One new addition to the Stanley InnerSpace line of small carts and personal workstations is the Harmony Point-of-Care (POC) Cart that combines mobile computing with ample storage capabilities and a large work-surface. The Harmony POC offers ergonomic sit-to-stand and push-button height-adjustment capabilities; 180˚ swivel top; additional left or right slide-out worksurface; 5 lockable storage areas; laptop, thin client and flat panel flexibility; built-in 7-port USB hub; keypad entry, Intelligent Locking System and battery options.

"It’s really bringing the best of both worlds together," described Shannon Kennedy, director of marketing, Stanley InnerSpace. "You have the flexibility for the bedside charting and computing but it’s also at a softer price point, with more storage capability built into it as well."

The new Featherweight Aluminum Cart from Waterloo Healthcare is significantly lighter than comparably sized steel carts – in some cases up to 80 pounds lighter, noted Steve Brothers, national sales manager. Nurses, and even hospital risk managers, may appreciate the easy maneuverability of the lighter cart. "From a safety standpoint for the workers, anywhere you can lighten the load is a benefit for the long-term health of your employees," reasoned Brothers. 

The Featherweight Carts are also standard-equipped with Waterloo’s unique U-Divide Metal dividers in every drawer. Eliminating the need to buy expensive and breakable plastic dividers, the rugged aluminum U-Divide system can offer a per cart cost savings of more than $400, even as high as $800, when compared to outfitting a six-drawer cart with plastic dividers that cost anywhere from $70 to $140 per drawer. "Customers are amazed at how quickly adding [plastic] drawer dividers can virtually double the cost of their new carts," said Brothers.

"What’s more, plastic dividers are easily broken, he noted. "They get thrown out, and everything gets stuffed in the drawer without any sense of organization."

Dual slide-out side shelves virtually double the work-surface area on Waterloo’s Featherweight cart. The shelves also allow the user to place a defibrillator/monitor directly on top of the cart, eliminating the need for a separate monitor shelf that can cost up to $200, added Brothers.

Updated, larger and more stylish, drawer handles on the Featherweight Cart make it easier to open drawers. A wider wheel base offers a more stable work platform when drawers are open, and a tracking caster aids maneuverability.

"Even with our new included dividers, dual slide out shelves and new drawer handles the price of the cart hasn’t changed," emphasized Brothers. "That was very important to us. We want to add significant value to the new Waterloo Featherweight Aluminum cart, while maintaining our already low price in the marketplace."

An anti-microbial surface on the Waterloo carts provides an added layer of protection. "Most of our painted surfaces include a silver-ionic compound within the paint that inhibits the growth of harmful bacteria," said Brothers.

Locking options and security features available with the Waterloo carts include Key Lock; Lever-lock for use with plastic breakaway security seals; Mechanical pushbutton lock with key override; Electronic Keypad lock with key override that allows for the tracking of staff access to cart; and a Proximity lock with electronic keypad and key override that’s compatible with most standard HID employee cards.

Brothers noted that Waterloo plans to introduce a Featherweight aluminum version of its Med. Jr. slim cart this August. 

A-Smart Premier Aluminum carts from Armstrong Medical are designed for maximum flexibility with a wide range of accessories and locking options including Auto-Locking Carts that feature SureSeal Drawers. Once within approximately an inch of being shut, the SureSeal Drawers close automatically, eliminating worry about whether drawers are fully closed or properly locked. Auto-Lock Timer can be set from 1 to 998 minutes, or it can be shut off so that the cart never auto-locks. An optional Proximity Reader with the Auto-Locking carts allows users to simply wave the card in front of the reader to open, and works with most low frequency HID Prox Cards.

Long-standing cart provider Artromick Solutions was acquired by Capsa Solutions in 2009. "The acquisition of Artromick by Capsa Solutions gives our current and prospective customer base a wider range of product solutions to choose from," commented Todd Ross, marketing director, Capsa Solutions LLC. "The product line and breadth of mobility solutions has been greatly expanded to include mobile and stationary wire shelving systems, utility carts, high-density storage, and transport cart solutions. And unlike alternative vendors for products of this type, our solutions arrive at the facility ready-to-roll, with no assembly required. This saves the facility time and money, without any compromise to design or quality. 

