Nurse-Led Design: Clinical Perspectives on Smart Room Technology
In Partnership with the Nursing Institute for Healthcare Design (NIHD)
Nurse staffing shortages continue to challenge hospitals, and the impact is expected to grow in coming years. A 2023 McKinsey Nursing Survey found that 45% of inpatient nurses are likely to leave their role in 6 months, while demand for RNs is projected to grow 6% through2033. There is a silver lining: technology can ease the burden. The McKinsey survey indicates that 15% of nurses’ time can be saved with tech enablement or automation. Smart room technology is one clear example of how innovative use of technology can save valuable nursing time and better serve our patients.
In partnership with the Nursing Institute for Healthcare Design (NIHD), we recently convened a panel of experienced nurses to share their insights on maximizing the impact of smart room investments. The expert team, moderated by our own Clinical Implementation Director, Erin Pangallo, MS, BSN, RN, included:
- Debbie Gregory, DNP, RN, FAAN – Nurse and Principal of Innovation Consulting, SSR
- Kim Malinowski, MHI, BSN, RN – Nurse and Head of Clinical Informatics at Orlando Health
- Kate Newcomb-DeSanto, MSN, RN, MSW, EDAC – Nurse and Owner of Connected Healthcare Resource Advisors
- Heidi Shedenhelm, DNP, MSN, RN, NE-BC – Nurse and Nurse Leader with Mayo Clinic
The panel’s conversation – recapped below – reveals perspectives on workflow design, implementation success factors, and the essential role nurses play in shaping purchasing decisions to ensure smart room technology serves clinicians and patients.
What are the key drivers of investing in smart room technology? What is leading this change?
Heidi Shedenhelm: “Some of the key drivers I see center around clinical excellence. We can create efficiency and bring our nurses to the top of their license while still addressing the nursing shortage. Patient and nurse experience are also part of the equation – creating a healthy work environment for our nurses and the optimal experience for our patients. And financial performance is a consideration. Where can we find opportunities for cost reduction and operational efficiency?”
Kim Malinowski: “We need to meet our patients where they are. So many patients are tech savvy, and expect modern technology to access information. Smart room technology allows us to bring the patient's family into the conversation as well.”
Kate Newcomb-DeSanto: “It also indicates a commitment to patient safety. There are many people who interact with a patient in a 24-hourperiod. Having information up to date immediately keeps our patients and staff safer. Take the example of a patient who shouldn’t eat or drink before a procedure. The smart room technology informs the dietary team in real-time, automating that communication without the need for a nurse or other care team member.”
Debbie Gregory: “I’m also seeing that the smart room integrates into the care delivery model as an extension of the care team. Ambient listening and automation augment the nurse by becoming a part of the care team.”
How do you define “smart room” and what investments do you see healthcare organizations making to move towards this model?
Debbie: “Patient engagement is a key factor. As nurses, we encourage patient and family education. Smart room technology helps them become part of their own care, helping them be accountable and informed.”
Kate: “A hospital stay can put tremendous emotional stress on patients and their families. It’s often difficult to hear and internalize all the information being given, but the ability to clearly show succinct visuals, available when they are ready to receive it, improves interaction and understanding. The patient has information readily available without needing to wait for a nurse to come in the room.”
Kim: “It broadens our care delivery model by supporting virtual capabilities. Some tasks – such as translation and admission services – can be performed by virtual nurses, taking the burden off the bedside nurse.”
Heidi: “Continuous patient monitoring is critical for patient safety and quality. There’s an opportunity for earlier detection and rescue with smart room tech, so nursing can be more proactive rather than reactive.”
How do you integrate nursing input into the design of smart room technology?
Kim: “Nursing is at the heart of the hospital and their input is just so valuable. I see some IT professionals put what they think nurses need or what they think patients need forward and it just falls short. Having their voice in everything that we do is so important, it makes it meaningful, and it also further engages them. The Aware digital door sign goes beyond nursing, for example, we all know that violence against healthcare workers is more prevalent than it should be. We have a campaign here at Orlando Health called “Magenta Matters”, so if you see magenta in a patient’s chart you know that’s a violent patient. With the door sign, you can turn the backlight to magenta, so everyone knows before they walk into that room that they need to take safety precautions. Having the nurses voice in this design, the number one person who interacts with the patient is just imperative.
