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Wallaroo with Isonas Presentation
- 6. TIME – CLINICAL STAFF
- 7. Medical/Surgical Unit Data Represented How Nurses Spend Their Time Communication 17.8% Walking 17.1% Other 13.6% Medication 13.5.% Documenting 11.3% Treatment 11% Assessment 7.3% Info Retrieval 5.9% Medical/ Surgical Unit Pediatric Unit Number of Tasks Observed 2,061 in 35.7 hours 2,182 in 49.5 hours Mean Length of Task (Seconds) 62.4 81.6 Standard Deviation (Seconds) 127.7 145.8
- 8. Research Design: Nurses from 36 medical-surgical units (n=765 ) participated in a time and motion study designed to assess how nurses spend their time, nurse location and movement, and nurse physiologic response. The authors identified three main targets for improving the efficiency of nursing care: • Documentation • Medication administration • Care coordination What Prevents Nurses From Being At The Bedside? Patient Care Activities Assessment/ Vitals Documentation Medication Administration Care Coordination 35.3% 17.2% 20.6% 7.2% 19.3%
- 9. Research Design: A 36-item questionnaire was completed by 272 nurses from 17 intensive care units (ICUs) of seven hospitals in Wisconsin and the frequencies of performance obstacles reported by intensive care nurses were computed. What Prevents Nurses From Doing Their Job? Technology & Tools Environment Organization Tasks ICU NURSE The most frequently experienced performance obstacles: 46% Noisy work environment 42% Distractions from families 40%/37% Hectic and crowded work environments 36% Delay in getting medications from pharmacy 34% Extended time teaching families 32% Equipment not being available/ someone else using it 32% Patient rooms not well-stocked 26% Insufficient workspace for completing paperwork 24%/23% Seeking for supplies or patients’ charts 23% Receiving many phone calls from families 21%/20% Delay in seeing new medical orders and misplaced equipment
- 10. Research Design: Authors sampled a cross-sectional group of six U.S. hospitals and collected minute-by-minute data on the activities of 11 nurses. In addition, they conducted interviews with six of these nurses using questions related to obstacles to care. The result was the creation of two surveys in 48 nursing units, one for nurses and one for managers, asking about the frequency of specific work system failures. Operational Failures Category of Failure Nurse Survey Manager Survey Observer Medication 1.2 1.5 1.5 Supply items 1.2 1.4 1.2 Medical orders 0.54 1.2 1.4 Equipment 0.98 0.8 1.1 Insufficient staff 0.59 0.8 1.2 Other 2.0 Total in 8 hour shift (average) 4.51 5.7 8.4 Average Number of Operational Failures Experienced by Nurses per 8-hour Shift
- 11. What does this data tell us • Clinicians are over taxed minute by minute • Inefficiencies in workflow and process add to this problem • Because nurses are involved in critical activities every minute there are more
- 12. Here’s where it gets interesting…
- 13. Wallaroo with Isonas: • Networked access control • Audit Trail for every transaction • Keep Meds & Supplies at POC • Reduce Walking & Distractions • Reduce Medication Errors • Spend more time with Patients How does it help achieve goals?
- 14. Communication 17.8% Walking 17.1% Other 13.6% Medication 13.5.% Documenting 11.3% Treatment 11% Assessment 7.3% Info Retrieval 5.9% GOAL ACHIEVEMENT Imagine a 12 hour workday where a critical activity is occurring every 1-1.5 minutes Even a modest reduction in the time spent walking, getting meds, charting and info retrieval has huge impact
- 15. 42.48 123.12 81.36 97.2 344.16 21.24 61.56 61.02 48.6 192.42 Info Ret. Documenting Medication Walking Total Impact on Time Min. Per Day before wallaroo Min Per day after Wallaroo 0.8 1.60 Before After Time Available Per Activity Before After
- 16. But what is Wallaroo with Isonas???
