T2 is happy to announce the availability of Vocera B3000 screen protectors. Similar to the protector sheets that you would use on an iPhone or Android device, the B3000 protectors are designed to protect your device’s screen from scratches and smudges. The protectors have the added side benefit of providing better viewing with less glare. Purchase the screen protectors along with our special Vocera-ready headsets directly from T2’s store.

Way back when Vocera was in version 1, someone in Cupertino shared a spreadsheet with me that had all the voice commands listed. At some point it was determined that this was not a good thing to give out to customers, and now everything is more properly tucked into the Users’ Guide. Many times I’ve just wanted to quickly look up a command and not have to resort to RTFM. So for those who learning styles call for the command spreadsheet, I offer the Vocera Command Summary Spreadsheet (Microsoft Excel format). BTW, this doesn’t include any of the easter eggs (or references to the “funny genie”).

In spite of seemingly having enough licenses (300 Enterprise), one our customers hit the wall Vocera licensing wise. There was a huge discrepancy between the number of active users in the admin console and the number of logged in users. For some reason the customer had chosen to not enable auto-logout (default for this is 60 m) in their setup.

It seems that large numbers of users have been using the system but NOT logging out of their devices. It is likely that they are either turning them off, or taking them out of the building. Since “auto logout” was not enabled, the system was taking up “seats” for all these users, in spite of the fact that they were really not online.

If you ever run into the situation that you need to quickly release licenses for users who are off network, enable auto logout and set it to 2 min. Since Vocera pings badges every 30 seconds to determine where they are at any given time, that will give the system 4 tries to find a badge. If it can’t find it by then, it will release the login slot that it’s using up. Once you have the license level down below the limit, you can change the auto logout to something more practical (e.g. 60 or 120 min).

According to the March 12th issues of the New England Journal of Medicine (as reported in MedPage Today), in some regions of the US, upwards of 70% of inpatient care now being taken care of by hospitalists. With the steady rise of these physicians who are primarily hospital employees, it’s no surprise that these doctors are increasingly part of workflow technologies like Vocera.

Communication needs and preferences are very different for different clinical roles, and hospitalists are no exception. The following illustrates a Vocera workflow for hospitalists that accommodate their preferred communication style. It’s a great example of how incredibly creative one can be with Vocera, without being technically burdensome.

Too Much Communication Can Be Counter Productive
Seeing the success that other staff has had using Vocera, the hospitalists at one of our customers believed that wearing Vocera badges would boost productivity for their role. As we worked through designing a Vocera workflow for them, they voiced concern that receiving direct voice calls would be counterproductive.

Instant communication is great thing. Too much communication can seriously impact efficiency and focus. They hospitalists felt they were getting paged too often about trivial matters that can wait. Their preference would be to use Vocera and always be on DND (do not disturb). This way nurses will leave them messages which they can get to when they are available. The hospitalists can call the nurses back from their Vocera badge when they are free.

But, of course, there’s a catch.

Work Teams
Hospitalists often work in teams. So, for instance, Dr. Hass and Dr. Dantz are a team. Since they are not at the hospital at the same time, if one doctor should get called while they are not at the hospital, they want the call to roll over to the other.

Initially a call forwarding scheme was attempted. What they discovered was that if Dr. Hass is called (and he is not logged in), the call forwards to Dr. Dantz (who is on DND), the subsequent message left would be for Dr. Hass not Dr. Dantz. To solve this, we needed to think out of the box.

Solution: Use Alternative Names
We created alternative user names for the hospitalists which are the opposite of their real names (Susan Hass logs in as “Hass Susan”, Victor Dantz logs in as “Dantz Victor”). We created a group called Doctor Hass, with an alternate spoken name of Susan Hass) and made the group sequential with the user Hass Susan the first name in the group and the user Dantz Victor as the second name in the group. I also created a group called Doctor Dantz with Dantz Victor as the first person in the group and Hass Susan as the second name. Now when either doctor is called, the caller will leave a message for the doctor that is logged in.

There are three teams. We created six groups.

But the plot thickens…

At night, when neither hospitalist is at the hospital, there is a nocturnist that will wear Vocera on DND. If neither Dr. Hass nor Dr. Dantz are logged in they want the call (message) to go to the nocturnist.

Solution: Use Groups
We created a group called “Nocturnist.” The doctors who are always nocturnists are entered into Vocera “first name, last name” as well as Dr. Last Name. They are also added to the nocturnist group. The group nocturnist is added to each of the six hospitalists groups as the third name in the sequence, and voila!

Note: Recording Greetings is Important to Making this Solution Work

For each group we recorded a greeting so the caller will hear, “You’ve reached the Hass/Dantz group. Please leave a message and one of us will return your call shortly.” To make this work transparently to the calling party, we had to record the same greeting for both the Doctor Hass group and the Doctor Dantz group–same process for the other groups. We also recorded one for the Nocturnist group so it is heard when that group is called directly.

Recently, while doing regular rounds as part of our ongoing support for one of our customers, I observed Kathy G (night manager) and a nurse pushing a bed with a patient in it to one of the nursing units. When I asked her where the transporter was (Brian M. was in the Night Transporter Group), she replied that she could not reach him.

I made a mental note to come back and chat with her regarding how we could make some modifications to Vocera’s calling behavior and workflow to help her in this type of situation.

