Back during the pioneer era of the 19th century when Americans migrated west to populate the frontier, people historically didn’t visit hospitals for their healthcare largely because those institutions as we might recognize them today had yet to follow them.
Instead, healthcare came to them in terms of “house calls” by local doctors who assisted in childbirths and performed surgeries.
Once the nation passed mid-century and entered the Civil War, major cities began to see the emergence of public hospitals where patients would go for healthcare.
The development and progression of carts and workstations seem to be mirroring the pioneer era.
Salus points to evidence of carts and workstations illuminating the trend of care going to the patient even before the pandemic emerged a year ago. Examples include anesthesia, which was predominantly performed in the Operating Room (OR) environment, now emerging in the Emergency Department (ER), in Radiology and Cardiology and in other places where patient care is given.
Salus homes in on the ER as a prime example of how carts and workstations not only reflect a trend but support it as well.
“On a more micro-scale, take a look at the Emergency Department,” he indicated. “It was designed with specific pods to provide patient care. However, during peak times, the pods are full, and patients continue to arrive. Some patients need immediate treatment and can’t wait for a bay to become available. Caregivers must treat those urgent patients where they can find room, oftentimes in the corridors. The mobility of carts, can bring the necessary supplies, equipment and even data to the patient.”
As a result, carts and workstations can be equipped with mobile power sources to allow applications, such as anesthesia and ER overflow, to be supported with supplies and patient data via computers and monitors linked to the hospital system without needing to be tethered to an outlet, he added.
“During the first half of last year most of our customers realized they were not tooled to handle an uptick in [personal protective equipment] supply levels,” Loper noted. “Enclosed security and PPE carts in patient care areas were in high demand, and the key purchasing requirements for the product group were lockable, cleanable, protectable, mobile, reliable and it must be delivered ASAP.
“Prior to COVID, the ability to move critical supplies within a single cart from point A to point B was important but once COVID hit, the needs for speed, mobility and flexibility hit the top of the priority list,” Loper continued. “It was ‘go time,’ and healthcare workers needed support. Some customers were scrambling like never before looking for specialized carts to be able to handle the surge in patients.”
Product lead times became mission-critical for DSI, which accelerated production to less than one week, according to Loper. “Specialized carts, such as isolation, bedside, PPE and temperature-controlled COVID vaccine carts became essential pieces of equipment to help the frontline workers save lives and get the job done,” he added.
“Frontline workers need to be more efficient, and to do this they need equipment that is designed to help them,” Hazelwood said.
To wit, Hazelwood cites two government studies that state most frontline staff spend 64% to 90% of their time on their feet1 and they also are mobile, walking 2.4 to 3.4 miles per shift.2
“Using mobile equipment that is designed to assist caregivers in their work can increase efficiency,” he continued. “Some of the work they do requires staff to move from room to room. Mobile products can help. Both mobile carts and mobile workstations can be used in-room at the point of care and then can be easily moved out of the way when not in use. Mobile carts and workstations can also help keep the focus on the patient as the patient-caregiver experience is important in achieving better outcomes.”
Carts and workstations can contribute to improving safety for the caregiver in terms of ergonomic positioning, according to Hazelwood.
“Reaching and straining can lead to fatigue injuries,” he indicated. “Better ergonomics is necessary for healthcare workers, who are among one of the most at-risk professions in the U.S. for musculoskeletal injuries. In fact, healthcare workers are almost three times as likely to suffer from work-related injuries than construction workers.3 Mobile carts and workstations can help improve efficiency and safety in the outpatient setting. But, more importantly, these products can assist in improving patient and staff experiences and clinical outcomes.”
“If you look at the evolution of the mobile workstation space, the first iterations of computer workstations were either charting stations based in the hall or bulky computers on carts, neither of which enhanced workflow or improved the patient experience,” Hillenbrand told Healthcare Purchasing News. “Today, the leading cart manufacturers are now designing carts with the patient experience and the user experience in mind. Today’s industry-leading carts are lightweight and highly mobile to bring technology to the bedside, ultimately resulting in a better episodes of care and higher patient satisfaction.”
Hillebrand highlights an increased focus on mobility and ergonomics as an ongoing development. For example, adjustments to the monitor mounts, keyboard trays and sit-to-stand height ranges are designed to provide maximum comfort and optimal ergonomics for the clinicians, he notes. “A lightweight cart that improves mobility and the ease to push, pull and steer are all crucial to clinicians who walk miles a day,” he added.
Hillebrand also emphasizes aesthetics and design as important for carts and workstations.
“This trend started in health facility interior design to improve the environmental aspects of a care and healing environment and has certainly filtered down into the equipment being used in these care settings,” he said. “Altus, for example, takes many design cues from our office furniture roots. These workstations are usually the first thing a patient sees when admitted, and the last thing seen when they leave. We believe in designing products that enhance the aesthetics of a care environment and is a key piece in patient satisfaction.”
