critical care patient lift pendants & equipment transfer

Critical Care Patient Lift Pendants & Equipment Transfer System

Enhancing patient & clinical outcomes through product innovation

St. George Hospital Report

April 2019

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St. George Hospital ICU- Patient Lift Pendants & Equipment Transfer System Report

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Document control

Name Role Action Version Date

Jodie Franks National Sales Manager, Wilhelm Integrated Solutions

Draft report V0.10 April 19 Leisa Ryan Supplier Development Director, HealthShare NSW

Susie Giddey Senior Category Manager, HealthShare NSW


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Table of contents

Executive Summary .................................................................................................................... 3

Overview ..................................................................................................................................... 3

Key Findings & Recommendations ............................................................................................. 3

Next steps ................................................................................................................................... 3

About this Document ................................................................................................................. 4

Purpose ....................................................................................................................................... 4

Intended audience ...................................................................................................................... 4

How to use this document ......................................................................................................... 4

1. Background ....................................................................................................................... 5

1.1 Supplier Development Management Program ................................................................. 5

1.2 Rationale for Report .......................................................................................................... 5

2. St. George Hospital Study .................................................................................................. 6

2.1 Overview ........................................................................................................................... 6

2.2 Equipment Selection Process ............................................................................................ 6

2.3 Technology Overview ........................................................................................................ 8

3. Results and Analysis ........................................................................................................ 10

3.1 Overview ......................................................................................................................... 10

4. Recommendations .......................................................................................................... 16

5. Acknowledgements ......................................................................................................... 17

6. Attachments ................................................................................................................... 17


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Executive Summary

Overview

In 2016, NSW Health implemented the ‘whole-of-government’ Supplier Development Program. An objective of the program is to work with the LHDs and suppliers on documenting projects that highlight how collaboration between parties can result in the introduction of innovative technologies that enhance the patient experience and result in clinical and operational improvements. The introduction of the Patient Lift Pendant (PLP) and Equipment Transfer System (ETS) technology by Wilhelm Integrated Solutions (Wilhelm) within the Intensive Care Unit (ICU) at St. George Hospital is one such project.

The report provides information on the following areas:

• Equipment Selection Process

• Technology Overview

• Clinical Data Sets

• Customer Satisfaction Surveys

• Recommendations

Key Recommendations

The following table provides a summary of the key recommendations relating to the selection, implementation and ongoing management of the PLP & ETS.

Recommendations

• Building a demonstration model of the equipment, enabling key stakeholders to view and trial the technology is key to ensuring clinician engagement and support for implementation.

• Post implementation, training refreshers for the PLP & ETS need to be undertaken every 3-6 months, ensuring new staff and orderlies are included.

• Senior Nurse mentoring of junior staff and manual handling champions advocating the technology will support ongoing use.

Next steps

This report is released to the South Eastern Sydney LHD. HealthShare and Wilhelm Integrated Solutions would like to acknowledge the feedback and time provided by the St George Hospital ICU patients and clinicians.

Leisa Ryan Susie Giddey Jodie Franks

Supplier Development Director

HealthShare NSW

Senior Category Manager

HealthShare NSW

National Sales Manager

Wilhelm Integrated Solutions


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About this Document

Purpose

The purpose of this document is to provide a review of Wilhelm Integrated Solutions (Wilhelm) Patient Lift Pendant (PLP) and Equipment Transfer System (ETS) within the Intensive Care Unit at St. George Hospital. As the use of this technology is the first of its kind in Australia, the report aims to document the collaboration that occurred between Wilhelm Integrated Solutions and St. George Hospital, as well as provide information to other prospective health facilities considering the introduction of this technology.

Intended audience

The audience for this document is as follows:

• Clinicians within Critical Care Units

• Clinical Visitors

• Wilhelm Integrated Solutions Customers

How to use this document

This document is divided into six parts:

Part Provides …

1 Background information, including the Supplier Development Management plan and approach and the rationale for the report.

2 Information about the technology, introduction and implementation approach.

3 The results and analysis resulting from the introduction of the technology.

4 A summary of the lessons learnt for the project.

5 & 6 • The names of stakeholders who provided assistance and time in the development of the report

• A list of related documents/attachments.


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1. Background

1.1 Supplier Development Management Program

The NSW Procurement Board approved the Procurement Benefits Program in 2016 to accelerate the pace of procurement reform and achieve the best value for money in the delivery of services. One of the associated projects was in relation to supplier development management.

