Innovation in Health Care: The 21st Century Medical Ward

1. The Medical Ward of the 21st Century: A living laboratory for innovation in health care.

2. Overview • Description of exciting new clinical care infrastructure in Calgary, Alberta • Description of the related research and innovation agenda • Description of the planned infrastructure for research • Creation of a ‘living laboratory’ for innovation in health care

3. W21C background • Futuristic initiative involving U of Calgary, CHR, and the province of Alberta • Concept of a “Ward of the 21st Century” • Initiative launched in late 2002 • Relocation of medical teaching unit to unit 36 of SSB • Not simple renovation of space… • Process guided by stakeholder consultation, and review of literature

4. Why Calgary? • University of Calgary • Strategic integration with Calgary Health Region • Coordinated regional strategies (IT, KT, simulation) • Centre for Engineered Care • Other complementary initiatives • Calgary Health Region • Large health region, fully regionalized • VP Research, VP Safety & Quality, VP Pt Experience • New South Hospital • Electronic health record initiative

5. W21C background • Ward opened officially in May 2004 • Novel features: • Enhanced infection control features • Wireless communication capabilities • Abundance of computer terminals for staff • Enhanced comfort for patients and families • Inter-professional educational facilities • Moveable walls and expandable capacity • Workplace enhancements for staff • etc.

6. The Design of the Medical Ward of the 21st Century

8. Education/Tele-health Intra-ward Amphitheatre

9. 21st Century Ward Goals: • Enhance the multidisciplinary approach to learning • Enhanced patient safety • Create an environment that promotes critical inquiry and innovation • Anticipate, create and support future endeavors in the CHR (i.e. EHR project) • Knowledge translation • Improve participant satisfaction

10. 21st Century Ward Goals: • Provider access to POC information • Information • Safety • Laboratory • Communication

11. Complementary Initiatives • Centre for inter-professional collaboration • Engineered Care Institute • BSc in Biomedical Engineering • Graduate studies program in Psychology • Graduate studies in Computer Science • Technology commercialization (Industry) • Tele-health Program • CHR health informatics, QIHI, Corporate Data • Calgary’s new South Hospital • Calgary Clinical Performance Research Centre

12. W21C • The next step: • to develop a research and innovation agenda for the University of Calgary and the Calgary Health Region, with W21C as the focal point.

13. W21C • The next step: • to develop a research and innovation agenda for the University of Calgary and the Calgary Health Region, with W21C as the focal point. • targeting the challenges of suboptimal safety and quality of care in Canadian health care

14. Research and Innovation • There is a need for innovation in health care • Preventable deaths • Evidence-care gaps • Workforce retention • Sub-optimal communication and information flow • Frequent dissatisfaction among patients • Lack of continuity across care sectors • Inefficiency • Poorly coordinated organizational policies

15. Research and Innovation • Concept of ‘living laboratory’ presented • State-of-the-art clinical infrastructure juxtaposed with research space and infrastructure • Multidisciplinary interaction • Vision: “to define the future of health care” • Mission: “to establish infrastructure that attracts multidisciplinary researchers to collaborate on developing innovative health care solutions to enhance safety and quality of care”

16. Research and Innovation • Concept of ‘living laboratory’ Proposed Research Space W21C Patient Rooms

17. Research and Innovation • Concept of ‘living laboratory’ Proposed Research Space W21C Patient Rooms

18. Research and Innovation • Multidisciplinary team • Medicine • Nursing • Para-medical disciplines • Engineering • Computer Science • Environmental Design • Communications • Psychology • Sociology • Anthropology • Various faculty from outside Calgary • Industry partnerships

19. Research Themes • Over-riding theme: enhancing quality of care and patient safety. • Sub-themes: • Technology integration • Data, information, and knowledge flow • Communication and interaction • Organizational and regulatory factors

20. Conceptual Framework • Focus on structure, process and outcomes Quality and Safety Process Structure Outcomes

21. Research and Innovation • Multidisciplinary team representing • Health disciplines • Social sciences • Engineering • Science • Industry

23. Research and Innovation • Two parallel thrusts: • A large CFI application to request funding to establish unique infrastructure for research • Multidisciplinary ‘demonstration’ projects already underway

24. CFI application • Requested infrastructure • On-site electrical engineering laboratories • On-site computer science laboratories • On-site human factors simulator • On-site qualitative interviewing laboratory • Multidisciplinary common space • Equipment for each of the above • Office/desk space for each of the above • Site renovation and/or construction costs • Database servers and associated infrastructure

26. Research Examples by Theme • Technology Integration • Smart Camera with motion sensing ability • Wireless vital sign monitoring • Database, Information, and Knowledge Flow • Implementation and Evaluation of POC Technologies • Visualization of Data in Health Care: Visualizing Uncertainty • RFID and WiFi tracking of a complex hospital ward system • Communication and Interaction • High fidelity Human Factors simulation • Development, Implementation, and Evaluation of a Web-based Communication Tool for Seamless Discharge of In-patients • Innovations for enhancing communication and information flow in asynchronous inter-professional collaboration • Organizational Regulatory • The organizational safety culture • “RCT” assessing hospital design features on W21C vs a traditional ward

27. Why this W21C ? • Calgary uniquely positioned to house this research and innovation agenda • CHR fully regionalized • CHR VP Quality and Safety portfolio • CHR/U of C partnership • New CHR/U of C VP Research • New South Hospital • Electronic health record initiative • Regional knowledge translation strategies being developed

28. Barriers to Telehealth • Adoption ,implementation, and integration of ICT • Understanding context and culture • Health system transformation and emerging technologies • Business models and framework • Evaluation, evidence, and best practises • Policy,standards,regulations, and partnerships

29. W21C and Telehealth • Several initiatives around Enabling Technology Transfer • E-Health Prototype Testing (E-Health Industry Project) • “testing of E-health technologies and simulated clinical environments to evaluate a tool for integration into practice” • End-user participation: focus group, sandbox, and proof-of-concept

30. W21C and Telehealth • PDA project • Multidisciplinary • Will help break down barriers • Expectations • Technologically naïve environment • Will help lead other projects • Smart camera • Other end user POC devices • Simulation and usability studies

31. W21C and Telehealth • Contacts, information exchange, W21C ward tours • Finland visit (Oulu and Helsinki)]

32. Website • www.w21c.org • Knowledge translation and exchange • Building collaboration and partnership…!

34. Questions? • wghali@ucalgary.ca • baylis@ucalgary.ca • Shandra.kimpton@calgaryhealthregion.ca • www.w21c.org