​​By: Glynis Ratcliffe​​​

On any given shift, a nurse can rack up between 7,000 and 11,000 steps darting from patients to workstations to supply rooms. That's the equivalent of five to eight kilometres. ​

All that walking isn't just physically taxing, it's a hidden drain on their time. The more nurses walk around, the less time they have to tend to patients. The industry even has a name for it: “sneaker time."

When Humber River Health (Humber) began designing its Wilson site, the hospital's leadership knew sneaker time was a challenge they had to address. The new hospital would cover 1.8 million square feet – nearly twice the size of the previous site – and transitions from multi-patient rooms to private ones, potentially increasing the distances nurses would have to walk during each shift.

To address this challenge, then-Redevelopment Lead Barb Collins hired GE HealthCare in 2007 to study how Humber's nurses divided their time. 

The results were eye-opening: 

• Just 38 per cent of each shift was devoted to direct patient care, such as checking vitals and changing IVs
  
• Paper documentation, e-charting, and extra processing work took up 29 per cent of a nurse's time
• Walking consumed another 13 per cent

If Humber was going to maintain its patient-to-nurse ratio of five to one in a building where patients were significantly farther apart, something would need to change.

“Health care is a very human resource-intensive business," notes Dr. Peter Bak, Humber's Chief Information Officer. “It's one of the last sectors to leverage tech to automate processes and people."

Dr. Bak was hired in 2009 to help Humber design a fully digital hospital that would save time and money while improving care – all in a space three times the size of the original buildings. “It's all well and good to say, 'I want a digital hospital'" he says. “But then what?"

Dr. Bak didn't want to design Humber's digital tools from scratch because of time and cost. Instead, he looked to existing commercial-grade solutions from other industries and integrated them into the hospital computer network.

Here are some of the technologies he helped put in place to reduce sneaker time.

Network-connected vitals monitors

Before moving to the Wilson site, charting could account for up to 16 per cent of a nurse's shift. Today, they can scan a bar code on a patient's hospital bracelet to automatically upload their vitals – blood pressure, temperature, etc. – to their digital chart, eliminating the need to record them at the nursing station.

Digital patient room signs

Patient rooms need signage that quickly informs clinicians of important information before they enter, such as infection control precautions or fall risks. Updating handwritten or printed signs

are a time drain for nurses and can lead to human error. Now, screens outside every room display specific information attached to that patient's bar code, showing their health status in real time.

Integrated Bedside Terminals and Smartphones

In most hospitals, patients press a call button when they feel cold, need help or want test results. This alerts the nursing station, where staff relay the request to the nurse doing rounds. To streamline this process, Humber introduced bedside terminals that allow patients to adjust their room's temperature and access physician reports. To keep nurses connected while on the go, they're equipped with ASCOM smartphones connected to the hospital's encrypted data network. These devices handle internal calls, display bedside alerts and alarms, scan patient and medication bar codes, and act as a nurse call system for patients.

Automated Guided Vehicles (AGVs)

Walking back and forth to deliver important items like medications, supplies and bedding used to account for 13 per cent of a nurse's shift, until Humber implemented AGVs. Now, these self-driving robots make nearly 75 per cent of the hospital's routine deliveries, independently opening doors, calling elevators and navigating hospital hallways.