The NSW Government objectives for the project were to:

• become a ‘customer of choice’ with a view to gaining better access to (and leveraging) strategic supplier capabilities

• realise mutual benefits for optimising cost and quality, while improving performance of strategic suppliers

• identify and implement innovations

• improve the customer experience through outcome-based engagement

• reduce risk in the supply chain, drive contestability and ensure security of supply

• enhance talent capability to leverage information, with a view to adding value and improving consistency to clusters, agencies and suppliers

1.2 Rationale for Report

An objective of the NSW Health Supplier Development program is to work with the LHDs and suppliers on documenting projects that highlight how collaboration between parties can result in the introduction of innovative technologies that enhances the patient experience and result in clinical and operational improvements.

In discussions with Wilhelm Integrated Solutions and St. George Hospital the introduction of the Patient Lift Pendant (PLP) and Equipment Transfer System (ETS) within the ICU at St. George Hospital is one such project.

The use of this technology within the St. George ICU environment is a first within Australia. An innovative product that focuses on patient safety, clinician safety, and room flexibility. Clinicians can reposition and transfer patients in and out of bed without the need for manual lifting, while saving valuable space and time.

The Patient Lift Pendant (PLP) eliminates the need to install tracks in the ceiling by integrating the track into the pendant arm. This results in only one single structure installed into the ceiling, reducing potential clashes and lower installation costs. Since being commissioned it has been acknowledged the technology has assisted improving the patient and clinician experience in areas such as health and safety and ease of use resulting from workflow improvements.

In the case of the Equipment Transfer System (ETS), thoughtfully designed by nurses for nurses to eliminate manual lifting that was once necessary for staff to transfer IV pumps. The complete ETS is an interface between the pendant and various types of beds and serves to eliminate manual handling of IV pumps and permits easy transport of patients and equipment the hospital.

The report documents the project scope, approach, technology and the patient and clinician benefits resulting from the use of the equipment within the ICU environment. The potential benefits include;

o Reduction in Lost Time Injuries & Incidents o Reduction in incidents of Pressure Ulcers o Improved Patient/Carer Satisfaction

Through the development of this report the intent is that the approach, insights and learnings will support future implementations of the technology within NSW Health and other health jurisdictions.


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2. St. George Hospital Study

2.1 Overview

The St. George Hospital is a major tertiary and teaching hospital in southern Sydney. The hospital has a designated medical trauma service and is the Medical Retrieval Service Coordination Centre for NSW. The Hospital's departments include anaesthesia, critical care, surgery, cancer care, medicine, women's and children's health, mental health, community health and medical imaging.

Stage 2 of the St. George Hospital Redevelopment included the construction of a new seven-level Acute Services Building. This provides an expanded acute services offering, including a 52 bed Intensive Care Unit. Patients admitted to Intensive Care Units are often the sickest and critically unwell in the hospital and as such require special experience and facilities for support of vital functions and to provide maximum patient care. As part of the Intensive Care Unit design phase, significant investment was undertaken in the equipment selection process.

2.2 Equipment Selection Process

The below table provides an overview of the key activities that were undertaken during the selection and implementation of the ETS & PTP. Two activities were consistently identified as key drivers in the success of the project. These included:

• Wilhelm’s comittment to build a demonstration model of the equipment at their warehouse, enabling key stakeholders to view and trial the technology and;

• The development of a prototype ICU room by Health Infrastructure as part of the implementation phase, enabling suppliers and staff to work together on the final room design and location of the pendants, as well as to support training in the use of the ETS & PLP.

Date Activity

03/06/15 Invitation to 4 vendors to present to St George ICU Clinical User Group

10/06/15 RFQ off NSW State Contract 900355 was undertaken, closing 19/06/15

22/6/15-29/6/15 Additional information submitted after tender committee requested further details

06/07/15 Live Teleconference with Amico in the US and St George Clinical User Group

08/07/15 Wilhelm PTP & ETS were shortlisted at the completion of the RFQ. As part of the Evaluation Process, NSW Health stakeholders requested to see the technology setup in Sydney

27/07/15 Wilhelm built a demonstration model at their warehouse in Camellia NSW, enabling key stakeholders from St. George Hospital, Health Infrastructure, HealthShare and Wilhelm Integrated Solutions to view and trial the technology

14/12/15 At the completion of the Evaluation Phase, the PTP and ETS were selected

08/08/16

As part of the implementation phase Health Infrastructure developed a prototype of the ICU room, which assisted in optimising the room design to assist in patient and clinician outcomes. This was also a great opportunity for staff to see their design become real and to also make any modifications and or changes to the layout of services and accessories prior to all pendants being manufactured.

