Fraser Health Authority
Transforming Ward Communication Through Digital Patient Status Boards
Improving staff communication, patient safety, and operational efficiency by modernizing a core hospital workflow
1
Project Overview
Adapting Communication Tools for Evolving Environments
Fraser Health Authority is one of the largest health authorities in British Columbia, serving a diverse and growing population across multiple hospitals and care facilities.
Royal Columbian Hospital (RCH) is preparing to open a new acute care tower in 2025 as part of a major redevelopment project. This expansion provided an opportunity to revisit and modernize long-standing clinical tools—one of which was the analog patient status board used in nearly every inpatient unit.
In hospital nursing wards, analog whiteboards have long served as vital tools for daily operations—displaying real-time patient information such as room numbers, safety precautions, appointments, clinical notes, and expected discharge dates. These boards act as a central point of communication, supporting quick decisions and coordination among staff.
With limited wall space and expanding care needs, Fraser Health began exploring whether a digital solution could resolve spatial limitations and improve access, especially for staff working in more remote or mobile ward areas.
Below is a rough recreation and example of an existing whiteboard currently used in Royal Columbian. The names and information are a fictionalization and do not express real patient data.
2
The Opportunity
Outdated, Out of Reach, and Out of Sync
The new nursing stations in the upcoming Royal Columbia Hospital (RCH) tower were designed to be more compact and efficient, with limited wall space. The large whiteboards currently in use wouldn’t fit. Moreover, the existing boards presented several issues that had long impacted staff:
Out of reach
They were often placed high above computer workstations, making them physically hard to access—sometimes even requiring a step ladder.
Single updates
Only one person could update or view the board at a time.
Limited space
Notes and appointments had to be handwritten in small spaces, and long messages often didn’t fit.
Out of sync
Updates relied heavily on unit clerks, who were often too busy to keep up in real-time.
Inconvenient
Staff working in other parts of the ward would have to return to the nursing station to check on a patient’s status—disrupting their workflow.
With the opening of the new building, there was both a need and an opportunity to digitize the patient status boards and improve the user experience for care teams.
3
Building Understanding
Understanding Our Whiteboard Users and the Ward Environment
Designing a digital replacement for such a deeply embedded analog tool required a thorough understanding of its users.
I began by spending time in the wards, observing how staff used the boards throughout their day. I shadowed nurses, unit clerks, and the Charge Nurse (head nurse of the unit) to understand their interactions with the board and their broader workflows.
Each role had its own relationship with the board:
Unit clerks were the primary updaters. They received constant phone calls from different departments and providers and were responsible for keeping the board current. This was often a challenge, especially during peak hours.
Nurses checked the board frequently, particularly after rounds, and occasionally added notes or updates themselves.
Charge Nurses used the board to assign patients and staff at the beginning of a shift and to track changes throughout the day.
Allied health professionals, practitioners, and porters used the board to view and receive updates about patients throughout the day, but they rarely updated the board themselves.
I also conducted interviews and remote observation sessions to deepen our understanding of each role’s pain points. We learned that while the boards were indispensable, they were also a source of daily friction and inefficiency.
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Synthesizing Insights
Emerging Themes and Needs
Through the process of interviewing and observing nurses, the care team, and unit clerks within the ward environment, several key themes emerged:
Access was a major issue. The board could only be viewed from one physical location, limiting visibility and requiring frequent trips back and forth.
Timeliness suffered as updates were sometimes delayed or forgotten because unit clerks were managing multiple tasks at once.
Information density was limited. Staff had to cram updates into small areas or abbreviate information, which sometimes led to misunderstandings.
Flexibility was lacking. Each unit had its own way of using the board, but the static format didn’t support customization.
What became clear was that everything on the board was essential. No field could be removed—only redesigned. The digital version would need to preserve all of the board’s core functionality while solving its most significant limitations.
The image below showcases an example of a task flow for the unit clerk, from receiving an update through to the board being updated.
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Considerations and Constraints
Balancing Simplicity, Safety, and Speed
Designing for a hospital environment comes with unique constraints.
Staff are already juggling multiple platforms. They were vocal about not wanting another system to log into. The analog board worked because it was fast, modular, and didn’t require navigating menus or interfaces.
We also had to consider environmental and human factors:
Readability from a distance
Alarm fatigue (avoiding overuse of notifications or alerts)
Shared vs. personal device use (whiteboards are communal; tablets and computers are personal)
Icons were another critical component. Current boards used magnetic buttons and custom-drawn icons to communicate isolation precautions or fall risks. Any digital solution would need to maintain this visual shorthand and ideally allow staff to add new icons as required.
Design Process and Early Concepts
To move from research to action, I mapped out current-state task flows and journeys for each role. This helped us identify the specific touchpoints where pain points occurred and where digital solutions could provide the most value.
We envisioned a digital board that could be displayed on wall-mounted monitors, viewed on nurses’ iPads or workstations on wheels (WOWs), and updated remotely. I also worked with clinical leaders and informatics teams to ensure the design aligned with Fraser Health’s digital infrastructure and privacy protocols.
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Prototyping and Stakeholder Engagement
Visualizing the Future of Patient Communication
Using Microsoft Power Apps, I will collaborate with our IT partners to build a low-fidelity prototype. We plan to test it with nursing staff, unit clerks, and patient care coordinators to validate the layout, iconography, and information hierarchy.
These tests will help us answer key questions:
Can staff read the board from across the room?
Can they update it quickly without deep navigation?
Can it adapt to different wards with different needs?
At each stage, we will share our findings with leadership—distilling role-specific challenges into clear, visual summaries to foster understanding and gain buy-in.
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Next steps
Early Outcomes and Anticipated Impact
Though the full implementation is still in progress, early feedback has been promising. The conceptual solution is expected to:
Improve safety by eliminating the need for ladders and hard-to-reach boards
Enhance efficiency by allowing staff to update and view patient information in real-time from wherever they are
Reduce communication delays and improve coordination across multidisciplinary teams
Support scalability across different units with modular, editable layouts
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Reflection
Our Learnings
It also reinforced an important truth in healthcare design: analog systems endure for a reason. They’re fast, visible, and flexible—qualities digital tools must replicate, not ignore. Our goal wasn’t to replace the whiteboard but to elevate it, preserving what works while addressing what doesn’t.
Designing for hospital staff requires empathy, clarity, and a deep understanding of context. It also requires co-creation. This case study wasn’t just about a product—it was about building the proper foundation for a better, more human-centred care tool.
