AdventHealth designs smart rooms for hospitals

AdventHealth is moving away from whiteboards, magnets, and magic markers in its hospital room.

The faith-based health system, which operates 57 hospitals and more than 2,000 care sites in nine states, is building “smart rooms” for patients across the organization.

Already, about half of AdventHealth’s patient rooms have undergone a digital transformation. The rooms feature video monitors and digital whiteboards that offer more information to clinicians and can help connect patients’ families to talk with doctors about their care.

Dr. Valerie McKinnis, AdventHealth’s vice president of clinical innovation, tells Chief Healthcare Executive® that she’s excited about the progress of creating smart rooms. She says the effort involves more than installing new tools.

“The smart rooms aren't just technology,” McKinnis says. “They're really about transforming care and bringing whole person care to our patients in a way that's very different.”

Fundamentally, hospital rooms went unchanged for many years. Until recently, rooms looked fairly similar to the way they did when McKinnis graduated from medical school in 2000, she says.

Now, she says the goal is to think about the hospital room differently.

She says, “How do they enable a different model of care that is much more personalized to the patient? And we know we can provide precision care with a lot of tools that we haven't had in the past, but smart rooms are a foundational piece of that.”

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Giving patients more information

AdventHealth is putting in smart rooms in more than 13,000 rooms, including patient rooms, emergency rooms and observation rooms.

The system is aiming to finish the effort by the end of the year.

“We're a little bit more than halfway installed and implemented, so that's exciting,” McKinnis says. “That's a milestone with that many hospitals, 57 hospitals. It’s a pretty big geographic footprint, so it's been an amazing journey.”

With the smart rooms, a digital door sits outside the room, and it captures information from the patient’s electronic health record. Instead of a board with signs and magnets, with the digital sign, “all of that information is visible for our caregivers, our staff, and our visitors before they ever enter the patient's room,” McKinnis says.

Two cameras are installed in the smart rooms, offering wider shots of the patients and the ability to zoom in and see “a freckle on your left eyelid,” McKinnis says.

The rooms also feature digital whiteboards with information about the patient’s care team members, their names and roles and the goals for the patients. The boards include information about the patient’s medication and diet, and they also outline the schedule for the day, such as the times of procedures.

Patients have appreciated being able to see all of that information at a glance, McKinnis says.

“That whiteboard has important things about their care,” McKinnis says. “It's got their care team, it's got their schedule. So, what time are they going to surgery that day? When are they going to be going to radiology? What time is their next pain medication dose?”

“Now all of a sudden they are really informed with that information,” she says.

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Connecting families and care teams

The smart rooms include monitors which allow doctors and nurses to connect with patients and answer questions, including questions about medication or planning for discharge out of the hospital.

With the digital whiteboards and cameras, it’s easier to bring together various elements of the care team, including specialists.

“We're able right now just through being able to click a button and send links to the people that need to be involved in that conversation to bring them all together at the same time, including other physicians,” McKinnis says.

If patients have family members who can’t be in the room when a doctor is present, they can connect onscreen. McKinnis says the digital conferencing is especially helpful for patients who don’t have family in the area and for family members of patients who may have cognitive impairments.

In addition, the smart rooms make it easier to bring in a translator for patients who aren’t fluent in English, or family members who also speak the patient’s language.

McKinnis says patients appreciate the capability of connecting with family members and having everyone necessary in the conversation at once, instead of calling a family member who wasn’t able to be present when the doctor was in the room.

“Patients' response to that has been overwhelmingly positive. They feel very cared for, and that we're bringing the right people to them, instead of them having to try and manage with us,” McKinnis says.

“It's been powerful, especially for those end-of-life discussions where we're trying to understand goals of care,” she says. “And those conversations are so important to have those extended family members or people from out of state, or if we're trying to make decisions.”

Video sessions aren’t recorded, to ensure privacy, McKinnis says. Patients are asked if they want to go on camera before connecting with a doctor or nurse.

“That was a decision we made early on for our patients to feel comfortable and not like they were being watched,” McKinnis says, adding, “We start with cameras always off and ask the patient for their permission.”

Keys to success

AdventHealth enlisted doctors and nurses at the outset of developing the smart rooms. McKinnis says that’s a critical factor in the success of the initiative.

“My advice would be to anyone considering a smart room project, you want your clinicians of all flavors involved in this from the get-go,” McKinnis says. “So, as you're doing design, even … how do we want the workflows to be in the room? What would this be like?”

McKinnis singled out the need to enlist nurses in the development of the smart rooms.

“Your nursing leaders are key, because the nurses are the people who spend the most time with our patients,” she says.

“At AdventHealth, they powerfully influenced our design and our use cases. So our nurses really worked through it with us and said, these would be the things that would be so helpful right in the course of patient care.”

AdventHealth also deployed “demo rooms” in each of the hospitals that were getting the smart rooms, and McKinnis says that also proved to be a wise step.

“We knew that we wanted our facility-based staff, not just people who sit in leadership at the corporate office, but really those people in the trenches with the patients to get hands-on technology to give us feedback,” McKinnis says.

“We knew we couldn't bring 57 people to the corporate office in Orlando, or 57 hospitals’ worth of people to Orlando,” she adds. “So we took demo rooms to them with the fully stocked equipment in a test environment. So far ahead of implementing any of this technology, though, that staff had input into design and really getting comfortable with it.”

In the course of those demos, McKinnis says nurses came up with solutions that hadn’t been considered. Emergency nurses suggested getting pharmacy histories from patients right in the emergency department, so patient medications would be in their records right away.

“We know that for our patients, as soon as we can get an accurate medication list in their electronic medical record, we provide better care,” McKinnis says.

“For each use case that we implement, it's based on feedback from our frontline staff,” she adds. “We create playbooks, and they have them in each of our facilities.”