07/09/16 – 19/02/17

As part of the implementation plan, training, mock clinical workflows, patient (staff) lifts/transfers were undertaken by St George ICU Clinical User Groups to determine suitability of PLP and ETS in prototype room as well as the layout/configuration of pendant services and accessories.

https://en.wikipedia.org/wiki/Anaesthesia

https://en.wikipedia.org/wiki/Surgery


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21/02/17 Final instruction received for minor variations to layout of services and accessories to initiate the manufacture of a further 52 PLP systems for the main ICU build at St George.

1/8/17 Installation of PLP’s into St George ICU

17/8/17 Meeting with St George educators regarding roll out of training before Go Live

24/8/17 User Group meeting to sign off on final location of all accessories before installing onto the 53 rooms

13/8/17 UAT ICU

28/9/17 ICU train the trainer day, whereby Wilhelm provided end user training in conjunction with Guldmann lifts to St. George Nurse Educators

21/11/17 ICU Go Live – Wilhelm on site to provide support as needed

Diagram 1 - St. George Hospital ICU Room Configuration


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2.3 Technology Overview

Patient Lift Pendant (PLP)

The patented Amico Patient Lift Pendant (PLP) is a revolutionary innovation that focuses on patient safety, clinician safety, and room flexibility. Clinicians are able to reposition and transfer patients in and out of bed without the need for manual labour, while saving valuable space and time. PLP eliminates the need to install tracks in the ceiling by integrating the track into the arm of the pendant systems. This results in only one single structure installed into the ceiling, increasing ceiling real estate to allow for installation of other medical equipment. The PLP can hold up to a 454 kg patient and provides for two (2) fully functional service heads on both sides of the patient, as it has 340-degree coverage around the patient bed.

Diagram 2 – Patient Lift Pendant Configuration


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Equipment Transfer System (ETS)

The ETS allows easy transport of vital infusion pumps that are in operative use by a patient throughout the passage of hospital with no manual lifting required by staff.

The IV Pump Holder can be effortlessly moved by one nurse from the pendant head in the ICU to the patient bed for transportation to Imaging or the OR and back again.

The IV Pump Holder can handle up to 8 IV pumps and or a 32kg payload. The IV Pump Holder mounts to the pendant or any bed for easy transportation and when required a compact Trolley for moving the pump holder on and off the bed in imaging or where no pendant is available for docking,

Utililsing the lifting mechanism of the bed to transfer the IV Pump Holder between the pendant and bed is quiet, safe and effortless. The robust design remains sturdy when transported through the hospital, in elevators and around hallway corners.

Features: Small Footprint – Pendant Dock can be folded tightly against the pendant head when not in use. Safety First - Bed Dock with compression stop which is simply twisted to lock the docking arm into desired position for transport. Storage - Nesting design on Trolley for ease of storage Self Aligning – The system will automitcially aligh itself to ensure a secoure and snug fit.

Diagram 3 – Equipment Transfer System Configuration


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3. Results and Analysis

3.1 Overview

The performance of the PLP and ETS were evaluated using a two pronged approach. Quantitative data relating to the following areas were provided by the St. George ICU team.

o ICU Staff Injuries related to moving patients

o Pressure Injuries related to immobility

o Falls related to mobilising patients out of bed

In conjunction with this, Customer Satisfaction Surveys were completed by the St. George ICU team. A summary of these results is presented below.

