1. Executive Summary

Intensive care units run on precision. Every data point matters, every minute counts, and even small workflow inefficiencies can add up to real consequences - for patient safety, staff workload, and hospital operations.

That’s why a 10-bed cardiac ICU decided to pilot HTG Urogram, an automated urine output monitoring system designed to replace hourly manual charting with accurate, continuous measurements. What they learned over just two weeks shows how simple automation can transform one of the most overlooked processes in critical care.

The goal was to reduce manual workload, eliminate measurement errors, and improve visibility of diuresis trends in real time.

Proven results:

• 280 minutes of combined nurse time saved per each 12-hour shift

• Error rate reduced from ~20 % to 3 %

• Earlier detection of response to medication (e.g. Furosan)

• Positive staff feedback and fast adoption

• Cost-neutral model with full ROI in ~2 years

For management, the pilot demonstrated a solution that strengthens patient safety, reduces operational inefficiencies, and supports staff during ongoing nursing shortages.

2. Background & Challenges

Before the pilot, ICU nurses logged urine output manually every hour.

This approach to urine output tracking created several issues:

• Up to 40 minutes of manual work per 12-hour shift, per nurse

• Missing or inconsistent entries during busy moments

• As many as 20% of manual entries were incorrect

• Delayed visibility of how patients responded to therapy

• Added admin work without improving care

The team knew automation could help. They just didn’t know how big the impact would be.

3. Implementation Overview

To evaluate the benefits of automation, the ICU equipped all 10 beds with HTG Urogram, connecting the devices through a LoRa wireless gateway.

What stood out immediately was how frictionless the deployment was:

• Installation time: under 2 hours

• Training: a single 30-minute session for nurses and physicians

• Operation: AA-battery powered for more than three months

• IT involvement: none — no downtime, no system changes

Within the first day, staff were fully onboard. The system captured readings every five minutes, without requiring anyone to change their routine.

4. Key Results

Efficiency

With hourly logging removed from their workload, nurses reported smoother rounds and fewer workflow interruptions.

On average, the unit saved 33 minutes of nursing time per 12-hour shift per nurse.

Nurses then redirected the saved time to patient care and not paperwork.

Data Quality

Manual measurements produced an accuracy of roughly 80%, mostly due to double-counting and transcription inconsistencies.

After automation:

• Accuracy increased to 97%

• Double-counting was eliminated

• Readings were captured every 5 minutes, not once per hour

This continuous data stream provided both nurses and physicians with consistent information they could trust.

Clinical Impact

When a patient received a diuretic such as Furosan, staff could observe changes in output almost immediately.
Instead of waiting an hour for the next manual entry, physicians had:

• earlier insight into therapy response

• clearer trend visualization

Enhanced data accuracy translated directly into better team communication and more decisive, timely clinical actions.

Economic Impact

One of the most important factors for hospital management is cost. The pilot delivered unexpected clarity here:

• The system operated cost-neutrally compared to traditional urine bag setups

• A full ROI is projected within approximately 2 years, primarily due to optimized consumables

• Labor savings were not included in the ROI, making it a conservative estimate

For leadership, this created a rare combination of better care at no additional cost.

5. Staff Feedback

“Installation and training took less than an hour. It just works.” - Head ICU Nurse

“I can see the effect of treatment in minutes, not hours.” - Cardiologist

6. Sustainability & Compliance

Sustainability

Optimized bag design reduced plastic waste by ~20 kg per bed per year, supporting hospital sustainability goals without compromising care.

European Quality and Reliability

The system is designed and manufactured in Europe, ensuring fast logistics, reliable support, and full compliance with EU MDR 2017/745.

7. Conclusion

In just two weeks, the pilot confirmed that HTG Urogram improves data reliability, reduces nurse workload, and enhances real-time visibility of patient diuresis. All without disrupting established workflows.

For hospital management, it represents a clinically validated and operationally sustainable step toward ICU automation.