She later had time to meet with me. I spent a few minutes discussing the concepts of “Urgent Call’ and “Urgent Broadcast,” and we also explored what the differences are:

• immediate connectivity to the recipient of the call without the opportunity to say “NO”
• the ability to break through a pre-existing call, and
• the ability to break through a Do Not Disturb)

As part of recent efforts to refine how Vocera is being used by this customer, I let her know that unit secretaries, RNs and aides now have the ability to Broadcast, Urgent Broadcast, and Urgent Call. After further discussion with Kathy, I gave all nurse managers the ability to locate users as well (which I also trained her how to do). I then gave all nurse managers VIP status, so they may do a soft break through of DND too (the Genie will announce “Here is…”).

We then discussed the advantages of having floating nurses, aides, etc. be members of the “Flex Team” group in Vocera, thus giving them the ability to add and remove themselves from the various nursing units and the ED.

• They will receive Broadcasts to the department they are working in
• They will not receive Broadcasts to their regular department
• All members of the present department will automatically be added to their Inner Circle (frequently called list)
• All members of the regular department will be removed from their Inner Circle
• They can be reached by the command “Call first name in present department”

With these minor Vocera profile modifications, a little bit of additional training, and some follow up reinforcement, we were able to empower Kathy to leverage Vocera’s roles-based calling features to reach the people she needs to efficiently.

Finding Vocera® devices that leave your campus is an issue that many customers are grappling with…What’s an organization to do?

Best practice for mobile asset management is a strong unit level coordination with well defined, managed procedures and financial accountability. In many organizations, despite management’s best intentions, that turns out be difficult.

It’s not uncommon to put drop boxes by the employee exit. One of our customers experimented with badge sign-out that required users to give car keys (or something else essential) as collateral (I’m pretty sure this was abandoned). Other customers have even gone further to ensure control, including the use of Pyxis medication and supply management systems to secure Vocera badges.

Still if you ask your peers, they will likely share that no matter what they do, devices end up in lockers, people’s cars, on nightstands, or in jacket pockets.

Recently, one customer’s CTO wondered aloud whether they would be able to track device escape by putting APs in their parking lots. He knew that Vocera had ways of identifying users’ locations, maybe there was some way of utilizing this.

At least for now, his brainstorm will not buy him much… Let me explain.

Those of you who administrate Vocera are familiar with the “Badge Last Used” report (BLU). If you have a Vocera Report Server (VRS), you run the BLU report to help track down a device that has disappeared. We use this same information in DeviceKeeper.com to match up device records with other key information about a device (its label, when it was put into production, warranty info, etc…).

To answer our customers question properly, we needed to better understand BLU events. In this post I will share what we found out so that you can understand what Vocera’s reporting engine can and can’t do for you on this front.

• Every 15 minutes a badge connected to the Vocera server sends an inventory record to the server, which is written to the report logs
• The inventory record contains information like the logged user, access point connected, battery voltage etc…
• The generation of this record is not based on calls or any user action
• On a scheduled basis (once a day in Vocera 4.0), the VRS captures only the last AP accessed and the time of that last access for every logged in user

So if someone walks out of the building with a Vocera® badge in her pocket, even though the VRS would know the last user and last AP they were associated with, the inventory record may or may not be sent while the last user is connected to the AP in the parking lot.

Oh well, good idea

In the future Vocera will likely tie to some RFID framework, or perhaps more easily support perimeter type tags. For now, keeping your devices in the building will require creative solutions.

<shameless plug/>Make sure to check out our SaaS asset management application DeviceKeeper.com</end plug>

Some of our users have noticed that the Vocera report server sometimes doesn’t seem to know about certain badges being logged into. This has to do with how Vocera logs inventory data. In order for a badge’s “last used” status to change in the Badge Last Used (BLU) report (or Devicekeeper, for those of you that use it), a user has to log in the badge and still be logged in when the badge updates its inventory record in the logs. This update occurs every 15 minutes (from when the badge is powered on).

In order to help keep track of Vocera badges, it’s a good idea to create a labeling scheme. For instance, have your Labor & Delivery unit badges labeled as L&D-1, L&D-2, etc. This helps units keep track of their inventory. It’s also helpful if users try to use the same badge every day. It helps keep them from getting lost if someone from each shift is always looking for “their” badge and they know who uses it on the prior shift.

Dymo and P-touch labels do the job quite well. Consider making the labels with enough tape to wrap around the badge and into the battery area. This way the edges are under the battery and are less likely to curl up and contribute to the labels falling off.

It’s also a good idea to write the label info next to the bar code on the badge label using a fine-tip permanent marker. That way if the outside label does come off, you can find the info under the battery.

I never go to a Vocera client site without the following in my tool bag:

• Vocera repair kit
• Goo Gone (or similar adhesive remover/cleaner)
• Napkins/tissues for applying the Goo Gone
• Paper clip or tweezers for removing pieces of broken battery clip from the grooves
• Super glue in case of broken plastic
• A couple of toothpicks – for applying glue
• Fine-point permanent marker (for writing the badge label info next to the bar code under the battery)
• Pencil eraser (for removing the aforementioned handwritten label if necessary)

Battery clips break. A temporary user fix is to tape the battery in place. Cellophane tape, medical tape, whatever is handy. Problem is, once the battery clip is fixed, the residue from the tape remains. Bring on the Goo Gone cleaner and wipe that adhesive mess right off. It’s great stuff – gets the sticky stuff off and leaves the badge clean. I carry a small bottle of it in my badge repair kit.