3.1.1 Clinical Data

(1) Staff Injuries related to moving patients

Table 1 - St. George Hospital ICU, Staff Injuries related to moving patients (2017 & 2018)

Staff Injuries 2017 FTE 2017 Staff Injuries 2018 FTE 2018

January 171 207 February 183 207 March 1 191 217 April 192 225 May 1 193 223 June 194 1 226 July 1 193 1 221 August 1 192 223 September 1 191 219 October 188 1 216 Total Staff Injuries 5 3 Av FTE 188.8 218.4 % Staff Injuries vs FTE 2.65% 1.37%

Graph 1- Staff Injuries related to moving patients (2017 & 2018)

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I C U S T A F F I N J U R I E S R E L A T E D T O M O V I N G P A T I E N T S

Staff Injuries 2017 Staff Injuries 2018 FTE 2017 FTE 2018


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(2) Falls related to mobilising patients out of bed

Table 2- St. George Hospital ICU Falls related data (2017 & 2018)

Month Falls 2017 OBD 2017 Falls 2018 OBD 2018

January 1 795 0 878 February 1 830 0 779 March 0 927 1 775 April 0 878 0 824 May 0 895 0 987 June 0 886 0 1019 July 1 927 0 964 August 0 916 1 1015 September 0 948 0 974 October 0 888 0 944 Total Falls 3

2

Average OBD

889

916 Total OBD

8890

9159

% Falls

0.034%

0.022% % Change: 2018 v 2017

0.01%

OBD = Occupied Bed Day

Graph 2- Falls related to mobilising patients out of bed

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FALLS RELATED TO MOBIL IS ING PATIENTS OUT OF BED

Falls 2017 Falls 2018 OBD 2017 OBD 2018

Commentary:

• The Patient Lift Pendants were implemented at St. George Hospital in November 2017.

• Over the 2017- 2018 period analysed, there was a 1.3% reduction in staff injuries while moving or mobilising patients in/out of bed, despite a 16% increase in staff FTE.


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Graph 3 - ICU Mobility Data

Source: ICU St.George Physiotherapist research project

(3) Pressure Injuries related to immobility

Table 3 - St. George Pressure Injuries data related to immobility (2017 & 2018)

PIs 2017 OBD 2017 PIs 2018 OBD 2018

January 4 795 7 878 February 4 830 2 779 March 3 927 3 775 April 7 878 5 824 May 1 895 7 987 June 5 886 7 1019 July 4 927 1 964 August 3 916 4 1015 September 1 948 2 974 October 1 888 3 944 Total Pressure Injuries

33

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Total OBD

8890

9159 Av. OBD

889

915.9

% Pls 0.37%

0.45%

OBD = Occupied Bed Day

Pls = Pressure Injuries

Commentary:

• Comparing 2018 vs 2017 data over the same period (January-October), a 0.01% decrease in falls related to mobilising patients out of bed was obtained.

• Please Note: There has been a 250% increase in mobilising ICU2 (HDU) type patients (as reported by St. George ICU Physiotherapist research project) since relocation into the new ICU - See Graph 3 above.

• This is a significant increase in numbers of patients being mobilised with a slight decrease in the number of falls.


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Graph 4 – Pressure Injuries related to immobility

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PRESSURE INJURIES RELATED TO IMMOBILITY

PIs 2017 PIs 2018 OBD 2017 OBD 2018

Commentary:

• The Patient Lift Pendants were implemented at St. George Hospital in November 2017.

• There was a 0.1% increase in Pressure Injuries related to immobility during H1 18 as staff transitioned to using the Patient Lift Pendants (PLP).

• The following should be noted in relation to the increase in Pressure Injuries. o The increase occurred over the same period there was a 3% increase in OBD. (OBD = Occupied Bed Day)

o Pressure Injuries are multifactorial and St. George Hospital treats very high acuity patients for whom a Pressure Injury is almost unavoidable.

o Further work was undertaken by manual handling champions to increase the uptake in use of the Patient Lift Pendant


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3.1.2 Customer Satisfaction

During January 2019, approximately 70 clincians (Nursing and Physiotherapy Staff) completed surveys in areas such as ease of use, patient and clinical safety and training received relating to the Patient Lift Pendant and Equipment Transfer System. Both quantitative and qualitative results were obtained.

In regards to the results, the below tables present the range and average scores for each question and the overall average. A summary of the benefits and opportunities for each equipment type is also presented.

Table 4 – Clinical Feedback: Patient Lift Pendant (PLP)

Table 5 – Clinical Feedback: Equipment Transfer System (ETS)


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Table 6 – Clinical Feedback: Benefits & Opportunities

Patient Lift Pendant

Benefits Opportunities

Practical & Convenient Clinicians to be provided training refreshers on PLP, ensuring new staff & orderlies are included

Makes effective use of space and time

Educators to include PLP in training programs and ensure room setup and sling selection is included

Patient care is made easier and safer for staff

Manual Handling Champions to ensure clinicians are supported and using the PLP

Very useful to have hoist available within each ICU room

Equipment Transfer System

Easy to move, efficient and reduces manual handling issues

Clinicians to be provided training refreshers on ETS, ensuring new staff are included

Very beneficial for patients receiving multiple infusions & lines

Equipment service scheduling to be reviewed to ensure optimum performance

Very time efficient when setting patients up for transport

Educators to include ETS in training programs

A copy of the survey’s are presented in the Attachments.


