About 70% of hospital IT pilots fail or face major challenges, according to research from the Standish Group. But it is very rare for hospitals to discuss these setbacks or share studies of implementations that didn’t go as planned.
Two nurse leaders bucked that trend by sharing an interesting story during a Thursday session at the annual HIMSS conference in Chicago. Monique Lambert and Nerissa Ambers — both senior managers of nursing innovation at informatics at Stanford Health Care — argued that project failure is nothing to be ashamed of because it can teach hospitals valuable lessons about what they need for technology initiatives to thrive in the future.
In Lambert’s view, failure is inevitable when it comes to healthcare technology pilots. She joked that “the best way to avoid the failure of digital health projects is by avoiding them in the first place.”
But not running digital health pilots is out of the question given the potential for good. So what should be done?
When it becomes apparent that a pilot isn’t working out the way the hospital had hoped, Lambert encouraged the team in charge of the project to “adopt a recovery-oriented mindset.” In this situation, the goal should be extracting as much knowledge as possible while the pilot is still ongoing.
She and Ambers shared an example of a failed health IT pilot from 2019 that they were involved in at Stanford. The health system had set out to create a modernized tech hub for its inpatients — the idea was to consolidate patients’ touch points into a single tablet-like device so that they could interact with all their in-room technology more seamlessly.
The device allowed patients to do a variety of things, such as control the window shades and view the daily menu. Patients could also use the device to make nurse calls and let them know what their specific request is, whether it was for pain medication, ice chips or a trip to the bathroom.
Usually, nurse calls go to the unit secretary, who has to figure out what the patient needs and which nurse is available to attend to them. The goal with the new patient hub was to eliminate calls to the unit secretary for commonly requested items, Lambert explained.
Three weeks into the pilot, the nursing informatics team’s data showed that only a couple calls had been made on the devices. The team then discovered that most of the patient hub devices they had installed in rooms were completely unused.
“There’s no data because nobody’s actually using it. And so you reach this point of, ‘Okay, what are we doing? How can we fix this? People aren’t using it — how do we make them use it? How can we rescue this project?’” Ambers said.
The nursing informatics team figured out that nurses were way too busy to educate patients about how to interact with the device. So the team started going into patients’ rooms to introduce them to the patient hub.
In many of the rooms that the team went into, the device had never been activated, Lambert said.
Staffing levels for nurses are dangerously low, so they don’t have time to set up devices for these patients. But patients require a good deal of hand-holding to effectively use the patient hub — many inpatients are older, on heavy medication or just came out of surgery, so they aren’t exactly the sharpest they’ve ever been, Lambert pointed out.
“You have to walk up next to somebody and walk them through it very slowly so they can have the experience with technology — so that they can experience the magic. That was something that we found out,” she declared.
But having a member of the nurse informatics team in the room to orient each new patient to the device isn’t feasible. Neither is requiring nurses to reset the device every time the room gets a new patient, Ambers said.
When a new patient comes into a room, the nurse would have to wipe the device and manually reactivate it, spending 15 minutes or so doing things like selecting language preferences, entering patient information and waiting for recalibration.
“If we put that kind of a burden onto a nurse who’s doing a million other things, it’s probably not going to be the highest priority for them to say ‘Let me make sure this device is wiped so that I can then introduce it to the patient,’” Ambers explained.
After the 90-day proof-of-concept pilot, the team realized that the technology simply didn’t fit into nurses’ workflows. But they didn’t write off the pilot as an embarrassing experiment that they should erase from their memory. Instead, they viewed it as a learning experience that gave the hospital knowledge about what it needs to do in the future to help technology projects produce desired results.
“Sometimes failure is the evidence you need to demonstrate what’s required to succeed,” Lambert explained.
Picture: Mykyta Dolmatov, Getty Images