Kate: “When nurses are not involved from the beginning, we see negative downstream impacts, from operational flexibility to financials. At the same time, the burden of patient-facing technology adoption always falls to the bedside nursing staff. They must learn, educate, fix, and modify based on real-world use. I encourage early design and planning with nurses to bring technology forward.”
Heidi: “I always recommend asking the question, ‘What problem are we trying to solve?’ The best implementation of technology is when nurses understand the problem and that they were involved in the design of the solution. What is the current workflow? How might the tech change the workflow? How can we plan accordingly? Being forward-thinking and testing for feedback will guide long-term use.”
Debbie: “Many interdisciplinary groups need to be involved to make a technology feel seamless and integrated. Considerations like meal delivery, facilities personnel, health system policies – hundreds of hours go into design of a workflow that operates efficiently across dozens of use cases for different departments. As my colleagues have stated, having nurses involved at the beginning is what ties all those things together.”
How do you intentionally make space for nurses to be involved in budgeting, design, and implementation?
Kim: “Your nurse leader champion is the most important person to make that case at the executive level. And we involve nurses at all levels for a 360-degree view across the organization.”
Kate: “We mockup space and bring staff in to interact with the technology. If you haven’t interacted with smart room tech before, it’s hard to imagine what’s possible. We did some level-setting education to show them how the tech can alleviate some of the burdens and then did deeper dives with design development.”
Heidi: “Leverage your existing committee structure to involve nursing staff. They can inform governance, safety, compliance, and other components. Another option is to run a pilot to get end user feedback before scaling to the broader organization.”
Debbie: “Assign a clinical liaison between the design team, the vendor, and the staff who can understand and document the decision points and why the decisions were made. This person acts as a translator between nursing and IT to clarify why workflows should be built in a certain way to benefit both patients and staff. Patient and family advisory councils are another great resource to vet workflows.”
How do you incorporate ongoing feedback and training after an implementation?
Erin: “At eVideon, we encourage a shared governance model with a nurse on the council so we’re getting constant feedback. It’s important that we stay with the healthcare organization through the life of the project to drive safety, quality, and experience.”
Kim: “What you display in a Med/Surg unit is very different from Labor & Delivery. We’re listening to our nursing staff across departments to make modifications as we continue to evolve the use of the technology.”
Heidi: “Subject matter experts and super users are invaluable to communicate refinements and enhancements. They feel a sense of ownership and excitement in being the voice to drive the next level of innovation. We also should consider new roles that support nurses at the bedside – how can we upskill our teams and engage team members in other ways?”
Kate: “Agreed. The digital transformation is an opportunity to redefine roles. We can use technology to give opportunities to staff members, who may not be nurses, to leverage tech and be more closely involved in patient care.”
Debbie: “We know that technology is going to move into the home with the patient, with wearables or connectivity back to the hospital. Those redefined roles can help support patients in that regard as well.”
What future advancements do you see to transform practice at the bedside?
Kate: “Patient education often doesn’t get as much time as it deserves. Smart room technology enables patients and their families to receive education on their schedule.”
Kim: “Virtual capabilities to bring families in from another location is another way to improve outcomes. Everyone can hear the information at the same time together, even if they can’t be in person. That helps nurses and patients to take part in their own care at home.”
Heidi: “I’m excited about the role clinical ambient intelligence can play. We all know the time nurses spend at the keyboard on documentation. If we can address that with ambient listening and autonomous wearable devices and allow nurses to spend more time interacting with patients, that will be powerful for patient and staff satisfaction.”
Debbie: “We are focusing on policy advancements, bringing nursing groups together. As we see shifts in technology advancements, nurses need to be at the forefront in shaping those policies.”
Smart room technology won’t solve the nursing shortage, but it can help shift the load. OhioHealth's CNO recently shared with Healthcare IT News that the Vibe Health by eVideon smart room platform, integrated with Caregility for virtual nursing, has helped slash nursing turnover at one hospital from 23% in July 2024 to 14% this year. By involving nurses in the design, implementation, and evaluation of these tools, healthcare organizations can drive smarter workflows, better patient outcomes, and safer, more satisfied care team.
