An emergency department team stopped one of our demos a few weeks ago, two minutes in, and told us it was not an ER board.
They were right. That story has been told. This is about the work that came after it, because the work is the part worth copying.
When a hospital asks for a patient whiteboard, the fast move is to open the design tool and start drawing rectangles. We did something slower first.
We catalogued every in-room patient company on the market. Element by element, from product documentation rather than marketing summaries, sorted into what everybody carries, what some carry, and what nobody carries.
Fifteen products.
Then we read the published evidence on what patients actually get out of a board on the wall.
One of the fifteen sells an emergency department product.
The category is built for inpatient units, where a patient stays for days and the board describes a plan. That is a reasonable thing to have built. It is also why so much of what an emergency patient needs is simply absent from the market. The board was never designed for someone who arrived forty minutes ago and does not yet know whether they are going home.
The evidence base is thinner than the product shelf. There are two published studies of in-room boards in an emergency department. Two. The one controlled trial is a promising pilot in four rooms, and we describe it as a pilot in four rooms, because that is what it is.
The useful column turned out to be the empty one.
Who we will call. The family contact — who the hospital will phone, and the ability for the patient to correct it. In the published survey work this was rated the most useful item on the board by every group of respondents asked. It ships on zero of fifteen products.
Discharge criteria instead of a discharge date. Zero of fifteen. A date is a promise that breaks. Criteria stay true all day and give the patient something to follow.
Shift change time. Zero of fifteen. It costs nothing, and it explains why the name on the board is about to change.
An interpreter request from the board itself. Zero of fifteen. Federal language access rules make this a first-class concern, and an emergency room is exactly where it bites.
Typical turnaround for a test. One of fifteen — and the best idea in the whole category. It answers how long without making a promise about one patient's result.
The patient's own questions. One of fifteen, and nowhere is the list touchable. The thing a patient most wants when the doctor finally walks in is the question they thought of at 2 AM and have since forgotten.
Touch on the board itself. Three of fifteen. Most of the category pushes interaction to the TV, a tablet, or the patient’s phone. In a treatment room, the wall is what is within reach.
Identity may be shown. The clinical reason may not. A patient’s name on their own board is defensible. A chief complaint on any surface a visitor can read is not. That one sentence settles most content arguments before they start.
Set expectations, never make promises. Ranges, next steps and criteria — not countdowns and dates. Every board that has ever disappointed a patient did it by being specific about something it could not control.
If it does not keep itself current, it does not go on. A field that depends on somebody remembering to update it will be wrong within a shift. A board that is wrong is worse than no board at all.
Not on the board: diagnosis, or anything that reads like one. An acuity number — it invites comparison between patients and explains nothing. Any countdown to being seen or to a bed. Result values in the open. Pending consults, social work, case management or behavioral health involvement. Code status, restraint status, sitter reason, legal hold. Anything at all about another patient.
Every one of those is technically available. Several would demo well. They are off the wall on purpose, and the reasoning is written down, so that nobody has to re-litigate it in an implementation meeting eighteen months from now.
Ask which of the seven items above their board carries.
Ask what they deliberately left off, and why. A vendor who has never had that argument internally will not have an answer, and the absence tells you what you need to know.
Ask where each field comes from, and what happens to it when nobody updates it.
Ask to see the sightline plan.
The proposal this research went into ends with the only paragraph in it that is really a pitch: we were asked for a whiteboard, so we went and found out what a whiteboard should say, what the hospital’s systems would give it, and what the rules actually require. Then we built one.
And then the line that matters more: if any of it is wrong, tell us and we will change it.
An emergency department told us we were wrong once already. It was the most productive thirty minutes of the quarter.
Ask us what we left off your board, and why