The evolution of nurse call systems - hpcimedia.comSpeaking to BBH this week, Phil Wade, sales director at nurse call supplier, Static Systems Group (SSG), said: “Although the fundamental

EvolutionLondon CallingFundamental requirements for nursecall systems have not changed since theearly 1960s

ResilientDesign MattersNurse call systems should be designedto be resilient, fault-tolerant and easy tomaintain

TechnologyA Sound FutureOpportunities to integrate systems suchas VoIP telephony, door access, bedstatus, fire alarm and medical gas alarms

The evolutionof nurse callsystems In association with

Imagine you are in a hospital bed and you want a glass of water, orare in pain and want to speak to a doctor or nurse about yourmedication. Today, as you would have done 50 years ago, you willundoubtedly use a nurse call system so you can summon staff toyour bedside when you need to.While the systems themselves have barely changed since the war,the technology behind them is unrecognisable from those first ‘belland buzzer’ devices.

Those early electrical systems featured abulky handset with a button for patientsto press if they wanted assistance. Thissounded a buzzer to alert staff.This was no doubt adequate forNightingale wards and larger hospitalbays, where staff had a good view ofpatients, but as the clinical environmentevolved, and wards were divided intosmaller bed bays, so came the need for achange of direction. By the 1980s bell and buzzer systemshad been replaced with microprocessor-based technology, which was not relianton relays and had the benefit of havingno moving parts, offering greaterreliability at a reduced cost.This evolution was much better forpatients, too. With a system of overdoorlights, staff would not only know when apatient was in need of assistance, butcould follow the light to the individualbed bay.But the third and probably mostrevolutionary development came withthe arrival of Internet Protocol (IP)systems, which have enabled, not onlyimprovements to the underlyingtechnology of nurse call systems, butalso their integration into moderninternet-based technologies.Speaking to BBH this week, Phil Wade,sales director at nurse call supplier,Static Systems Group (SSG), said:“Although the fundamentalrequirements for nurse call systemshave not changed since the early 1960s,it is an environment that has had hugechange thrust upon it from a variety ofsources including governmentinitiatives, new technologies andchanging medical practises.“In the 1960s nurse call was based uponelectro-mechanical relays that were

bulky, expensive and prone to failure.However, along came the thyristor, inessence a ‘static switch’, which changednurse call radically and became the maincomponent of the new electronicsystems being developed. “Some other key developments thatquickly followed included theintroduction of additional facilitieswhere, for instance, radio sound wascontrolled from the patient hand unit tosupplement the simple ‘pear push’button. This was the forerunner tomany future additional facilitiescontrolled from the bedside.”What used to be simple nurse callhandsets can now do a variety of otherthings, including room and bed lighting,control of TV or radio, and also windowblinds and heating. Importantly, thesecomputerised systems can also keep alog of activity, providing an audit trail ofthe nurse call facility and response timesfor quality control purposes.Increasingly, systems are also requiredto link in with a hospital’s telephone,building management and fire systems.Today, the manufacture of nurse callsolutions is governed by HealthTechnical Memorandum 08-03, aDepartment of Health guidancedocument. Guidance is also given in adocument drawn up by Space for Healthentitled Bedhead Services: TechnicalDesign Manual.It states: “The ability for patients tosummon nursing assistance at the bedspace or nursing location, and forclinical staff to communicate remotelywith the patient and with each other, isan essential lifesafety component ofbedhead services.“Nurse call systems should be designedto be resilient, fault-tolerant and

The evolution of nursecall systems

2 BBH SPECIAL REPORT January 2013

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Although thefundamentalrequirements fornurse call systemshave not changedsince the early 1960s,it is an environmentthat has had hugechange thrust upon itfrom a variety ofsources

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The ability forpatients to summonnursing assistance atthe bed space ornursing location, andfor clinical staff tocommunicateremotely with thepatient and with eachother, is an essentiallifesafety componentof bedhead services

