3 Steps to Improved Critical Care Workflow


By Susan Bushman, RN, BSN

In my conversations with clinicians, managers, and administrators, two issues frequently come up as recurring themes. First, the need for clinicians to spend more time at the bedside and second, how challenging it is to efficiently maneuver around in a critical care environment.

Workflow modifications can give you the opportunity to address both issues simultaneously. Here are the primary objectives to focus on for greatest impact:

#1: Make information access easy

Using a single workstation at the bedside reduces equipment clutter, saves time, and brings the clinician to the bedside. Look for a workstation that lets you:

  • View patient monitoring data, including real-time vital signs, waveforms and alarms
  • Look up lab data
  • Use the Medication Administration Record (MAR)
  • Chart patient assessments and interventions
  • Access the Hospital Information System (HIS) for admission demographic data via a wireless bar code scanner, which you can also use for admitting a patient to the monitor, charting, and administering medication

Choose a workstation that adjusts easily to each clinician’s height, has ample space for medication, interfaces with equipment such as the ventilator, and can be positioned so that you face the patient.

Test drive the layout by bringing all the equipment you’d use for your sickest patient into an empty ICU room. Move things around and try out different placements for the best workflow – and invite all clinicians to give their input.

#2: Streamline patient transport

Transporting a critically ill patient is stressful, time-consuming, and risky. Monitoring vital signs during transport is essential – so pick a transport monitor that allows a safe and efficient process.

By using the same monitor for bedside and transport, you can eliminate time spent looking for a separate transport monitor, disconnecting/reconnecting your patient, and untangling cables in the exchange.

Choose a monitor with these features:

  • Battery life that can support all patient transports, with easy charging between uses
  • Ability to monitor on transport everything you are monitoring at the bedside
  • Compact and lightweight, easy-to-read screen
  • Wi-Fi enabled for continuous data flow to the EMR 
  • Critical patient data is protected from unauthorized access

Examining your patient transport workflow and implementing improvements can increase patient safety and give more time back to clinicians for their patients.

#3: Get alarms under control

It’s no surprise that constant alarming desensitizes clinicians to alarms, disrupts workflow, and jeopardizes patient safety. But what can you do?

  • Educate staff on current best practices (focusing on units similar to yours) and the proper use of all of alarming devices in the unit.
  • Form a multidisciplinary group and start with “easy fixes” (proper electrode placement and skin prep). Up to 99% of alarms are “false or clinically insignificant.” Working on easy fixes can reduce these numbers with minimal effort.
  • Update policies and procedures related to alarm management and notify staff.
  • Engage hospital administration and management at all levels of the process.

Finally, take a hard look at how you can improve the culture of managing alarms in your unit. Establishing a culture of active and proper alarm management will benefit your unit – and patients – for years to come. 

Susan Bushman, RN, BSN is with Patient Monitoring and IT, at Dräger.

This article was republished with permission from Dräger. It originally appeared as a blog post in INSIGHTS by Dräger. INSIGHTS by Dräger is a continuous series of ideas and innovations that can help you achieve your clinical and business goals by improving clinical outcomes, managing the cost of care, ensuring staff satisfaction, and enhancing the patient experience. Check it out here.

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