We can integrate technology to enhance humanity in healthcare. 

October 24, 2026

Technology is a tool. People can use technology to support cognitive needs. At a basic level, people need access to data and information to make decisions. However, those decisions must also be based on knowledge for the most effective outcomes. 

For example, consider something as simple as the name of an over-the-counter medication. While many are familiar with the brand name of Tylenol, fewer are familiar that the active ingredient in the brand Tylenol, is acetaminophen. Acetaminophen is the generic name of the medication. Acetaminophen can be purchased over the counter as well as a generic brand, often located right next to the Tylenol. They both have the same active ingredient. However, the prices are often different. While not everyone is exposed to this knowledge, every nurse, pharmacist, doctor learns it as part of their educational preparation. 

Now, what if there was a way to bridge this knowledge gap for patients and people who could use this insight while deciding about what medication to buy at CVS or Walgreens? This is a place where technology could be helpful to other humans by being a knowledge resource as it is unlikely the pharmacist could answer every over-the-counter medication question that comes through each day. In this example, the direct beneficiary would be the person (who may or may not be considered a patient at that time). Healthcare or the care of health is a daily ongoing event, not just when one needs to see a doctor or go to the hospital.

A second example where additional knowledge would be beneficial is in the hospital setting. In the example I am about to share, the direct beneficiary of the additional knowledge is the nurse. What you may or may not know is that nurses often are looking for equipment around the unit to assist with administering medications. Many intravenous medications require a piece of equipment called a syringe pump. Syringe pumps are notoriously hard to find on a patient care unit. 

So, sometimes nurses, who know they will need a syringe pump will proactively seek one out ahead of the scheduled medication time. They may search supply rooms, empty rooms,and/or other places where there may be a syringe pump. There is no systematic way to identify this essential piece of equipment to deliver meds. The patient may never know the struggle the nurse is facing trying to make sure the medication is delivered on time. 

If one is found, the nurse may opt to hide it somewhere for later. However, what if this did not have to happen? What if there was a way to tag the equipment and link it to a find my equipment search tool available for nurses across the hospital? We know the technology exists. We know there is a need. The benefit would be to the nurses directly and indirectly to the patients. 

I just offered two very simple examples of how humans could benefit from more knowledge to make informed decisions. The additional knowledge can come through technology solutions that would benefit the person or user seeking out answers. While these two examples are relatively simple in terms of the problem, they do represent the approach that offers a human need for an answer that can be supported through technology. We must keep this perspective in mind as new technologies are presented that may or may not be solving a problem faced by a human. 

Patients are People Too

January 25, 2025

Patients are people first. Patients are people who should have a voice in their care.

Patients are people. While this is inherently known amongst us all, the words do have some differences in meaning within healthcare settings.

The first pilot research study that I conducted investigated the meaning of knowing the patient. To know the patient is to know the clinical aspects of the individual as well as the personal aspects of the individual.

Of course, it is essential to understand the clinical needs of the individual patient. This includes the diagnosis, reason for visit, treatments and plan of care to name a few items.

However, as a person, the personal aspects of the the individual can be overlooked at times when a patient. This could be any type of preference. However patients tend to have categories of preferences. For example, I know that my right antecubital vein is very difficult to find in my arm whereas the one on the left tends to be easier. Knowing this as a healthcare provider can make a significant difference for the patient who sees his or herself as a person first.

Knowing this can save unnecessary sticks in the arm when knowing that the phlebotomist has a great chance of being unsuccessful the first time. Knowing this can make the person feel known as a patient. Knowing this can improve the patient experience overall.

Patient-centered care is one of the six categories of healthcare quality as defined by the Institute of Medicine (now the National Academy of Medicine).

Patient-centered care is defined as, “Providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions.”.

After all, patients are people too. Patients are people first. Patients are people who should have a voice in their care.

For patients, be sure to ask questions and share information that can help provide more individualized care.

For nurses, doctors and all healthcare professional roles, be sure to include patients in their care. They are the reason we are there and deserve to have a high quality experience.

Change can be good.

January 05, 2025

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We have just entered a new year, the year of 2025. My year of 2024 was quite full of events, effort, activities, and more from start to finish. So full, that I did not quite catch my breath until the last day of the year. Even on the first day of the new year, I felt the need to slow down instead of speed up. Last year, I came out of the gate ready to go. I am not reading too much into this shift at this point. However, it is an indication of change. Change can be good.