"Additionally, a full line of ergonomic prep tables and materials storage/handling solutions compliment the full line of medical, medication and computer workstation cart products," he continued. "The wider product line gives Artromick the ability to address all cart, storage, and mobility solution requirements for nearly every department in the facility."

Look for some new introductions from Artromick/Capsa in the near future including the NX15 Workstation which according to Ross will incorporate an enhanced set of features and functions "that give the clinical and IT teams at the facility greater flexibility with regard to product configuration." Building on the platform of the Artromick NX10 Workstation, the NX15 will feature a fully integrated cart light system, integrated and articulating keyboard, dedicated mouse storage, independent vertical height adjustment for the monitor with the ability to tilt and pivot vertically and horizontally, as well as automatic push-button vertical height adjustment for the worksurface.

Artromick is also developing a full line of computing carts expected to launch this autumn, intended as a more economical base model mobile computing solution. Ross noted that the new platform meets a lower price point for facilities that need mobile laptop computing solutions but without such advanced features. "They have good functionality, they’re aesthetically appealing, but they may or may not have an onboard power system," he said.

Metro, a provider of technology, storage and transport solutions, recently realigned its healthcare division by integrating its clinical storage products with Flo Healthcare, Lionville Systems and medDISPENSE’s mobile computing and medication management solutions. A division of Emerson, InterMetro (Metro) acquired the three companies in 2006, 2007 and 2008, respectively.

Metro’s storage and transport solutions start in central supply and support clinical workflow requirements (supply, med, info) throughout the entire facility. Among applications supported by Metro systems: EMR/clinical documentation (supports a variety of requirements); remote admission (ER/outpatient settings); telehealth; BCMA/eMAR - medication management; radiology/X-ray viewing support; vitals integration; CPOE; operating room case documentation; lab results and CDSS (flow sheets, error checking, etc.).

New enhancements and additions to Metro’s mobile cart and workstation offerings include: Microban antibacterial offering for all cart/mobile workstation platforms; laptop cart offering (supports variety of configurations, upgradeable power options); wireless administration of electronic locking features (adding/deleting users, "from the comfort of your own desk", etc.); advanced workstations that support telehealth applications (i.e. remote care giving); enhanced efficiency power management offering (Lithium Nano); and a fleet management module that supports power management (i.e. analytics, reporting options, battery cycle count, other maintenance/features).

As the exclusive North American and Canadian distributor for Scan Modul, Logi-D offers a complete range of modular, customizable mobile carts, racks and cabinet systems. 

"With its extensive flexibility and range, Scan Modul’s storage system enables optimal placement of supplies and the workflow in any healthcare environment through its ability to accommodate and organize all supply categories and adapt to the physical constraints of a floor plan," said Richard Philippe, president, Logi-D. "The system also offers greater storage capacity and picking convenience as it eliminates the problem of under-utilized space in the back of storage units due to supplies becoming cluttered in the front.

"However, the key attribute of the Logi-D offering is the compatibility of the Scan Modul storage system with Logi-D’s material management automation solutions, which feature its 2Bin-iD solution, a unique RFID-enabled two-bin replenishment system," Philippe emphasized. "The solution provides consistent stock rotation to eliminate obsolete supplies. It also increases productivity by capturing demands without the need to count supplies or register consumption at the item level.

"With more than 5,000,000 possible combinations, Scan Modul’s Scancell cart concept can be customized to accommodate any supply chain or point-of-use need. Whether the requirement is for distribution carts, mobile storage units or workstations, there is no longer a need to source through multiple suppliers and settle for a fragmented storage and transport system. Instead, customers can choose a cohesive and flexible system that adapts to their workflows and floor plan."