SPECIAL REPORT January 2013 BBH 3

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carry a small handset that will alertthem to patient alarm calls withouthaving to return to a central nursingstation is having a major effect on staffefficiency and costs.So too are manufacturers having toconsider issues like infection control,producing handsets that are easy toclean and impregnated with bug-bustingmaterials. Wade said: “In the early days greatemphasis was given to the technicalattributes of equipment, with onlysecondary importance given to thedesign of front plates and enclosures –hence some of the rather bulky patienthandsets of the 1970’s! But thatchanged in the mid-1980s with theintroduction of waterproof hand units.Now handsets could be easily wiped andcleaned between users.“Today it is expected that equipmentprovided at the bedhead is designedwith this in mind and it is usual toincorporate anti-microbial technology toassist in this. Anti-microbials and theinclusion of such additives are, in theirown right, a highly specialist area. Now,manufacturers, who by background areexperts in mechanical and electronicsystems, have had to embrace andunderstand a whole new set of skills toequip them to ensure products are fitfor purpose in this respect.”Suppliers have responded to marketdemands and now there is a huge rangeof products to choose from, many

easy to maintain. It should be possiblefor the system to log all of thecalls/events to provide detailed historyreports when required.”With most modern systems, calls areinitiated by the patient operating apush-button on a handset at theirbedside or by pulling a cord in dayroomsor washrooms. Once activated, areassurance lamp should illuminatesteadily within sight of the patient totell them their call has been logged. Aswell as a lamp on the handset andbedhead, a lamp outside and above thedoor of the ward, cubicle or room shouldalso illuminate. Simultaneously a lamp or liquid crystaldisplay (LCD) should light up at themain communications desk, often thecentral nursing station, and in otherareas where staff are frequently located,such as utility rooms and offices.All bedside and central workstationlights should remain activated until themember of staff arrives at the patient’sbedside to answer the call. They canthen reset the alarm from the bedhead,or call for further assistance using anemergency call function.Accompanying audible alarms are oftenused. A switch on the maincommunications panel can reduce thisvolume at night or on high-dependencywards.Another major development has beenthe introduction, in recent years, ofwireless technology. Enabling nurses to



providing the NHS with ways toimprove ward efficiency and cut costs.Wade said: “For example nurse presencesystems, which in the early days ofnurse call were operated by switcheslocated by the ward door, can now befully automated. They can even identifynurses by name. Link such options withtwo-way speech and it can be reasonedthat some real efficiencies can berealised by being able to quickly andeasily locate and communicate with staffmembers. Such options fit well withcurrent NHS initiatives and drives forimproving patient care.”John Pohill, national sales manager atsupplier, Courtney-Thorne, added:“Nurse Call Systems have come a longway from the lamp-based hard-wiredwall boards of the past. The future isthe integration of the nurse call systemwith other technologies. IPcommunication is fast becoming theplatform for system integration somodern nurse call systems should beable to utilise IP without relying upon ittotally.“The right technology for the right job,rather than technology for technologysake is the principle that Courtney-Thorne has adhered to in its 20-plusyears developing nurse call systems.Wireless communication between thebedhead call point and display panelsoffers clean, easy installation, scalabilityand low-cost maintenance. Touch-screen

operation of display panels improvesease of use and infection control, and IPcommunication between control panelsand integrated systems offers thegreatest flexibility.“The delivery of nurse call informationto smart devices such as mobile phonesand tablets will also be widespread overthe next 10 years, an area Courtney-Thorne has pioneered in conjunctionwith Samsung Electronics ResearchInstitute.From a practical point of view, it is morecommon for new nurse call systems tobe added when healthcare buildings aredeveloped. SSG was recentlycommissioned to provide a nurse call,staff attack and bedhead trunkingsolution for the new Emergency CareCentre at Foresterhill in Aberdeen. Thebedhead services for the 10-storey, 365-bed new-build facility were assembledoffsite.But, looking towards the future, theNHS is unlikely to see new buildprojects on anywhere near the samescale of the past decade and is morelikely to be looking to improve theestate it has already got. So how doesthis affect the adoption of new nursecall technologies?Wade says: “With the recent slowdownin new hospital building we are seeing asignificant increase in the supply of newnurse call systems for wardrefurbishments and upgrades. Thelatest nurse call systems are designed tobe easily integrated with existingwiring, which although sometimes over15 years old, was usually installed to avery high standard in robust metalconduits. As long as the wiring is ingood condition, then specially developedinterface modules can be used toconnect legacy wiring to newequipment.” This was evident during work SSGcarried out at North Tyneside Hospitalin North Shields. Here, the containmentcould be reused and a new system wasinstalled around it.Aid Call also produces next-generationwireless systems, which are a popularchoice for working hospitals. Thecompany’s national sales manager, ChrisDonnelly, said: “Fitting systems can bedisruptive, time consuming andexpensive. If you have to decamp an

