Evaluating a smartwatch notification system in a simulated nursing home

Abstract

Aims This paper evaluates a high‐fidelity prototype of a smartwatch‐based communication system for nursing homes. The system could improve communication between residents and caregivers, thus reducing staff response time and improving residents' safety. Background Across the country, nursing homes are often cited as having serious quality and safety issues. Deficiencies in the communication systems that connect residents with caregivers significantly impact the quality of care. Most nursing homes still use traditional call light systems, that give visual and auditory cues to caregivers, who may or may not be in proximity to the system. This study evaluates a smartwatch communication system developed to quickly relay a resident's requests for assistance to staff anywhere in the nursing home. Method Certified Nursing Assistants (CNAs) employed by nursing homes were recruited to perform routine tasks using both a traditional system and a smart system. Response time to call lights, staff performance and outcomes were measured through direct and recorded observations and through the surveys of participants. Results The smartwatch system reduced staff response time to call lights from bedrooms by 40%, from bathrooms by 58% and from bed exit alarms by 29%. The smartwatch system also reduced perceived workload by about 50% and was highly accepted by the CNAs. Conclusion A smartwatch‐based notification system may increase staff performance and decrease workload, thus leading to greater staff and patient satisfaction, which could ultimately lead to better quality of care and patient safety. Relevance to clinical practice This study provides empirical evidence for the usefulness of smartwatches in facilitating the notification and communication processes in healthcare settings and is also among the first to actually examine a smartwatch system in a healthcare setting.

Perspectives of Nursing Homes Staff on the Nature of Residents-Initiated Call Lights

“…However, despite their prevalence in nursing homes and their importance to patients’ experience and safety outcomes, the influence of the call light system as a communication tool has been largely ignored in the literature. Furthermore, despite the importance of call light systems in ensuring patient safety, quality of care, and general health outcomes, surprisingly little research has been done on how call light systems are being used (Ali & Li, 2019; Kalisch, Labelle, & Boqin, 2013; Tzeng & Larson, 2011).…”

“…Their nurse call integration allows patients to communicate directly with their assigned nurse and allows for the nurse to call the patient back and the patients will get the message through a pillow speaker (Yang & Rivera, 2015). Although these advances provide improvements for workflow and offer an opportunity to improve response times, none of these systems have improved efficiency, increased patient safety, or reduced cost (Ali & Li, 2019; Tzeng, 2010).…”

“…The literature suggests that the negative perceptions of call lights felt by nursing home staff are likely caused by challenges in usability, and these challenges are caused by a lack of user feedback (Ali & Li, 2019). A study, which tested the reactions of nurses to new technology, suggests that nurses respond positively to opportunities to provide feedback on the technology they use (Kent et al., 2015).…”

Notification and Communication Technology: An Observational Study of Call Light Systems in Nursing Homes

“…It was also described by Meade et al (2006) as a 'lifeline' for patients since it is linked with patients' needs and alerts the staff to the situations in which patients may ask for help (12). Nurse call light systems in nursing homes are associated with many ergonomic concerns and usability issues (3,7). Malfunctions of the nurse call light can cause negative medical outcomes, as the literature identifies other healthcare settings whereby a relationship exists between the time it takes to respond to a call light system and unintended consequences such as falls (13,14).…”

Using Tactile and Multimodal Notifications on Smart Watches in Clinical Settings

“…Wealthy evidence of research work and data in the healthcare domain supports that the benefits of effective communication patient outcomes. Recent research has explored the use of wearable/hand-free devices, such as smartwatches (Ali & Li, 2015, 2016, 2019Ali, Wong, & Li 2017)), in clinical settings. Smart watch, in particular, can display information in different modalities, including visual, auditory and tactile, and thus has the potential to improve communication and notification in clinical environments that are overloaded with sensory information.…”