                  Change can be good. However, change is often perceived as something to approach with trepidation and/or resistance depending upon where you fall in Rogers’ Diffusion of Innovation Adopter category for the particular change (e.g., innovator, early adopter, early majority, late majority, laggard).

                  I teach this in my academic role and see it in practice every day. When introducing a new idea or product to someone, there will be a reaction. The reaction will provide insight as to where that person or group falls on the adopter curve. That insight is crucial to understand the readiness of that person or group for change.

                  I will give you an example from my own experience thus far this year. Every January, I have my eyes examined to order my annual supply of contact lenses. I have worn glasses since I was in middle school. I had trouble reading the board in the classroom. As time went on, I was able to get contact lenses in college. Since that time, I have worn them nearly every day for some years now. 🙂

                  Two years ago, I was introduced to multifocal lenses. I spend a lot of time in front of my computer but need the prescription primarily for distance vision. The optometrist thought that I would like them. She sent me home with them to try out. I did not like them.

I did not like this change. I felt as though my eyes were looking all over the place and it was hard to focus with these new lenses. I called the office and asked them to fill the prescription from the lenses I had been wearing for years.  

                  I resisted the change because I did not need it. I was ok with how it was, and they worked for me.

                  However, this year, two years later, I shared that I was finding the ability to see tiny print (think of the print on an acetaminophen bottle 🙂 ) from the contact lenses quite difficult. I would fluctuate between my contact lenses, glasses, and readers and found it quite annoying to go back and forth throughout the day. I thought perhaps my vision had dramatically changed in the last six months.

                  As it turns out, my prescription remained the same but this time, she introduced the multifocal lenses again. Immediately, I felt the difference. I lit up and she even noticed my excitement and happiness.  I could see the tiny print and the distance with these lenses without difficulty. Those readers are now collecting dust, and I am absolutely ok with that for the time being!

                  She sent me home with a few trial lenses to confirm that I like them before committing to a year supply. I have been wearing them for the last two days and excited for this change. I did not expect this positive change from that visit. Change can be good.

                  Change can be good, but we need to give it a chance. We also need to feel that need for change to increase the likelihood of adoption. If the need for change is not yet there, it may just be too early for that person or group. Give it time and try again.

                  Cheers to a new year. May you find good change in 2025.

Views from the Patient Side

November 24, 2024    |   , , ,

“I am going to have you sign the consent form.”

I heard this while checking into my Primary Care Provider (PCP) appointment a few weeks ago. When I go into a healthcare appointment, I am always looking around for opportunities to improve on the patient experience. However, I never expect what I do encounter.

This visit had been rescheduled and I was happy I got into my PCP within a couple of weeks of making the phone call! The receptionist checked me in for my appointment. She then told me I needed to sign the consent form.

I looked down and there was no paper nor any form of a device for me to see the consent form. I thought she would have given me something to read in either a paper or electronic form.

I asked, “Where am I signing this?”

She pointed me to the pen pad for signature. I realized I was not going to see the consent form before signing it.

I asked, “Can I read the consent form?”

Now I know in general what I expect to see in the consent form. There is language about HIPAA, Consent to Treat, Payment Responsibility, and more. However, I also know that I should have the ability to read the form before I sign and acknowledge that I read it.

The receptionist got up and got a master copy from a folder and gave it to me to read. I then asked if I could get a copy. She did print out a copy for me to take with me after I read and signed it.

Had I not asked, I may not have read it nor had an opportunity to get a copy to take with me.

Now, I do not think that the practice aims to not provide the consent forms. More than likely, the intended workflow has slowly eroded over time from what is expected to occur.

As a patient, you cannot change the workflow, but you can (and should) ask questions!  

Lost Time is Costly for Nurses and Patients

November 05, 2024

Approximately 10% of the time during a nurse’s shift (e.g., workday) is spent on workarounds [1]. Workarounds arise due to systemic inefficiencies or barriers that complicate the ability to complete an activity needed for care delivery. Between 65 to 80% of nursing shifts are 12 hours in length. With 10% time lost to workarounds on a 12-hour shift, this equates to a total of 72 minutes (or 1.25 hours) per nurse lost to operational inefficiencies.