- 18. Traditional System 8 Door Panel • A Wiegand Reader at the door (with no intelligence) . . • Multiple copper Proven Revolution . . . everything on the left is equal to the single PowerNet reader-controller at the door shown above. ISONAS PowerNet System and a Cat 5 Ethernet Cable US patent No. 7,775,429 ISONAS 3’ 8” 2’
- 19. Solution Topology Cabinet PowerNet Host With Crystal Matrix Cabinet Open Sensor Optional EasyWeb / Mobile w/PoE Electronic Latch
- 20. Multi-Functional Use-Case Crystal Matrix PoE Switch Remote Cabinets ParkingMobileNo Wired NetworkIT Assets Wireless Router
- 21. • Just a few of many customers that current use Isonas Technology The Tech Behind Wallaroo with Isonas
- 22. It’s not just Wallaroos • Full access control for the entire facility, or entire system! – Doors, Pharmacy, Garages, Ambulances • Access control is everywhere, and this solution is – Less expensive – More sophisticated – Easier to use and install
- 24. Thank you very much.
Editor's Notes
- THIS SLIDE MEANS THAT NURSES SPEND AN AVERAGE OF ONE MINUTE TO ONE AND A HALF MINUTES ON EVERY TASK THEY UNDERTAKE—image spending an entire 12 hour shift doing a critical and vital task every one minute? It speaks to the reason by errors occur and how important it is to have an efficient workflow...
- Because hospitals have silos within silos the outcome is often a breakdown in workflow resulting in clinicians spending more time dealing with issues and less time doing their job. In this research study, which included a time and motion study of 765 nurses, the authors conclude that while all the tasks noted in the graph are nursing activities, most of nurses time is spent on activities that are outside of direct patient care. Nurses need to be at the bedside for a greater percent of their shift, we have to find better ways, more efficient processes to streamline the nurses workflow. use of nurses' time and the safe delivery of care.
- In another study, a questionnaire was completed by 272 ICU nurses and they reported on job performance obstacles, bottlenecks that get in the way of bedside care. The list includes: 46% noisy work environment 42% distractions from families hectic (40%) and crowded work environments (37%), 36% delay in getting medications from pharmacy 34% spending considerable amount of time teaching families 32%, equipment not being available/someone else using it 32%, patient rooms not well-stocked The point is....all of these workflow interruptions should not be happening, most can be fixed with a concentrated effort of understanding the appropriate flow that is needed and working as a healthcare team to fix the problems....take the low hanging fruit here....in an ICU, how can the patient rooms not be stocked with the supplies needed since most of the activities that happen there is repeated every day, some twice a day but most 6 to 8 times a day or more.
- Here is a study with a much smaller sample size but there are two big take aways here.....the Nurses observed experienced an average of 8 work system failures per 8-hour shift—that is one an hour—just think for a minute is the airline industry experienced this? This could shut down an airport, one of those systems errors.... The five most frequent types of failures, involved medications, orders, supplies, staffing, and equipment The authors concluded....given that nursing work is fragmented and unpredictable, designing processes that are robust to interruption can help prevent errors. We will get to solutions in a minute but a few more studies to illustrate the problem...
- To summarize the hardware proposition: The PowerNet reader-controller is the main piece of ISONAS hardware at the door. It is an intelligent device, in that it has its own databases, and can make its own decisions on whether people should be admitted or not. The system might be configured so that the host computer is making these decisions. But if the host computer goes off-line, the PowerNet’s intelligence will allow it to automatically switch into Standalone mode, and begin to make the access control decisions. ++The PowerNet is a network appliance. It has an IP Address assigned to it and connects to the network with a standard network cable. When integrators explain this feature to their customer’s IT staff, the IT staff become very favorable to this solution, because they understand the technology, and the technology fits in with the rest of the customer’s IT infrastructure. ++Different credential technologies are supported by the family of PowerNet readers. Proximity is the most commonly used technology in the market today, but PowerNets are available that work with smart cards such as MiFare and iClass. ++The PowerNet’s small physical size gives the customer extra flexibility when they are selecting the installation location. This image of the reader-controller is shown with the optional integrated keypad. The keypad can be configured within the system to be an independent entry method, or the keypad can be part of a dual-authentication credential verification scheme. ++The PowerNet is rated for both indoor and outdoor use, so the same model can be used throughout the customer’s locations. It is IP-56 rated, and can be used between minus 40 to 120 degrees Fahrenheit ++There are a number of ways that the PowerNet can be powered. Power-Over-Ethernet is supported, which allows the same Cat5 cable that is supplying data to also