In 2009, the American College of Emergency Physicians, Section for Emergency Medical Informatics, presented a Task Force White Paper on emergency department information systems (EDIS). The Task Force acknowledged that patient tracking is an essential element for emergency department (ED) workflow.1 Smith and Feied validate this assertion noting the “locator board” has enabled EDs to track patients and organize their clinical data “for decades.”2 There is now considerable evidence supporting the benefits of an effective patient-tracking tool used to enhance ED operations,3-6 including improved
- ED operational efficiency
- Collaboration among ED staff
- Patient satisfaction
- Emergency physician performance
There is little question that patient-tracking functionality is an indispensable and invaluable function of any EDIS.
ED patient tracking has been performed for years using a large dry-erase board. This board has been referred to by a variety of names, including the ED whiteboard, census board, status board, the bed board, the grease board, or locator board.2,4-6 This board was traditionally placed in a highly visible location in the ED, allowing staff to ascertain the name and location of all patients currently being treated in the ED. As the model evolved, departments often customized these boards by using various colored markers, symbols, and icons that conveyed patient information and assisted clinicians in their provision of care.7 Managing and displaying information in a format that is accessible to the entire care team are optimized in an electronic environment.
Computerized patient tracking with an electronic whiteboard (EW) brings the dry-erase board concept to a platform that can be easily accessed by all ED clinical personnel from workstations throughout or even outside of the ED. Unlike the dry-erase board, the EW is protected by a password protocol minimizing the risk of unauthorized viewing of private health information. This information can be entered and viewed from any workstation location by clinicians. With increasing sophistication, clinical devices, such as an automated sphygmomanometer and other patient-monitoring equipment, can be integrated to input and display valuable clinical data.8
Given these capabilities, EWs have become the command and control center of the ED. In one study, interactions with and viewing of a fully implemented EW took approximately 10% of the physician's time.4 The study concluded, “that the EW improves the efficiency of work and communication in the ED.” As EWs become increasingly integrated as part of the EDIS, or with other clinical information systems, and/or devices, it is vital for individuals tasked with managing the ED to “package” this data into information that supports high-quality medical care in the ED—a highly dynamic and data-dependent environment. The EW can also be leveraged as a key performance improvement tool while communicating daily clinical care.
The goals of this chapter are to define the key elements of an electronic patient-tracking system, describe detailed functions of these systems, and offer evidence to assist in understanding user interface ...