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4. Recommendations

The following recommendations are made in regards to the selection, implementation and ongoing management of the PLP & ETS.

• Building a demonstration model of the equipment, enabling key stakeholders to view and trial the technology is key to ensuring clinician engagement and support for implementation.

• Where possible, there is significant benefit in the establishment of a prototype room during the implementation phase, enabling suppliers and staff to work together on the final room design and location of equipment, as well as supporting training in the use of the ETS & PLP.

• Post implementation, training refreshers for the PLP & ETS need to be undertaken every 3-6 months, ensuring new staff and orderlies are included.

• Senior Nurse mentoring of junior staff and manual handling champions advocating the technology will support ongoing use.

• Preceptors to ensure appropriate education is provided to staff on the use of the PLP & ETS.

• ETS to be serviced every 6 months to ensure equipment is functioning at an optimal level.


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5. Acknowledgements

HealthShare NSW and Wilhelm Integrated Solutions would like to acknowledge the following members of the St. George Hospital ICU and Wilhelm Integrated Solutions for their assistance and time during the preparation of this report:

Name Role

Clare Loveday Acting Nurse Manager, Critical Care, St. George Hospital

Kim Bonnici Acting Nurse Manager, Intensive Care, St. George Hospital

Kate Powell Nursing Unit Manager , Intensive Care Services, St George Hospital

6. Attachments

The following documents are attachments to this report:

• Attachment A – Nursing / Physiotherapist Questionnaires


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• Attachment A- Nursing/Physiotherapist Questionnaire

Nursing/Physiotherapist Questionnaire

Patient Lift Pendant in the ICU

Overview

HealthShare, St. George Hospital and Wilhelm Integrated Solutions would value your feedback on the

Patient Lift Pendants at St. George Hospital.

This survey is anonymous and will contribute to the development of a report highlighting the collaboration

between St George Hospital and Wilhelm.

Please circle your responses to the below questions.

Please rate your experience of using the Patient Lift Pendant (PLP)

Very Poor

Poor Fair Good Very Good

a Ease of Use 1 2 3 4 5

b Ease of Cleaning 1 2 3 4 5

c Overall impact on the patients care by using the Patient Lift Pendant

1 2 3 4 5

d Time required to use the Patient Lift Pendant vs the Patient Hoists previously used

1 2 3 4 5

e How would you rate the patient’s safety when the Patient Lift Pendant was being used?

1 2 3 4 5

f How would you rate your safety when you were using the Patient Lift Pendant?

1 2 3 4 5

g How would you rate the training received on the use of the Patient Lift Pendant?

1 2 3 4 5

Are there any other comments or suggestions you would like to make on the introduction of the Patient Lift

Pendants into the ICU.


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Nursing/Physiotherapist Questionnaire

Equipment Transfer System in the ICU

Overview

HealthShare, St. George Hospital and Wilhelm Integrated Solutions would value your feedback on the

Equipment Transfer System at St. George Hospital.

This survey is anonymous and will contribute to the development of a report highlighting the collaboration

between St George Hospital and Wilhelm.

Please circle your responses to the below questions.

Please rate your experience of using the Equipment Transfer System (ETS)

Very Poor

Poor Fair Good Very Good

a Ease of Use 1 2 3 4 5

b Ease of Cleaning 1 2 3 4 5

c Overall impact on the patients care by using the Equipment Transfer System

1 2 3 4 5

d How easy is pushing the patient’s bed with the Equipment Transfer System in place?

1 2 3 4 5

e Time required to use the ETS vs the previous manual process

1 2 3 4 5

f How would you rate the patient’s safety when the ETS is being used?

1 2 3 4 5

g How would you rate your safety when using the ETS?

1 2 3 4 5

h How would you rate the training received on the use of the ETS?

1 2 3 4 5

Are there any other comments you would like to make on the introduction of the ETS into the ICU.

critical care patient lift pendants & equipment transfer

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