Voice over WLAN (VoWLAN) technology was selected to boost the effectiveness of communications at Swedish Medical Centre after a survey found that employees were frustrated with the existing communications system.
The survey, designed to help improve working conditions for the staff, revealed that nurses, doctors and patients were craving a more efficient system to keep everyone in touch, according to Chad Landry, the hospital's director of information services and telecommunications.
Under the original system, nurses typically had to go to the main desk on the floor, phone or page a doctor, and wait at the desk for a response -- which could take a few minutes or much longer. Likewise, if a nurse did not wait for a response when the doctor returned the call, the nurse would have to be paged to the front desk or physically tracked down while the doctor waited on the phone.
That method, Landry said, was inefficient, especially considering that the nurse could be involved in an important care-giving task and even a few wasted minutes could be detrimental.
The staff indicated that the (frequently long) delays in response between doctors and nurses and the lost time spent physically tracking down a doctor or nurse who did not respond to paging hindered timely patient care and caused an unnecessary loss in productivity.
In an effort to improve the employees' work environment and job satisfaction, and also to improve the treatment and care received by patients, the IT staff set out to find a more effective communications solution.
Initially looking at a 900 MHz system, the hospital soon learned that these systems suffered from a number of problems, such as poor reception and frequent interference. In addition, the actual range in which the device would operate was not always adequate in a hospital environment where the airspace is already fairly crowded.
"The 900 MHz system was an older technology operating in a very crowded broadcast space," Landry said in regard to Swedish Medical Center's first thoughts on a new communications system.
In addition to looking at new communications systems, the hospital was also preparing an improvement to its Electronic Medication Administration Records (EMAR) system, which allows more effective tracking of patients' medical history to ensure medication safety. The EMAR system often uses computers on wheels, known as COWS, which incorporate the use of laptops and wireless technology.
The hospital was already planning a wireless 802.11 network installation to accommodate the EMAR system, and the IT team realised that this wireless network could also be used to support voice communications. This led the team to consider Voice over IP (VoIP) and investigate whether or not VoIP would actually be a good idea in an often-hectic hospital environment.
Deploying the wireless network also meant that the hospital would be able to run several new services -- voice, data and Internet access for patients and visitors -- on one architecture, and it would be able to use EMERGIN software to integrate its text paging and alert messaging system with the new VoIP system and phones.
"We decided that providing wireless phone service to the staff would be an aid in increasing the effectiveness of [the type of] communication [that would improve our employees' satisfaction with their workplace]," Landry said.
Looking at solutions from several vendors -- Polycom, Cisco and Avaya among them -- Landry's main criteria were the durability of the phone, battery life, battery-charging schemes (using desktop chargers vs. gang chargers), ease of maintenance, service, and openness of the standards on the phone itself.
Following up its research, Landry's team settled on the Spectralink system offered by Polycom because of its openness and its ability to handle differing vendors on both the phone switch side and the phone device side. For the switch, Landry chose Cisco's CallManager.
The choice of Polycom's Spectralink system meant that Swedish Medical Center would be able to capitalise on some of the features that VoWLAN technology promises -- saving money by not running wires, greater mobility of staff, and the ease of deployment and use that many IT departments are looking for. In particular, Polycom's solution would allow Landry to keep his system open because Spectralink boosts an interoperability that lets the hospital work with any number of vendors.
Ben Guderian, vice president of marketing at Polycom, said: "Promoting this type of interoperability allows our customers to continue making best-of-breed decisions, which gives them the opportunity to build the specific type of network that works best in their environment."
Landry added that the necessary hardware for the Polycom system also offered better durability and longer battery life at the time of purchase.
The only disadvantage, Landry said, was that when Swedish Medical Center deployed the Polycom solution, clamshell or pocket-sized phones were not available. For nurses, who are typically in scrubs (which do not require a belt), it was difficult to find a place to carry a phone.
Guderian noted that the next step for VoWLAN technologies -- in addition to more implementations in "carpeted office environments" -- is to build up security around wireless voice, allowing any industry using it to feel confident that communications are being transmitted securely.
Once the decisions were made, the next step became the installation. One of the factors that Landry needed to consider was deployment of the new VoIP system in conjunction with its Avaya TDM switch, tying together the two switches with their internal T1 lines. Running both switches, he said, allowed him to retain existing technology at the hospital and continue using it to provide an alternate route for phone calls in case of an emergency outage. Essentially, the TDM switch was considered a disaster-relief phone switch.
Discussing other ways Swedish Medical Center is looking to fully utilise its wireless network, Landry said: "By requiring a well-developed IP network for our voice communications system and EMAR system, we are now in place to move ahead a planned renovation of the Nurse Call as the Homodynamic Monitoring system and alarm management and integrating it in with our phone system. We will also be able to provide Internet services to both our patients and guests."
To ensure that a wireless voice system runs smoothly, Landry recommended the creation of a multi-disciplinary team to outline the needs of all work groups that will be affected by the implementation. Formalising the selection process and creating an effective way to measure the success of the system are equally important.
"The deployment of a VoIP system, while [providing] several advantages, is not a small undertaking," Landry said. "Identification of the issues and goals was critical to keeping everyone on track."
This was first published in August 2007