Cart and workstation design and utility also have been applied to the nonacute settings as well, according to Hillebrand.
“Point-of-care charting has proven to reduce errors and improve workflow, [so] it is only natural that adoption flows across the continuum of care,” he said. These workstations benefit both the clinician and the patient.
“The patient benefits because [when] the doctor or nurse [uses] a mobile workstation, they can position it in a way so that they are still facing the patient, making eye contact and providing a higher level of care – known as the triangle of care,” he continued. “For the clinicians using the workstation, they benefit from improved mobility and ergonomics that you might not get while carrying a laptop [from] room to room and typing on your lap, as well as reduced workplace injury claims.”
“With heightened media attention on hospitals, clinics and health systems surrounding the pandemic overall and vaccine rollout, it may seem like carts and workstations play a bigger role in healthcare,” Poulson mused. “But over the years, these solutions have become increasingly more integrated into caregiver workflows. As caregivers need more access to the electronic health record (EHR) and complete a greater portion of their documentation work while they’re with the patient, the need for carts and workstations has increased.”
With the aging baby boomers needing more care, including long-term care, demand for carts and workstations is increasing, according to Poulson.
Another key motivator? The pandemic, which has caused explosive growth in telehealth adoption, she observed. Mobile solutions, such as carts, remain key for telehealth and offer an opportunity for vaccination support.
“Recently, there’s been a lot of demand for carts that support vaccination rollout workflows — mobility is critical,” she added. But Poulson also acknowledged that installing wall-mounted workstations may be preferable to limit the number of carts that go in and out of patient rooms each day.
“Well-designed workstations offer flexible solutions for mounting displays and devices, easy access to supplies, and secure and safe medication administration,” Torbett noted. “They are essential not only for ease-of-use and efficiency, but also for maximizing patient engagement by facilitating caregivers’ ability to remain close to and interact with patients. It’s all about improving patient care and workflow, while designing the workstation ergonomically to minimize physical strain for caregivers.”
Torbett zeroes in on tablet use by many physicians for basic tasks. The small displays on tablets can limit physician capabilities and make them less efficient for more intensive use, he added.
“We have seen growth in use of small rounding carts by physicians and other highly mobile users with tablets and small laptops for these other benefits compared to carrying a device by itself,” Torbett noted. “We have seen demand grow for larger displays and even dual monitors as technology interaction keeps advancing at [the] point of care. For example, telehealth has grown dramatically, leading to requirements for separate cameras, sound/microphone bars and other devices. Workstations also provide easy access to supplies and medications. They offer full size keyboards and mice for efficient data entry, which is particularly important during more time-consuming tasks. Nurses typically spend a majority of their time doing documentation, medication administration and care coordination, all of which require use of their workstation.”
“We are constantly striving to find ways and solutions to minimize the footprint yet increase the efficiency and productivity on the work floor,” Specter said. “Mobile cart workstations are just that, the ideal solution that have enabled us to provide an integrated computer data system, a plethora of tools and equipment, multiple devices and a means of remote communication all packed into a minimal footprint and sleek design. The mobile cart offers the healthcare workers a one-stop solution with ample opportunity for storage and accessories.”
Moreover, modernization has paved the way for more innovative design and more practical solutions atop four wheels, Elliot reflects, “powered to stay charged all day, easily maneuvered from room to room and fully loaded with technology. There’s plenty of room for growth in this market as we learn to facilitate the need for mobile medicine and communications,” he continued. “COVID-19 unfortunately put these devices at the forefront of the workforce as the mobile cart workstations offer a menagerie of answers and solutions for the healthcare professionals that pilot them and navigate through the hallways.”
The emergence of telehealth/telemedicine and availability of technologically advanced and customizable medical carts also are driving development and growth, Specter indicated. “Today, medical carts are being customized for carrying, dispensing, transporting and storing medical drugs and instruments, depending on the nature of the procedure or where the cart is used,” he added.
Trends in cart and workstation design can be translated to automated dispensing systems and automated supply cabinets, too.
Medication therapy has increased in complexity and remains a critical component of patient care, safety and efficiency, according to Len Hom, Director, Product Marketing, Point of Care Solutions, Omnicell Inc. “Nurses have always carried a tremendous load in patient care from med administration, charting, patient/family education, learning new technologies, etc., to simply comforting patients. It’s our responsibility as [automated dispensing system] vendors to drive more efficiency for nurses to keep them, and patients safe.” Hom highlights the ability of single-dose dispensing, automated links to electronic health records, bar-code scanning, automated label printing and patient-specific medication management as key features.
There’s more to the story.
Read “Pandemic punctuates cart, workstation utility”
Read “What cart, workstation improvements would you make?”
References:.
1 https://www.bls.gov/ors/data.html
