Continuous Patient Monitoring in the Catheterization Laboratory: Usability and Operational Impact Assessment

Background Currently, there exists no evidence on how workflows impact staff and work efficiency when patient monitors travel with patients and integrate into the catheterization laboratory (cath-lab). This prospective, pre/post study compares a Continuous Patient Monitoring (CPM) workflow to a workflow switching between stationary patient monitors (stationary) in a cath-lab environment. Methods The Philips Hemodynamic Monitoring System with IntelliVue X3, which can work with the monitoring devices (MX700 with IntelliVue X3) from the holding area (six bays), was installed in two cath-labs. Retrospectively, timestamps were collected by the staff before the introduction of CPM. After a four-week training and washout period, the staff collected timestamps for the CPM-phase and answered a survey containing context- and usability-specific questions (Usefulness, Satisfaction, and Ease of Use (USE) and System Usability Scale (SUS) questionnaires). Results The CPM workflow was implemented on the 6th of March 2023, and 15 cath-lab nurses participated in the CPM usability survey. The survey resulted in an SUS score of 70% (N = 15) and a USE score of, on average, 6 out of 7 (N = 15), with ease of learning (N = 15, mean: 6.7 ± 0.57) and ease of use (N = 15, mean: 6.4 ± 0.66). Qualitative feedback indicated that the CPM workflow may save time, is self-explanatory, is easy to use, and results in consistent monitoring of the patients' vital signs. For operational metrics, a total of 1042 patients were included (stationary phase: 444, CPM phase: 598) in this study. The difference in means between the pre-preparation times for the stationary phase (N = 438, 12.8 ± 4.95 min) and the CPM phase (N = 433, 13.1 ± 5.58 min) is -0.32 (-1.02, 0.38) minutes. The Hodges-Lehmann difference in medians is 0.15 (-0.52, 0.80) minutes. For the post-preparation times, the difference in means between the stationary phase (N = 416, 10.6 ± 4.27 min) and the CPM phase (N = 412, 11.3 ± 5.47 min) is -0.65 (-1.31, 0.03) minutes. The Hodges-Lehmann difference in medians is 0.32 (-0.23, 0.87) minutes. Conclusion CPM has been successfully implemented in the cath-lab environment. SUS was above the published average values, and the USE indicated that the ease of learning and ease of use scored high for the system. The USE score results were not significantly different from USE scores for CPM in the perioperative setting. No clinically meaningful difference in patient preparation times was found. The staff experienced an increased sense of patient safety and were positive about the usability of CPM.