In recent years, the technology driving nurse call systems has evolved into a world of digital and networked IP-based systems that have helped to improve patient care in many hospitals. Nurse call systems are becoming more intuitive and easy to use, with specialized options designed to handle patient requests, according to manufacturer’s supplying nurse call equipment to the nation’s health care facilities. While code-required functionality has not changed over the past several years, nurse call systems continue to expand their capabilities beyond life safety provisions, experts agree. Targeting improvement in patient satisfaction, staff communications and operational efficiencies, features that used to be considered optional are now standard.nurse-patient-call-button-new

Today features such as Patient-to-staff voice communications, assimilation with real-time locating systems (RTLS), and integration with electronic health records (EHR) and admit/discharge/transfer (ADT) are just a few of the new integrations surrounding the “Nurse Call” systems today. We are now in an era of information and each system in a hospital has the ability to collect data. The challenge is to control that data and create solutions that interpret information and drive capabilities across a health care organization’s enterprise to improve patient care, satisfaction, and efficiency.

System Innovations

Today’s nurse call systems are IP-based with session initiation protocol (SIP) and voice over Internet protocol (VoIP) for audio communications. The IP infrastructure allows hospitals to use off-the-shelf structured cabling, which reduces installation time, enables faster troubleshooting and sometimes allows facility personnel to perform their own maintenance. Systems today also interact with hospital departments by using intelligent devices in the patient rooms and charting areas. This allows staff to deploy personnel to a specific patient with instructions as to what is required. Simply stated everything now relies on sophisticated computer hard drives, networks, servers, and programs. Metal cabinets that take up rooms of space, using simple switches, with an on or off button have been replaced with endless possibilities for complete facility and campus wide innovation of integration, information, and notification solutions.

Nurse call solutions are becoming more intuitive and easy to use. Patients can now ‘talk’ from the pillow speaker to their care team who are using devices such as wearable badges and smartphones. This can improve the patient experience and translate into improved HCAHPS scores.

Now there are applications that give facility employees the ability to locate and call other staff members; place a staff emergency, normal or Code Blue call; update workflow status; and initiate requests. In addition, these systems include a status board application, which is viewable on any PC on the facility’s network. The status board, often displayed on a large flat-screen monitor near the nurse’s station, displays the status of the bed, patient information and location information. This enables floor staff and unit clerks to ascertain the location of peers and the safety of the patient’s environment.

Systems Integration

The integration of nurse call systems with other data and communication systems is a key development in the evolution of this technology along with the ability for the system to link up with RTLS. The nurse call solution must include both workflow and staff assignment capabilities. In addition, the ability to integrate with SIP telephony and secure messaging systems is very important. This type of integration continues to evolve from the hand bell bed side ringing to pocket pagers. However, today integration is with facility information systems (FIS), telemetry equipment and smartphones. RTLS integration is almost a necessity in new installations. The biggest current development is integration of nurse call systems currently are with EHR providers.

The latest nurse call systems are able to gather information and connect to patient monitors, alarm management systems, beds and other IT systems to enhance the efficiency of notifications, experts say. More mobility platforms and alarm management systems are leveraging the staff assignment modules in nurse call systems to identify where to route important alerts and alarms. In some environments, calls may be cancelled remotely. A very popular trend in this area is SIP wireless phone integration, which allows routing patient calls directly to their assigned caregiver’s wireless phone.

With the medical community moving to electronic health records, integration with other data and communication systems is a key development. The request to integrate nurse call solutions to other hospital systems is now mandatory. We are requested by hospitals and skilled facilities on almost every installation to integrate with their new or existing communication systems to share data and have a single point of entry.

System Interfacing

Interfacing nurse call systems with handheld devices is a key trend. Connecting nurse call systems to handheld communications is absolutely the direction that health care is moving today as clinicians are more mobile, and there is increased focus on enabling them to spend more time at the bedside. Some Nurse Call systems have the ability to send calls and alerts to a caregiver’s wireless phone. “For example, if a patient places a call, that call can be directly routed to his or her assigned caregiver, who can accept the call, speak to the patient, or reject the call and have the escalation procedures automatically route the call to the next person in the queue.

The challenge facing nurse call system vendors is how to take this to the next level. We know that certain patients are inclined to avoid the nurse-assist button — similar to pressing a flight attendant call button on an airplane. The more user-friendly this interface can become, the better the patient satisfaction scores. Currently there are some manufactures working with clients to implement a videoconference feature via the patient television screen that will allow caregivers to respond quickly and have face-to-face interaction without entering the patient room.

System Investing

Hospital facilities professionals must deal with various purchasing and training issues when selecting and installing nurse call systems. “Consolidation is everywhere in health care and as facilities consolidate, they have greater interest in standardization on such clinical systems as nurse call solutions. We work with centralized purchasing far more today than we did in the past.

When purchasing a nurse call solution, the facilities professional must make sure there is both a clinical champion and an IT champion on board early in the design phase. Having the right infrastructure in place is important, but equally important is the process change and design associated with the new technology. The call system should enhance workflow, not slow it down.

There are more possibilities of remote troubleshooting and even fixing certain problems today, which makes self-maintenance attractive to facilities managers. At the same time, this can add more responsibility to an already over-taxed department. As the systems become more IP-focused, ownership within the facility seems to be shifting to IT and telecom groups. Because there is so much integration, more departments are called upon to assist in the pre-purchase, installation, training and maintenance of the integrated communications solution.

Evolving regulations

The regulatory landscape also is evolving, especially in the area of assisted living, and standards have been updated to cover wireless devices.

The regulatory environment for nurse call has changed a great deal in recent years and some manufacturers that provide more advanced integrations are now treated as medical device suppliers by the Food and Drug Administration (FDA). While this does not impact smaller manufacturers, it has forced many changes for larger suppliers that now must register their products and comply with quality process requirements of the FDA.

New standards have been developed by Underwriters Laboratories (UL) and manufacturers to provide a minimum level of performance in assisted living residences, which currently have no regulatory requirements. UL 2560, Emergency Call Systems for Assisted Living and Independent Living Facilities, was developed for this market. Introduced in 2011, the UL 2560 standard was driven by industry to address special communication challenges outside the hospital.

The newest priority in senior housing is being able to locate residents when they call for help from outside their residence. Current technology solutions are available and require the addition of receivers to pinpoint the location, which can be costly depending on the system and its ability and the need of the facility.

The UL 1069 and UL 2560 standards now cover wireless devices for various components of nurse call systems. A wireless system is attractive for any retrofit application or any facility that expects to repurpose spaces. Another sensitive regulatory issue with respect to nurse call systems is HIPAA compliance. This will continue to grow as an issue as more medical systems venture out into the public and into smartphones.