provide power for the PowerNet, and power for most electric door locking mechanisms. The PowerNet can also be powered with 12 or 24 volt DC power. Low-voltage power is sometimes used on retro-fit projects, where there is low-voltage wiring already installed at the door locations, and that low-voltage power will be used to power the locks and the reader-controllers. ++Anywhere that you can send an IP message, you can control a door or access point. So the physical location of the reader is not important. As an example, a school might have the host computer located in the Administration Building, and control doors at every school in the district. The increment of growth of the ISONAS system is door by door. The readers are independent from each other and they exchange small messages with the host. Your system size can range from a site with one or two doors, to a larger installation with 1000’s of doors. Our installation at the South Country Schools in NY supports more than 1,200 doors across their entire district. ++ The solution is very secure. The data traveling between the reader and the host can be encrypted using AES 256 bit encryption. The data that is stored on the reader itself is encrypted. The optional Exterior Door Kit can be used to fully isolate the door lock’s wiring from the exterior of the building. The reader is equipped with an anti-tamper device, so if the reader is disturbed, alarms within the system will be generated. ++ The efficient design and localization of components means that the manufacturing carbon-foot print of the ISONAS solution is smaller than the footprint of traditional access control systems. In operation, it is very energy efficient, and in many locations, can share it’s PoE power source with the customer’s VoiceOverIP Phones, or IP Cameras, which results in even greater energy efficiencies. ++ ++ {to next slide}
- This is what a traditional access control system looks like…. The panel is installed in a control closet. It can handle 4-8-12 or even 16 doors. The control panel is the “brain” of the system and makes the decision to approve or deny a credential. If a credential is approved, the panel sends a signal to the door via some specialize intra-office wires that unlocks the electronic latch which releases the door. In addition, the “motorcycle batteries” shown below the panel are in place in case the power goes down. If the power goes down you don’t want your access control to no longer work…. ++ In contrast, this is the patented Isonas PowerNet. It greatly simplifies the entire system. The reader and controller are combined into one compact unit. This supports decisions being made locally, but programmed centrally. If the network goes down, the PowerNet continues to operate without interruption…. The only intra-office wiring required is a standard Ethernet cable that is installed at each door. The hardware at the door, such as the Electronic strike, Request for Exit button, and door sensor can all be powered from the PowerNet and PoE. No AC power is required at the door location. This means no electrician, no conduit and/or the drywall work that comes with the code requirements around 125v electrical power. The PowerNet makes your entire network easily scalable 1 door at time, and is significantly less expensive to install and operate. ++ {to next slide}
- To review now the full topology of the ISONAS solution, we will focus on a simple single door installation. ++A PowerNet reader-controller is installed at the door location. ++Additional components at the door location, such as a Request-for-exit device, connects to the PowerNet’s Pigtail . ++The pigtail will be used to control the door’s lock ++and monitor the door open sensor. So the items located at the door are connected to the PowerNet itself. ++The PowerNet reader-controller is connected to the data network. For our illustrated installation, PoE power is being used, which allows the Cat5 cable to provide power for the reader, the door lock, and any other additional components. ++ Next the Crystal Matrix software package would be installed on a host computer, and Crystal Matrix would configure and control the PowerNet over the customer's network. ++ The customer might also use EasyWeb or Easyweb-Mobile, in parallel with Crystal Matrix, to maintain and control the system. ++ {to next slide}
- So far we’ve covered the details of the ISONAS solution and how it differs from the systems you may be use to. But the superior & powerful flexibility of the solution, becomes clear when we understand how a single integrated system can be used to control disparate resources within an organization. To illustrate this, next we will discuss controlling different assets on a college campus. We start with the network of doors that we saw previously, all being administrated from the central host. ++The system is extended to the school’s weather research station, located on a remote mountain top. A standard PowerNet is installed there. One important benefit of this usage is realized the next time a graduate student drives to the mountain top, and forgets their card. The student can call back to the school, and request to have the station’s door remotely opened. ++To control who is allowed to operate loading equipment at the school’s receiving dock, PowerNets are installed on the school’s forklifts. This allows the school to meet safety requirements, by enforcing that only