not leave a good impression with the media or general public,
it’s nonetheless become a part of doing healthcare business, particularly in
light of caregiver shortages, increasing patient acuities and ever-shrinking
One way facilities are aiming to streamline efficiencies and improve
outcomes is by adopting products and practices that allow for better data
capture and care at the patient’s bedside. As more and more healthcare
organizations can attest, mobile workstations – fast becoming the gold
standard for point of care computing and charting —can go a long way toward
reaching those goals.
"Mobile carts allow a nurse or clinician to have real-time access to
patient information in a convenient and mobile platform, while also
providing a work surface and optional storage drawers that enable them to
make fewer trips back and forth to the nursing station," explained Phil
Smakula, national sales manager for IT Solutions,
Lionville Systems Inc.,
In terms of investment, mobile workstations also provide more bang for
the buck. Because computers can be moved where needed, facilities don’t have
to purchase a computer for every room and a workstation for every user. They
can invest in fewer devices, yet still benefit from flexibility and
mobility, according to Keith Washington, vice president and general manager,
Flo Healthcare, Norcross, GA. "In this sense, mobile workstations are the
productivity-enhancing devices for the lowest cost of ownership."
Convenience and efficiencies aside, perhaps the biggest perk afforded by
mobile workstations is that they allow the clinician to spend more time with
Nurses select nursing as a profession because they are passionate about
providing care for patients, stressed Brad Blackwell, senior product manager
for Mountain View, CA-based
"Their highest satisfaction comes from direct time and care at the
bedside, and patients feel the highest level of comfort and care when the
nurse is with them. Finding efficient and effective workflows that can be
performed at the bedside is crucial to improving a nurse’s ability to
provide the highest quality patient care," Blackwell noted, adding that a
well-designed mobile workstation meets a large number of those objectives.
Brains — and brawn
As the name implies, mobile workstations primarily center around
computing. Depending upon the model – and a facility’s unique needs and
budget — these workstations can support all software platforms and
accommodate virtually any size and type of existing computer hardware
(including barcode technology), or if preferred, can be outfitted with an
integrated computer system and built-in network.
In terms of connectivity and integration capabilities, some mobile
workstation "smart carts" are really living up to their name.
"The ability to add optional equipment [such as] vital signs [equipment]
and data collection devices has become a regular expectation," Smakula
noted. Lionville designs and engineers its carts for such integration.
With this added power and IT capabilities comes the need for better and
longer-lasting power supplies. More and more, manufacturers are
incorporating improved batteries and power supplies into their mobile
workstations, allowing for longer run times and rapid recharging. Remote
battery management software is also available to extend the life of a cart’s
power system, pointed out Steve Reinecke, global director of healthcare,
Ergotron Inc., Eagan, MN.
Patricia Moore, vice president of marketing and sales,
Louisville, KY, explained the push for advanced power this way: "At the end
of the day, if a [workstation] isn’t functional because its power supply
fails it really doesn’t matter how many other features the cart has. A good,
reliable power system is a must-have. CompuCaddy’s DC power design allows
maximum computer runtime (between 8 and 24 hours depending on technology
configuration, application, battery age, and usage pattern). The company’s
X2 Power Option – for use with CompuCaddy’s X2 Series carts – implements a
direct DC to DC connection, thereby omitting the need to invert the energy
from the battery. This allows more efficient use of power when transitioning
power from the battery to the computer.
Ergotron’s Styleview Cart
When comparing workstations and power capabilities, Omnicell’s Blackwell
said customers should look for those that "provide wireless connectivity and
come equipped with a battery that can last 12 hours" and recharge quickly.
Beyond that, he said a nurse should also be able to easily change the
battery without the use of tools.
Battery monitors, an option on many of today’s workstations, display
real-time battery power status and remaining runtime, meaning clinicians
won’t be left stranded. Omnicell’s BatteryPro, for example, even allows
clinicians to configure alerts to sound when the charge dwindles to a preset
percentage. Users can also set BatteryPro so that data will be saved if the
system shuts down. "This is a big deal for someone who has just spent two
hours documenting," Blackwell explained.
Facilities concerned about the environment will be pleased to learn that
vendors are also stepping up with battery replacement and recycling programs
to keep batteries out of the landfill. "Obviously, customers will have to
replace their batteries at some point," said Jeff Chochinov, senior product
Rubbermaid Medical Solutions (RMS), Huntersville, NC. "We offer
a battery swap-out program that allows customers to offload the recycling
part to us."
Form meets function
These days, workstations manufacturers are providing power in other ways
as well, most notably in terms of their products’ durability and improved
Not surprisingly, customers are generally seeking smaller, more
lightweight – yet sturdy – workstations that are easy to maneuver and
flexible enough to accommodate a broad range of needs and upgrades.
"Several years ago, the average cart weighed 180 pounds and had an
overall base of 21 by 21 inches," said Washington. Today, Flo Healthcare’s
most popular workstation, the Flo 1750, weighs just over 100 pounds with a
17 by 17 inch base, he said, explaining that during this transformation,
Flo’s displays have become bigger, its computers faster and with more
memory, and its battery system more powerful. We have also added peripheral
devices, such as printers, scanners, enabling devices, and storage.