Continued Philippe, "The modular flexibility of both the storage and technology solutions within the Logi-D offering is well-adapted to the dynamics of today’s healthcare facilities. The leading ISO 60/40 standard, invented by Scan Modul, facilitates full compliance across the entire storage and transport platform. And because each unit is part of a high density system and not a standalone product, any bin or basket will fit into any storage and transport unit in the most space-optimal way. The fact that units installed 40 years ago are still compatible with the company’s latest products speaks volumes about the scalability of the system.

"The scope and modular concept of Logi-D’s solutions facilitate scalable automation and therefore the ability to prioritize automation in high impact areas of the supply chain. The solution integrates fully with the entire range of Scan Modul storage equipment and has been developed to manage the vast majority of supplies in all hospital departments, from the operating room to radiology."

DSI Direct also offers modular flexibility with its Modu-stor product line. Described Peter Lane, president, "The Modu-stor open rack system and the Modu-stor enclosed cabinets can be utilized in a mobile or stationary configuration. This allows a great deal of standardization within the hospital when these products are used in tandem with our ‘built-in’ cabinet systems and workstation. Everything is designed to increase storage capacity, improve inventory management, workflow efficiencies and point-of-use supply distribution."

Key to Modu-stor’s flexibility is its standardized baskets, bins and wire baskets that are available in a variety of sizes to enable standardization throughout the facility. According to Lane, each basket, bin or wire basket can be utilized in a "custom" configuration as designed by the end-user. "Storage capacity in a specific area can usually be increased by 25 to 60 percent," Lane estimated.

The unique feature of the Modu-stor system is that the standardized storage bins can be used within the enclosed or open rack carts. Modu-stor also lends itself favorably to any type of "exchange" program within the hospital, suggested Lane.

Omnicell’s base model mobile point-of-care carts serve as a platform that users can build upon by adding hardware, software, as well as drawers to the carts. A variety of accessories can be added such as barcode scanners, baskets on the back to transport supplies, and privacy screens for the monitor. Individually locking drawers can be added easily in the field, to take the cart from a workstation to one that can serve as a medication cart where it provides safe and secure transport of medications to the patient’s bedside.

Further flexibility is provided with Omnicell’s AnywhereRN software which provides remote medication management with the Omnicell automated medication dispensing system, allowing nurses to remotely request medication issues and returns, document waste and review the patient profile, without having to go directly to the cabinet. 

Waterloo’s U-Divide system is also easily field-customizable, giving nurses the ability to modify and adjust the dividers to meet their unique and changing storage requirements. 

In addition, "Waterloo is a true manufacturer – therefore we can offer customized solutions for our customers’ mobile storage needs," offered Brothers. "We’re very quick to respond." He described how Waterloo worked with a prestigious hospital system in the Midwest to design a customized phlebotomy cart based on their input, that accommodates phlebotomists rounding for longer periods of time, with increased storage capability, clear-view tilt bins and built-in sharps container all in an easily maneuverable platform. 

"We designed a cart that allowed their phlebotomist to stay out longer in the hospital doing blood draws before they had to run back to the lab, " said Brothers. "It was customized for them and we put in our catalog, and it’s been a tremendously good seller for us. They knew what they were talking about."

Flexibility is equally important with technology solutions. For example, Artromick’s fully configurable carts can accommodate a wide range of mobile computing hardware and peripheral solutions, permitting the facility to design every cart (or group of carts) uniquely for the specific clinical application, yet maintain a common platform across all carts in the facility. This greatly increases cross-discipline familiarity with the solution as well as significantly simplifies training, service, and support, explained Ross.

"An integrated technology platform (PC, power systems, etc.) provides enhanced value to the IT professional by streamlining serviceability, platform, standardization and total cost of ownership, " noted Dave Salus, clinical products group manager, InterMetro Industries Corp.

With EMR adoption moving forward at record pace, hospitals are working to provide clinicians with access to computers at the bedside and throughout the facility.