properly trained personnel operate the equipment. Wireless technology allows the forklifts to report on who is operating the equipment, and to allow the forklifts to be notified of any changes to the pool of qualified operators. ++ The same wireless topology can be used when controlling isolated storage areas on the campus. These are locations where the school’s hard-wired data network is not available. Standard wireless bridges are used to connect the remote location to the campus’s network. ++Built-in cabinets located inside science research labs can be controlled. The PowerNet’s ability to control multiple cabinet doors simplifies this type of installation. This enables the lab to control access to dangerous materials, and generates a log of who access the materials, and at what time. ++Installing PowerNets and long-range readers at the entrances to the faculty parking lots reduces conflicts, and makes it quick and easy for the college staff to park their vehicles. ++The school equipped their data center’s computer racks with the PowerNet solution to improve control and accountability of these critical assets. So with one simple-to-install system, you can address many different challenges throughout the campus. And to review, even though all of these items are controlled by a central system, the Crystal Matrix software has the ability to give different administrators control over different portions of the system. So, the weather station and research labs might be managed and monitored by the science department, the computer racks could be managed by the IT staff, and the building entrances and parking access could be managed by the school’s security office. ++ {to next slide}
- To summarize the hardware proposition: The PowerNet reader-controller is the main piece of ISONAS hardware at the door. It is an intelligent device, in that it has its own databases, and can make its own decisions on whether people should be admitted or not. The system might be configured so that the host computer is making these decisions. But if the host computer goes off-line, the PowerNet’s intelligence will allow it to automatically switch into Standalone mode, and begin to make the access control decisions. ++The PowerNet is a network appliance. It has an IP Address assigned to it and connects to the network with a standard network cable. When integrators explain this feature to their customer’s IT staff, the IT staff become very favorable to this solution, because they understand the technology, and the technology fits in with the rest of the customer’s IT infrastructure. ++Different credential technologies are supported by the family of PowerNet readers. Proximity is the most commonly used technology in the market today, but PowerNets are available that work with smart cards such as MiFare and iClass. ++The PowerNet’s small physical size gives the customer extra flexibility when they are selecting the installation location. This image of the reader-controller is shown with the optional integrated keypad. The keypad can be configured within the system to be an independent entry method, or the keypad can be part of a dual-authentication credential verification scheme. ++The PowerNet is rated for both indoor and outdoor use, so the same model can be used throughout the customer’s locations. It is IP-56 rated, and can be used between minus 40 to 120 degrees Fahrenheit ++There are a number of ways that the PowerNet can be powered. Power-Over-Ethernet is supported, which allows the same Cat5 cable that is supplying data to also provide power for the PowerNet, and power for most electric door locking mechanisms. The PowerNet can also be powered with 12 or 24 volt DC power. Low-voltage power is sometimes used on retro-fit projects, where there is low-voltage wiring already installed at the door locations, and that low-voltage power will be used to power the locks and the reader-controllers. ++Anywhere that you can send an IP message, you can control a door or access point. So the physical location of the reader is not important. As an example, a school might have the host computer located in the Administration Building, and control doors at every school in the district. The increment of growth of the ISONAS system is door by door. The readers are independent from each other and they exchange small messages with the host. Your system size can range from a site with one or two doors, to a larger installation with 1000’s of doors. Our installation at the South Country Schools in NY supports more than 1,200 doors across their entire district. ++ The solution is very secure. The data traveling between the reader and the host can be encrypted using AES 256 bit encryption. The data that is stored on the reader itself is encrypted. The optional Exterior Door Kit can be used to fully isolate the door lock’s wiring from the exterior of the building. The reader is equipped with an anti-tamper device, so if the reader is disturbed, alarms within the system will be generated. ++ The efficient design and localization of components means that the manufacturing carbon-foot print of the ISONAS solution is smaller than the footprint of traditional access control systems. In operation, it is very energy efficient, and in many locations, can share it’s PoE power source with the customer’s VoiceOverIP Phones, or IP Cameras, which results in even greater energy efficiencies. ++ ++ {to next slide}