ChristianaCare is the first health system in the Philadelphia region piloting an innovative tool called Moxi, a collaborative robot — or “cobot”— that can assist in the hospital by making deliveries and performing other non-clinical tasks so that nurses and other clinical staff can spend more time focused on what they do best—caring for patients.
With a landmark $1.5 million grant from the American Nurses Foundation, ChristianaCare will deploy a total of five Moxi cobots at Christiana Hospital. It is the largest single grant in the history of Nursing at ChristianaCare.
Research published in the Journal of Nursing Management shows that nurses spend a significant amount of time — up to 33% of their shifts — on time-consuming but simple tasks such as dropping off lab specimens, collecting supplies or picking up medications from the pharmacy. By taking over these time-consuming but simple tasks, Moxi enables nurses to focus on patient care, where their skills are most needed.
“Nurses need the time and space to deliver care and patient education at the top of their license,” said Ric Cuming, Ed.D., MSN, RN, NEA-BC, FAAN, chief nurse executive and president, ChristianaCare HomeHealth.
“Moxi will be doing those hunting and gathering tasks such as getting equipment and supplies, which nurses are doing today but don’t need to be doing.”
Cobots are designed to share workspace and interact directly with people. In ChristianaCare’s initiative, the Moxi cobots will be integrated with the Cerner Corporation electronic health record (EHR) platform and use artificial intelligence to proactively identify when nurses will need equipment, supplies, medications and lab tests.
The Moxi cobots will be deployed to 11 inpatient units, partnering with more than 400 nurses. The American Nurses Foundation grant will enable ChristianaCare to evaluate the impact of cobots on nursing practice with the goal of scaling the technology if successful.
“Moxi is not a replacement for a nurse or nursing position — or any position,” Cuming said. “It is an additional resource for nurses and their teams.
“With robotic technology, we are using resources wisely and effectively, creating more efficient workflows, reducing repetitive tasks and freeing up nurses’ time for the complex clinical work that they excel at doing.”
Reimagining Nursing
ChristianaCare is one of 10 grant recipients from the American Nurses Foundation Reimagining Nursing (RN) Initiative.
“We are proud that the American Nurses Foundation has the confidence in bold nurse-led ideas that will lead to large-scale, replicable change,” said Katherine Collard, MS, RN-BC, chief nursing informatics officer at ChristianaCare.
“This grant will support nurses at ChristianaCare and our nursing colleagues across the nation in realizing their full potential, giving them the tools, resources and power to improve health care now and in the future.”
With the American Nurses Foundation grant, ChristianaCare will conduct research on driving nursing outcomes through robotics.
“We have a transformative opportunity to generate new knowledge and to move the science forward around robotics in nursing and in health care,” said Susan Birkhoff, Ph.D., RN, nurse scientist at ChristianaCare.
“Through research, we will study Moxi’s impact to nursing caregivers that will have broad implications for nursing practice, workforce and education,” she said.
ChristianaCare began exploring the potential of robotics to support Nursing with two Moxi cobots acquired in February, funded through the generosity of donors including Good Samaritan, Inc. and E.J. “Woody” Rice.
With the grant, said Birkhoff, ChristianaCare will take Moxi to the next “bold frontier,” adding three more cobots with the goal of automating and optimizing nurses’ workflow without interrupting care. With five total cobots, ChristianaCare will be home to the largest number of Moxi robots in health care.
The Little Bot That Can
Before Moxi can become fully part of the care team, it must learn to navigate the hospital and respond to the nurses’ needs. Using artificial intelligence, Moxi is mapping out Christiana Hospital through sensors and other machine-learning technology so that the cobots can ultimately navigate and work autonomously.
“When the Moxi cobots are fully integrated, we anticipate that they will complete up to 200 delivery tasks a day,” Collard said. “By making point-to-point deliveries, Moxi can save nurses hours of time and thousands of steps.”
Designed to be compatible with the busy environments of hospitals, Moxi’s features include:
- Social intelligence: Moxi won’t bump into people or objects in hallways, waves when it sees someone new and happily poses for selfies.
- Mobile manipulation: Moxi can learn to use its robotic arm to operate existing automatic doors and elevator panels.
- Human-guided learning: The more Moxi is used, the more Moxi learns and adapts to the environment and specific ways of doing things.
- Friendly and safe design: With heart-shaped eyes and a friendly appearance, Moxi is designed to navigate safely and get the job done so nurses can focus on patient care.
“What Moxi is doing in health systems like ChristianaCare is really transforming the way we think about health care and allowing staff to focus on the people in the hospital as opposed to the tasks,” said Dr. Andrea Thomaz, CEO and co-founder of Diligent Robotics, which created Moxi.
“Robots are not something way in the future. Our robots work side-by-side with humans to ease the stress and workload of one of the most demanding jobs in society, nursing. The partnership between Diligent and ChristianaCare shows that the future is now.”
Hospital Helper
Directly from the Cerner EHR, Moxi will be able to anticipate clinician and patient needs and perform tasks without human involvement. Examples could include:
- Delivering items to patients based on nurses’ order requests.
- Making rounds across units to deliver lab samples on collections completed in the electronic health record.
- Making just-in-time deliveries of pharmaceuticals not stocked on the floor.
- Prioritizing tasks based on the nursing workload in a unit, so that the busiest nurses will get help first.
“Connecting Moxi to the existing technology that clinicians use on a daily basis is key to making it easier to anticipate needs so clinicians can spend more time on patient care,” says Eva Karp, DHA, MBA, RN-BC, senior vice president, chief clinical and patient safety, Cerner.
“Moxi could make a real difference in a nurse’s day — alleviating burnout and staffing shortages, which have become especially prevalent since the pandemic.”
Incorporating the electronic health record into Moxi is part of the study funded by the American Nurses Foundation.
“It’s absolutely in the best interest of our patients that Moxi can work alongside nurses so we can spend more time working directly with our patients to do what we do best,” said Pam Owen, MSN, RN-BC, nurse manager on 7E, one of the pilot units. “And Moxi brings a smile to people’s faces.”
Fast Facts About Moxi
- Works in 22-hour shifts.
- Needs only two hours of charging time.
- Weighs about 300 pounds.
- Can carry a total weight of 70 pounds.
- Gender-neutral. Pronouns are “it” for a single Moxi cobot and “they” for more than one.
- Named one of America’s Greatest Disruptors in 2021 by Newsweek and one of the Best Inventions of 2019 by Time Magazine.
About ChristianaCare
Headquartered in Wilmington, Delaware, ChristianaCare is one of the country’s most dynamic health care organizations, centered on improving health outcomes, making high-quality care more accessible and lowering health care costs. ChristianaCare includes an extensive network of primary care and outpatient services, home health care, urgent care centers, three hospitals (1,299 beds), a freestanding emergency department, a Level I trauma center and a Level III neonatal intensive care unit, a comprehensive stroke center and regional centers of excellence in heart and vascular care, cancer care and women’s health. It also includes the pioneering Gene Editing Institute.
ChristianaCare is nationally recognized as a great place to work, rated by Forbes as the 2nd best health system for diversity and inclusion, and the 29th best health system to work for in the United States, and by IDG Computerworld as one of the nation’s Best Places to Work in IT. ChristianaCare is rated by Healthgrades as one of America’s 50 Best Hospitals and continually ranked among the nation’s best by U.S. News & World Report, Newsweek and other national quality ratings. ChristianaCare is a nonprofit teaching health system with more than 260 residents and fellows. With its groundbreaking Center for Virtual Health and a focus on population health and value-based care, ChristianaCare is shaping the future of health care.