"Mobile workstations are becoming an integral part of the workflow and a companion to the nurse who requires real-time, ready access of the EMR and/or E-MAR for their patients anywhere, any time," observed Susan Williams-Clark, senior group product line manager, Omnicell. "Nurses are seeking safe, secure, efficient processes around medication administration as they take patient meds from the medication cabinet to the patient bedside. Future workstations will be turning to sophisticated software management of the cart system and integration with the automated dispensing cabinet (ADC) and the bedside." 

Rubbermaid Medical Solutions (RMS) recently launched a revamped series of wall-mounted EMR workstations to complement its line of mobile computing solutions.

"When people are looking at carts they’re also looking at wall-mounted workstations," explained Jeffrey Chochinov, senior product manager, Rubbermaid Medical Solutions. "We’ve never seen one hospital have 100 percent of one solution."

Among forces driving sales of workstations that provide clinicians with convenient access to EMRs are funding incentives for adoption by 2011, explained Chochinov. "If you look at legislation around adoption of EMRs, the implications are that you need to provide more and more access points, because you have a lot more people using the data for a lot more things in the hospital. You can’t just have a couple of computers sitting in a nursing station. You need them to be mobile, in the hallways, for visiting nurses, physicians’ pre- and post-patient assessments, and you need them at the point-of-care. "

The new RMS workstation line includes four compact, adjustable wall-arm models that have integrated worksurfaces and positive position height adjustment to allow for better patient interaction while using EMRs, as well as two modular wall-cabinet models.

Noted Chochinov, "The thing people like about a cart is when you’re bringing it to the point-of-care, you can interact with the patient. It’s easy to get to where you want to be and when you’re done you can wheel it out of the room." Conversely, "one of the issues with [typical] wall-mounted workstations is the lack of worksurface and depending on where you have it mounted, the nurse has his or her back to the patient. When you’re doing assessments or interacting with the patient, you want to keep your supplies at hand and maintain eye contact. The other thing is that they were very clumsy and difficult to maneuver and adjust, so they often left them where they were without any adjustment at all."

The RMS Tandem Arm wall-mounted workstation features unique dual pivot joints for flexible screen positioning at the point-of-care. In addition to providing 180˚ rotation from side-to-side and away from the wall, the dual-arm design keeps the workstation stable and prevents it from bouncing or drifting as can be common with gas-shock based systems. A positive locking lift mechanism also ensures the system is stable while in use. 

The RMS workstations include a large worksurface for preparing medications and supplies – a feature commonly reserved for mobile cart solutions – with a unique spill-retaining raised edge. An optional ergonomics bundle includes independent monitor height adjustment, keyboard tilt and task light. 

Features contributing to a cleaner and overall more professional look include a built-in keyboard drawer; pre-wired, internal cable management; and an integrated technology box to conceal and secure the computer.

The RMS Slim Line configuration folds to within 4" of the wall for storage. RMS Wall Cabinets feature standard task light, automated user log-off, integrated worksurface, ergonomic keyboard drawer, dedicated mouse storage and choice of 21 finishes including a dry-erase whiteboard surface. 

Built-in flexibility for the RMS carts and workstations can help meet hospitals’ fluctuating needs including accommodating for those that are in different stages of EMR implementation according to the HIMSS EMR Adoption Model (www.himssanalytics.org), noted Chochinov. Currently, about half of U.S. hospitals are working on implementing Stage 3, which encompasses nursing/clinical documentation.    

"Stages 3-5 are where workstations really start to come into play," said Chochinov. "That’s when the clinicians are starting to use electronic medical records. Stage 5 [closed loop medication administration] – is when the barcoding starts to happen, so the need to incorporate medication storage and prep space becomes more critical," he added.

With the Rubbermaid M38 series of mobile computing carts, users can add drawers to the compact, lightweight carts via an optional medication expansion pack.

As EMR initiatives move forward, several hospitals are also well on their way to implementing E-MAR (Electronic Medication Administration Record) capabilities, necessitating mobile computing carts that also secure medications and offer barcoding functionality.