Manufacturers, whoby background areexperts in mechanicaland electronicsystems, have had toembrace andunderstand a wholenew set of skills toequip them to ensureproducts are fit forpurpose

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entire ward in order to fit a hard-wiredsystem, the cost could well beprohibited. This has led to creation ofwireless systems such as our Nurse Callsystem. With this, you can installequipment while a patient is in bed withminimum disruption. There is no need

to install cables to any of the call pointsand wireless systems also have lowerinstallation and operating costs and arequicker and easier to install, are easilychanged and can be expanded.”Having seen so much change over thepast 50 years, nurse call systems arelikely to continue to evolve over thenext decade, driven by new technology,modern construction techniques andchanging market demand. Wade says: “The use of such IT-basedtechnology and structured wiredsolutions opens up a number ofopportunities to integrate systems suchas VoIP telephony, door access, bedstatus, fire alarm and medical gasalarms. “As an example, with the growth in two-way speech nurse call as the movetowards single-bed wards gains pace, IPtechnology now enables the call systemto be easily linked to other systems onsite. A good example of this being voiceover internet protocol (VoIP) telephony.Touchdown nurse bases and the

management of calls can be moreeffectively realised by the introductionof wireless VoIP handsets, thusproviding in essence mobile nurse bases.Our ‘culture’ helps here with acceptanceof such systems as we all grow more andmore accustomed to use of similar

technology in everyday life.”Donnelly adds: “With the continuedspread of mobile data, and theundoubted developments in over-airtransfer throughout healthcareestablishments, we will be in a positionwith our equipment to improve staffefficiency, providing accurate and timelyinformation to them wherever they are,which will include call and stafflocations, patient records and their callhistory on a host of devices that theywill be familiar with in their daily lives.”But both suppliers and healthcaremanagers will need to be prepared tomake changes in order to keep pace withthese changes. “A key impact, given the wide choice offacilities now available, is to recognisethe need for much greater involvementfrom nursing management teams in theprocurement process,” says Wade.“Suppliers must not simply ‘up-sell’advanced technology for the sake of it –after all technology can do virtuallyanything we want! Applying that

With the recentslowdown in newhospital building weare seeing asignificant increase inthe supply of newnurse call systems forward refurbishmentsand upgrades

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Success is achievedby the need to keepmoving forward, afterall no one stumbleson a good idea sittingdown

technology sensibly and appropriately isnow the issue. Consideration must begiven to nursing management protocol,hospital design, and patient ‘type’ indeveloping future solutions.“One of the clearest changes has beenthe need for teamwork and anacceptance of the valuable role thatnursing and support teams can have inhelping the advance of patient care inthese contexts. For manufacturers, suchchanges demand from them not just theability to sell clever technology fortechnology’s sake, but to engage in theprocess of finding out what each hospitalteam needs and the best way ofdelivering a tailored and effectivesolution. Manufacturers are seeing theirrole in today’s healthcare environmentas ‘service providers’ rather than‘product producers’ and their role is to

consider each application and provideexpert guidance and solutions to eachneed.“As with all other aspects of life andbusiness, success is achieved by the needto keep moving forward, after all no onestumbles on a good idea sitting down.The next half-century is guaranteed tobe as challenging and stimulating as thelast.”

SPECIAL REPORT January 2013 BBH 7 www.buildingbetterhealthcare.co.uk

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The evolution of nurse call systems - hpcimedia.comSpeaking to BBH this week, Phil Wade, sales director at nurse call supplier, Static Systems Group (SSG), said: “Although the fundamental