Customers are also looking for workstations that are easy on the eyes, as
well as a slew of ergonomic design elements. And the models on the market
"Carts today have a sleek, pretty design that really appeals to today’s
nursing staff," said Reinecke. "Advancements in ergonomic functionality,
such as height adjustability and negative tilt keyboard trays, are now being
incorporated into workstations."
One change CompuCaddy recently made was moving the handle from the side
of the cart to the front. "This makes it easier and more comfortable to
maneuver. We also offer sturdy, six-inch casters – the largest in the
industry – to make it easier for clinicians to push the cart down the
hallway," said Moore. A pull-out keyboard tray saves space and improves
comfort, while a slide-through mouse pad tray accommodates both left- and
Infection control is also catching on with mobile workstation
manufacturers. CompuCaddy’s new Cynergy workstation, for example, features a
new antimicrobial work surface, as well as an antimicrobial cord compartment
that allows cords and wires to be tidily tucked away.
Mobile workstations are also offering unsurpassed flexibility and
customization, allowing facilities to tailor the design and features to the
unique needs of their end users – whether they’re used in admissions, the
emergency department, operating room, at the bedside, and virtually
everywhere in-between. Drawers and compartments that can house supplies come
in a wide range of sizes and configurations, and can feature sturdy,
tamper-resistant key- or combination-entry locks.
Understandably, carts that can blend computing and patient care delivery
functions are gaining momentum. Workstations with medication storage and
dispensing capabilities are a prime example. In April, RMS launched its
Medication Expansion Pack for its M38 Mobile Computer Cart line, thereby
creating a secure storage system that is essentially a hybrid of traditional
computer and medication carts. Carts can be configured with two to six
drawers. A patent-pending drawer system allows on-the-go customization for
changing nurse-patient ratios (California legislation stipulates that
patient to nurse ratios be limited at 5:1 or less).
"Our research shows there is a capacity and size gap between traditional
computer and medication carts. One of the goals in creating this system was
to eliminate that gap and provide a global platform that services any part
of the hospital," Chochinov noted. Flexibility is key. Customers have the
option of buying the M38 cart now, and then upgrading with the Expansion
Pack in the future.
The Mobile Cart Solution by Omnicell comes with and without medication
drawers (up to eight), and offers individual locking drawers, allowing for a
nurse to be directed to the appropriate patient’s medication, explained
Blackwell. Further, customers who purchase Omnicell’s Smart Mobile Cart
Solution benefit from SafetyMed, a bedsite point-of-care software solution
that’s integrated into the cart. "Customers using Omnicell’s Smart Mobile
Cart Solution will often remove medications from existing Omnicell
medication cabinets located on the nursing floor and then load them into
patient-specific medication drawers on the mobile cart," he continued,
adding that once at the patient’s bedside, a nurse can then scan the
patient’s barcoded identification band, which will simultaneously unlock
that patient’s medication drawer(s).
Omnicell’s SafetyMed solution,
extends medication safety solutions from automated medication
dispensing systems to the patient’s bedside
What lies ahead?
While today’s mobile workstations are indeed sophisticated, vendors
agreed that the industry has just begun to scratch the surface of advanced
capabilities. In the future, look for workstations to allow for greater
automation of repetitive tasks.
Having a workstation become a "partner" of the nurse is one possible
future scenario, Blackwell said. He reasoned that a cart could automatically
move to the first patient’s room where the nurse is going to need it.
"It would pleasantly and audibly let the nurse know it was time to
perform an activity, such as medication administration. The software would
then guide the nurse through the appropriate process and best practice,
while allowing flexibility and human judgment whenever appropriate. The cart
would then automatically move to the next room," envisioned Blackwell.
Beyond that, mobile workstations of the future could also ensure that nurses
complete all activities, know when new orders exist for patients, when lab
specimens are to be obtained and when results are available.
Lionville’s Smakula predicts the market will see even more lightweight
workstations (less than 100 pounds, including technology and power supply).
Workstations that can integrate with the hospital’s software applications –
including clinical and pharmacy data – are possibilities for the future, he
explained, as is a battery or power system that can be recharged over a
wireless or radio wave-type signal.
In the next ten years or so, Reinecke predicts that inputting of
information by a caregiver will also start to disappear. "In the future, we
will see more clinical information gathering integrated into the patient’s
bed, medical equipment and room. These will monitor and record the
information and activities that are taking place automatically."
Such high-level advancements aside, the adage of today – one size does
not fit all – will be one that carries into the future. According to
Washington, mobile workstations will probably always start with a common
foundation, allowing every department and user in the hospital to configure
a workstation to their own unique requirements.
"Although the hardware of future workstations will change very little,
the software, systems and processes around data management will evolve,"
Washington explained. "For instance, we will see more Web-based
applications, as well as increased visualization, where servers and data
centers will handle applications more often than mobile devices, which will
make devices more efficient and effective."