Aug 10, 2006Since November 2004, the ear, nose and throat (ENT) surgery unit at Heartlands Hospital, in Birmingham, England, has used radio frequency identification to identify and track more than 1,000 day-surgery patients. Such patients wear wristbands with embedded passive 13.56 MHz RFID tags, while interrogators identify and track their location from the moment they check in until the minute they check out. A patient information management system links each person's electronic case notes with the unique ID on the RFID tag.
The pilot has been so successful that the hospital has taken steps toward expanding the RFID-based patient surgery tracking system throughout the entire ward, and for surgical patients who stay overnight. In February, the Heart of England NHS Foundation Trust—the local health authority with responsibility for the hospital—published a call for bids from systems integrators and RFID systems vendors to expand its RFID system to include a total of four wards, three pre-operative/anesthetic rooms, three surgical theaters and two recovery rooms each with its own RFID-enabled PC terminal, as well as 17 PDAs for staff members. A decision regarding the bids is expected within the next few weeks.
Prior to the current RFID system, the patients in the day-surgery ward had utilized wristbands providing only printed data. The printed information, however, sometimes became illegible and was not always checked by the staff during the treatment process. The RFID system uses passive 13.56 MHz RFID chips embedded into patient wristbands made by Precision Dynamics Corp. (PDC). Each chip has 1 kilobyte of memory and is encoded with the patient's name, date of birth, unique ID number and other details. The same data, along with a bar code, is printed on the wrist strap to be read directly by staff.
The addition of RFID tags to the wristbands ensures that staff members can read and access their data. The staff then verifies that the encoded data matches the information stored on a PC or handheld PDA. This helps make certain that the correct steps are being taken in the processing of a patient through surgical care.
As a patient moves through to surgery, the surgery nurse, the anesthetist and the surgeon all use handheld PDAs equipped with RFID interrogators to identify that person positively. The PDAs also display a checklist of procedures that must be carried out before that specific patient can progress through to the next stage of the surgical process. The PDAs operate using a wireless network deployed through the RFID trial area as part of the project.
According to the company, Heartlands' RFID system eliminates the potential for patient misidentification and the serious problems that can result. In the late 1990s, for example, a change in the order in which the hospital's patients were taken into surgery was not properly recorded, causing doctors to operate on a patient's healthy ear by mistake. According to research from the National Patient Safety Agency (NPSA), approximately 10 percent of inpatient episodes result in errors, about half of which are preventable. A lack of bedside checks and a high rate of missing wristbands are both cited as major contributing factors.
The RFID system also provides Heartlands with a way to improve its efficiency. Because patients' movements are tracked and time-stamped during their stay, the hospital has been able to use that information to work more efficiently. In addition, patient IDs can be positively identified and immediately linked to their case notes, enabling greater flexibility in the order in which patients are brought to surgery. If a scheduled patient is not yet ready for surgery, for example, the next available person can be moved into surgery without fear that the surgical team might mistake that patient for the one being replaced.
"RFID has increased efficiency [at the hospital] to enable one more patient operation a day," says Jeremy Turberville, head of sales and marketing at Safe Surgery Systems. "Hospitals in the NHS are paid by results, so that means more funding."
The ENT staff uses handheld interrogators to scan the wristbands each time a patient moves from one stage or room to the next—from pre-op to surgery to recovery and back to the day-surgery ward. The interrogators communicate with PCs located within each location. The networked PCs use an application that manages patient data, such as unique numbers stored on the RFID chips, enabling nurses to validate the patient's identity by matching the data on the tag with the data in the file. This includes a photo taken when the patient arrived at the hospital. According to Safe Surgery Systems, the wristbands cost £1 ($1.90) each and are intended only for single use.