"It is critical to secure and organize the medications dispensed out of the pharmacy or med cabinet during that last 50-feet of the clinical medication management process," said Ross, Artromick. "Documentation at the point-of-care as part of the medication administration process ensures a closed-loop accounting of required documentation and greatly mitigates the chance for error. Features that facilitate the use of EMR/eMAR are an integration of medication storage and organization with a flexible platform for mobile computing."

"Omnicell sees mobile carts aiding in the medication management process by providing better workflow efficiency, safe and secure drawer location for medication transport, and the added security of individual locking drawers for safe medication practice at the bedside," stated Williams-Clark. Further increasing patient safety, the Omnicell mobile carts can automatically assign drawers to individual patients via an optional software application.

"Omnicell’s mobile cart is designed for workflow efficiency and patient safety through secure transport, verification and accurate administration of all medication. The optional secure medication drawers fit within the cart’s small footprint allowing the cart to easily roll to the patient’s bedside for barcode medication administration (BCMA) applications."

Salus advised facilities to consider a medication management workstation provider who can "provide the breadth of line that supports ‘your’ medication delivery process (store, dispense & administration)." Components offered by Metro include: Wall cabinets, pharmacy transfer carts, BCMA/point-of–care workstations, traditional medication carts and automated dispensing solutions.

Advanced security features and high-tech support options are helping to ease time-consuming administrative tasks and reduce cost of ownership.

New from Stanley InnerSpace is its first to market Intelligent Locking System (ILS) that provides an enhanced level of security for the company’s line of small carts including general storage, procedure and point-of-care carts. With the Web-based system, administrators can easily customize security settings, enrolling or restricting users down to the individual cart level.

"You can actually enroll users through a website and then that information gets pushed out to the carts in real time," explained Kennedy. "So if you have a hundred carts on a patient floor, instead of walking around to every single cart and manually programming locks every time a new nurse comes on board, now you can do it all through a website in less than 15 minutes. It’s a huge administrative time savings."  

ILS also provides audit trails allowing visibility into who has accessed which carts and when.

Rubbermaid’s Network Fleet Software allows facilities to remotely update PIN codes for all or a group of select carts or cabinets at the same time versus connecting with each individual workstations’ software or physically going to the carts themselves to make changes. Chochinov noted that some states are requiring hospitals to update medication security PIN codes on a regular basis, for example one requires them to be changed at least every 90 days.

Rubbermaid has also updated the fleet management capabilities for its power system software allowing a facility’s entire fleet of carts to be viewed at once. "We have functionality on our high-efficiency system to track how much of the battery has been used up so that you can be more predictive as to when batteries will need to be replaced, versus letting them die and creating a lot of user dissatisfaction," said Chochinov.

"We’re seeing increasing adoption of lithium-based chemistry, or lithium-ion batteries, which are more expensive but have other benefits around a longer cycle life and lighter weight," he added. "Even though they’re more expensive there is a positive return on investment for those. And when you talk about reducing weight, hospitals will spend more money if it means it will increase nursing satisfaction, or if it increases the probability that the nurses will use the cart all the way to the point-of-care versus leaving it sitting in one place."

An Intelligent Battery Monitoring feature on Motion Computing’s Motion MCW-200 clinical workstation provides charge time predictability to protect against data loss and increases battery life and workstation availability. Continuous charge control simultaneously charges batteries and operates PC and components for shorter charging cycles; a dual power supply system offers exceptional performance, efficiency and availability for power throughout daily shifts; advanced thermal system reduces heat build-up and dust/particle intake to lower maintenance requirements. The MCW-200 also includes 98% recyclable batteries and highly energy-efficient design to provide long life and a lower total cost of ownership.

Artromick is also in development on a "service module" software to monitor workstation status and connectivity issues.

Among the more innovative ways that healthcare facilities are using mobile carts and workstations noted Salus, Metro: Telehealth, advanced applications; integration of point-of-care workstations with procedure carts (supply/point-of-care hybrid); convergence of applications and technology systems (i.e. help solve the ever crowding bedside, facility space constraints) including vital signs, printers, BCMA, CPOE and temperature monitoring.