Smartphones Improve Rounding on Behavioral Health Units

A few months ago, patient care nursing assistant Anne Darwin, relied on paper logs to track her rounds in the Child & Adolescent Psychiatry Unit at Cleveland Clinic Fairview Hospital. She’d perform a safety check on each patient every 15 minutes.

But it would take additional minutes to document each visit, update the patient’s medical record and calculate time until the next rounds — not to mention keeping track of who needed to be checked next.

In November 2016, Darwin traded her clipboard for a smartphone. New mobile functionality now tracks her safety checks, automatically updates the electronic medical record, and prioritizes patients due for the next round.

All behavioral health inpatient units at Cleveland Clinic hospitals have begun using smartphones for safety check rounding.

How it works

The new functionality was added to IRIS, Cleveland Clinic’s proprietary app that connects smartphones to its EMR.

Designed with input from behavioral health nursing teams, the app lists patient names, coded in red, yellow or green, based on the number of minutes since their last safety check. Red means it’s time for another check. By touching a name in the app, a screen is revealed for updating the patient’s location and status.

Each behavioral health unit has several smartphones shared by the nursing team. Some of the phones charge when the others is in use.

“Now rounding is so much faster—we can complete rounds with a few touches on the phone instead of having to go back to a computer and log in to the EMR to document the visit,” says Darwin. “We can focus more on our patients and their demeanor while we’re documenting their location.”

Further, charge nurses and nurse managers can see real-time updates to track their team’s progress and workload. “The app minimizes the risk of missed timing for rounds, thanks to the color coding. Patient lists update when new patients arrive on the unit, and the timer stops when patients are temporarily off the unit,” Darwin adds.

Safer and more efficient

The behavioral health rounding app is a first for Cleveland Clinic. But it may set a new standard for rounding in other areas too.

“We were concerned that paper records weren’t as effective as we wanted them to be,” says Nelita Iuppa, DNP, RN-BC, Associate Chief Nursing Officer of Nursing Informatics. “We felt that an electronic system would improve safety for unit patients. We went to our technical team in the Clinical Solutions Center in September 2016, began developing the app and purchasing smartphones in October, and rolled out the program in November. Everything happened quickly once we got started.”

Suzanne Fink, MSN, RN from the Clinical Solutions Center notes, “It’s been terrific to partner our agile mobile technology team directly with nursing caregivers to improve this workflow. They were shoulder-to-shoulder with staff, working to get this right. That level of companionship makes this process rewarding, and is what yields quick and effective results when introducing new technology.”

Users continue to suggest enhancements. “This app is a game-changer for our caregivers,” says Dr. Iuppa. “It helps them work more efficiently, but also frees them to be more alert and aware of patients and their safety.”