Topics: Healthcare Quality, Visual Management, Action Drivers, Distraction, EMR

Sight and sound are our most vital links to the world, but they are by no means equal. Our eyes control over 30 times the nerve connections to our brains that our ears do, and as much of 50% of our brain’s computing power reflects the same bias. This ‘sense inequality’ trickles down to the way we think as well, with sight being first in line for processing split-second decisions, and sound coming in as a back-up trigger for emotion or volume, but generally falling behind available visual cues. Ironically, in the information age, this primal understanding has been lost at the practical level – which is precisely where it matters most.

Recent developments in healthcare have created a pervasive information noisiness that leads to missed opportunities, mistakes, or distractions from patient care altogether, particularly in emergencies. Whether it is the copious data digitally stacked in patient records, or check-box gauntlets in the EMR, or even the ever-present Dr. Google on patients’ smartphones, clinicians are increasingly struggling to stay focused on what is most important.

Even with implanted devices streaming data to EMRs and the cloud, the majority is often left unused until there is a clinical event that drives clinicians to struggle through the data vaults in search of meaning and potential actions. It falls on the shoulders of those on the front line to decipher what is most important in the data, which is often poorly connected to the clinical decision frameworks that they learned in school.

Focusing on what is most important, having clear focus on the needed actions, is critical to the success of any organization, but especially in healthcare. Lives are literally on the line, as is tremendous cost, not to mention the quality of patients’ lives beyond a care episode in the long term. Clear priorities means tracking down and filtering out the most critical elements of a problem, and then taking critical actions there is still clinical value to be had. Patients need treatment before it’s too late.

Keeping caregiver cues visual, and obvious as to the needed action, makes our visual wiring a strength, rather than a distraction, helping prevent the process breakdowns that drive so much unnecessary cost, morbidity, and mortality. The critical components to drive success are:

Right place, right time: If the caregiver can’t see the cue when they need to know about it, no action happens. Additionally, needing to step away from the point of care to capture data is impractical and adds to the risk that processes fall apart.

Obvious: If you have to stop or divert from normal process to get the cue, it probably won’t happen at moments of crisis. Similarly, if it’s too hard to figure out what the meaning of the product is, it will tend to cause more errors. Limiting the amount of display information will proportionally increase the value of the remaining visuals.

The in-hospital colored wristband is a great, albeit imperfect, starting point. Even though patients fill out admissions forms in duplicate and allergies are highlighted in several places throughout the EMR, the only way this information becomes practically useful at the POINT OF ACTION during a hospital stay is when a red band with the word “ALLERGY” is applied to the patient’s wrist. And then it serves primarily to trigger a clinician to ask the question – “what allergy do you have?” The data from the admission forms and entered into the EMR are powerless to help prevent a potentially life-threatening exposure to an allergen, superseded by a simple red wristband. Without the wristband, the data sits in a vault, remote from the point of action. Although this movement for colored wristbands struggles because of the need to standardize across centers and states, it is still the type of inexpensive and easily implemented tactic that can really yield dividends.

Medical technology is churning out more and more data, however the real battle will be won by making data actionable, not just to evaluate population health, but by connecting caregivers and practitioners to actions where and when they need to happen. While visual, obvious and actionable cues for caregivers are only beginning to emerge as a trend in healthcare, we at Dock believe it is the next big thing.


Tico Blumenthal

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