Impact of Single Sign-on Adoption in an Assessment Triage Unit: A Hospital's Journey to Higher Efficiency.

BACKGROUND: Clinician time is a valuable and costly resource. In an age where computer and clinical application usage is increasing, the need for providers to remember multiple usernames and passwords is increasingly inefficient. Further complexity is added to clinical workflows if clinicians must log into smart devices frequently without a simple solution for access and data security. OBJECTIVE: The purpose of this study was to measure the average time required and time savings when taking vital sign measurements using the Single Sign-On (SSO) (badge scan and go) on the electronic medical record-connected vital sign monitors versus using 2-factor authentication (entry of username and password). In addition, user satisfaction, system usability, workflow preference, and efficacy of the deployment of Network Connectivity Engine, that is, the host middleware for SSO, were evaluated through surveys. METHODS: A preimplementation and postimplementation study was performed in the unit piloting the initiative before hospital-wide deployment. Clinician usability and workflow preference surveys were conducted postimplementation. RESULTS: Analysis showed significance in time savings by adopting SSO. CONCLUSION: SSO had a positive impact on staff efficiency and was the preferred method versus the 2-factor log-in.

Accurate blood pressure during patient arm movement: the Welch Allyn Connex Spot Monitor's SureBP algorithm.

BACKGROUND: Current blood pressure (BP) measurement guidelines specify patient requirements, including being still. Some populations of patients cannot comply. A new International Organization for Standards is being developed to test devices that claim tolerance to transport-induced motion artifacts. This study proposes the first protocol to assess BP device accuracy in the presence of patient-induced motion. PARTICIPANTS AND METHODS: Forty healthy volunteers (23 males) participated. The device tested was the Welch Allyn Connex Spot Monitor (CSM) using the SureBP algorithm. A reusable cuff was placed on the left arm. During inflation/deflation cycles the participant performed pronation/supination movements of the left forearm every 5 s. The CSM readings during motion were compared to the average of manual resting auscultatory estimations immediately before and after each motion cycle (bracketing). RESULTS: The CSM recorded a BP reading on the first cycle in 37 participants. It displayed a reading in all 40 participants with one repeat cycle in the other three. The mean±SD for the device minus the manual BP values was 0.9±7.3 mmHg for systolic BP and -3.4±7.9 mmHg for diastolic BP. CONCLUSION: This study represents a proposal for an automated BP device assessment in the presence of patient-induced motion. The CSM device, which uses an inflation-based algorithm, routinely produced BP values that closely matched auscultatory values bracketed immediately before and after the motion-associated cycle. The CSM should be of significant clinical value in populations in whom resting 'still' readings are not usually feasible, such as pediatric and geriatric patients, and patients in pain from injury or illness.