Enterprise Healthcare
The Last 100 ft of Medication Delivery
A systems-level investigation into infusion workflows that examined how verification, device interaction, and physical space intersect during bedside medication delivery.
Client
Baxter
Duration
9 months
Industry
Healthcare
The Challenge
An Initiative in Innovation
This project began within Baxter’s R&D innovation program to explore workflow breakdowns at the point closest to the patient. Our focus: how digital systems, devices, and physical space intersect during infusion setup.
The goal was not feature refinement, but systems-level insight.
“Innovation distinguishes between a leader and a follower.”
Steve Jobs,
Discovery
Mapping the Workflow
We documented the full auto-programmed infusion process across EMR, drug library validation, barcode scanning, pump programming, monitoring, and documentation.
Mind mapping the infusion nurses’ complete process
The 19-step sequence was validated with clinicians. While technically sound, it revealed repeated verification and hidden complexity.
The system was safe — but not efficient.
An experience map created to identify pain points
Clinician Validation
The Missing Dimension
The process map showed what happened — not where it happened.
Infusion bag hanging in a medsurg unit of hospital.
Nurses moved repeatedly between workstation, patient, pump, and supply areas. The physical layout introduced friction invisible in the digital model.
This realization triggered a pivot
Deeper Discovery
Ambulatory Mapping for a More Complete Experience
I translated the workflow into architectural room layouts and mapped clinician movement during infusion setup.
Ambulatory map in a standard “Med/Surge” hospital room
Across configurations, movement patterns repeated: back-and-forth walking, supply retrieval loops, and distributed verification steps.
The problem wasn’t just interaction design — it was spatial workflow design.
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Key Insights
A Verification-Driven Workflow
Nearly every major step confirms:
- Patient identity
- Drug selection
- Pump configuration
- System synchronization
Administration is secondary to validation.
Improvement required rethinking where verification happens — not removing safeguards.
Verifying the Workflow
Step-by-step Clinician Workflow.
- Nurse goes to workstation or Electronic Medical Record (EMR) and finds that a new order for drug sent by pharmacist.
- Nurse then leaves room to gather all supplies.
- Nurse returns and places the supplies on the counter.
- Nurse follows clinical hand washing procedure.
- The nurse then walks to pump to turn it “On” and ensures WiFi is connected.
- Ensure pump is connected to hospital’s wireless and activate A-P workflow.
- Nurse walks to patient to scan wristband.
- Confirm scan of wristband is for correct patient in EMR.
- Nurse scans the barcode or QR code on medication.
- Confirms the medication in the EMR.
- Scan QR code on the pump to sync to EMR.
- Nurse then sends order to the pump from workstation.
- Load sets into pump and spike to bag.
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Administration is secondary to validation.
Improvement required rethinking where verification happens — not removing safeguards.
Ideation
Baxter Innovation Day Workshop
After the initial review by the engineering team, clinicians, and directors. I was honored to be selected as the featured speaker at Baxter’s Innovation Day to present “The Last 100 ft of Medicine” and formally frame the problem space.
Images of the workshop break-out sessions.
The day began with a clear and comprehensive framing of the problem statement, streamed live to a broad cross-functional audience. Following the presentation, participants broke into smaller groups of 10–20 to explore the challenge through guided discussion and collaborative exercises.
The session reframed the final stage of medication delivery as a critical design opportunity, aligning teams around patient safety, workflow transparency, and systems-level thinking.
Feasibility
Reimagining Verification
Innovation workshops explored how verification could be embedded closer to the bedside:
- Bed-integrated EMR and scanning
- RFID-enabled patient/device association
- On-device scanning
- Automated set recognition
Concepts were filtered for feasibility and aligned with engineering constraints.
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Current infusion medication delivery workflow.
Concept modeling of a Centralized Hub interaction approach reduced that to roughly 14 steps — over 50% fewer movements.
Revised Centralized Interaction Hub infusion medication delivery workflow.
Revised Centralized Interaction Hub infusion medication delivery workflow.
Opportunity
Strategic Framing but Opportunity Matrix
Opportunities were mapped against difficulty and reward:
- Device integration — lower challenge, high impact
- App integration — lower challenge, high impact
- Product integration — higher challenge, transformational
This reframed the work from ideation to roadmap thinking.
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Concept modeling of a centralized interaction approach reduced that to roughly 14 steps — over 50% fewer movements.
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What We Covered
A validated end-to-end infusion workflow model
- A validated end-to-end infusion workflow model
- A physical movement analysis layered onto digital mapping
- A reframing of infusion setup as verification-centric
- Quantified movement reduction modeling
- A prioritized innovation direction
The conversation shifted from feature tweaks to systems-level redesign.
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Conclusion
Outcomes Targeted for Further Research
This project explored the hidden inefficiencies in bedside infusion workflows. Through clinician interviews, direct observation, and spatial mapping, the study revealed that verification-heavy processes and fragmented physical interactions dramatically increased cognitive load and unnecessary movement—informing a reimagined, centralized interaction model.