Given the care complexities medical teams can face day to day, Nurse Handoff was designed to be as simple and straightforward as its name.
The team developed a tool, named Nurse Handoff, that shows nurses the electronic health record on one side and the AI-generated output on the other. Using a hospital-provided mobile device, nurses are able to easily review and add information throughout their shift. Google’s MedLM models, running within the Nurse Handoff app, can ingest, analyze, and develop a cohesive and concise view of pertinent patient information for the oncoming nurse for handoff.
Traditionally, nurses rely upon their recollection of events, conversations, and data points, leaving room for error and inconsistency in the information given during handoff. Using Nurse Handoff during their shift, nurses can easily find the information they and their peers have collected through the automated shift report and add their own notes, so the system keeps building. This can include relevant patient data from notes, orders, tests, and more. All this happens within a highly secure cloud environment, to keep patient information confidential.
HCA Healthcare is currently piloting Nurse Handoff in five of its hospitals, gathering feedback and continuing to fine tune both its AI model and the user experience.
Nurses’ orders
An important part of building an effective app that frontline nurses would want to use was working directly with them on its development. That included K.C. DeShetler, a registered nurse on the HCA Healthcare DT&I team who became product owner for Nurse Handoff.
“We fed our model the information nurses want to know, prompted the model in a multitude of ways, used retrieval augmented generation to identify citations for the generated content, provided templates for organizing information the way we want and so forth,” DeShelter explains.
The approach they settled on shows nurses a familiar electronic health record on one side of the screen and an AI-generated output on the other. Hall, the nurse from Tennessee, was among a group of early testers who reviewed the model’s output to highlight what was unnecessary, repetitive, inaccurate or missing.
“We went through that process three or four different times,” Hall recalls. “And each time, it became a little bit more accurate, a little less filled with fluff that we don’t need. The more we worked with it and provided our feedback, the more useful it became for the handoff setting.”
As HCA Healthcare’s five-hospital pilot has progressed, plans call for a version to be rolled out for use by all 99,000 nurses working across the healthcare system. So far, the solution looks very promising: Nurses testing the Nurse Handoff tool at one HCA Healthcare facility have rated it as 86% factual and 90% helpful.
“When I talk to direct care nurses and nurse leaders about technology and the emergence of AI in nursing,” Dr. Staub-Juergens says, “I often challenge them to be bold, be brave, take the keys to the car, get in the driver’s seat and use their voices to drive the design of the solutions moving forward.”