The median hourly wage for nurses across the United States is $41.38 [2]. Many states have a starting hourly wage higher while others lower than this rate. However, consistently across the U.S., nurses are not recognized as a billable service. Instead, nurses are (unfortunately) recognized as a cost to a healthcare organization [3] despite research evidence demonstrating the positive impact of nursing care on improving patient health outcomes [4].

Hospitals are broken into different care units and areas. I worked on a medical care unit, a medical/surgical unit, and a cardiac step-down unit during my years in direct care practice. I worked at three pediatric academic medical centers across the United States. As a bedside nurse, I was responsible for as few as 3 to as many as 6 patients per shift. The number of patients assigned depended on the severity of the patients’ collective care acuity needs and the staffing norms of the unit.

If we use the assumption that there are 8 nurses working on a patient care unit per shift, and each nurse is losing 72 minutes to inefficiencies, the unit loses 576 minutes or 9.6 hours per day! Now, with two shifts per day, that becomes a collective 19.2 hours lost to workarounds per patient care unit.  A total of 19.2 hours times the average hourly wage of $41.38 per hour equates to a total of $794.50 per day per patient unit. Applying that daily cost to a full year equates to $289,992 of lost time per year for one patient care unit.  Each hospital will have many units. If approximating one hospital to 10 care units, the cost then becomes $2.89 million in time lost over the course of the year. The average salary for a nurse in the US is $89,010. Thus, this equates to the cost of 32 nurses per year.

Now, these are general assumptions made about the number of nurses per unit and number of units per hospital or health system. However, the fundamental opportunity exists. How can nurses obtain 10% of their time back with the help of system (e.g., organizational) level changes while also helping to save costs of nurses that are not there (e.g., 32 nurses per year for example) There are many opportunities to do so. However, such help must be a collective effort between leadership within the healthcare organization and the nurses who are experiencing these challenges in care delivery.

[1] https://pubmed.ncbi.nlm.nih.gov/25102517/

[2] https://www.bls.gov/ooh/healthcare/registered-nurses.htm

[3] https://www.wolterskluwer.com/en/expert-insights/shifting-the-payment-paradigm-for-nurses-and-why-direct-reimbursement-is-critical

[4] https://www.nursing.upenn.edu/live/profiles/93-linda-aiken

Caring for Oneself while Caring for Others

October 17, 2024

I was eager to become a nurse and help other people. My mother has shared with me that even as early as pre-school, I was eager to help others in the classroom. Fast forward a few decades, and the desire to help others continues in a variety of ways. While I am no longer in direct patient care, I have always felt that the roles that I have taken on have been with the purpose of helping other nurses and healthcare professionals.

As a nursing student, you learn how to care for others. You are trained on how to assess another person across all body systems while also applying the science of nursing to the care delivery process. From nursing diagnoses of knowledge deficit that often apply to most if not all patients, to something more specific that applies to the admitting diagnosis for the patient, nurses are continually thinking about how to improve the health of others.

Yet, over the last several years, I have had the opportunity to reflect on caring for oneself while also caring for others. I realized that in many ways, I had to learn how to care for myself. I had spent so many years thinking like a nurse and putting the needs of others ahead of my own. “I would be fine”, I would often think to myself. Whether it was cutting corners on sleep or exercise, or other areas, surely the other person needed that time more than I did.

Today, I see the limitations in that thinking pattern. I am not a machine nor are you. Even if we were, machines need downtime to recharge and full the battery again or be upgraded with the newest updates and fixes to the software platform. Vehicles need gas or an electric charge to run.

Why would we not think that we also need that time to recharge, reboot, upgrade, and more simply put, care for ourselves?

We are soon approaching 2025. The last five years have been both long and fast in terms of seeing time pass us by. In the last 5 years, I learned how to care for myself and I will continue to do so while also caring for others. You can accomplish both.

I have found this has started with one small act of caring for myself on a regular basis that turns into another and another. Over time, you begin to see the results of those self investments.

I encourage everyone to consider ways they can reflect on what it means to care for oneself and know that this can be done while also caring for others. For nurses, this may require a new person to focus on, yourself.

Sincerely,

Tiffany Kelley