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RFID Tags Survive Hospital Sterilization

The University of California, San Diego (UCSD) Medical Center is using RTLS tags from Awarepoint to track surgical instrumentation throughout the sterilization process.
Apr 07, 2009This article was originally published by RFID Update.

April 7, 2009—Hospitals across the country have embraced real-time location system (RTLS) technology to track a variety of assets, including everything from wheelchairs to IV pumps, and even staff and patients. Certain surgical tools have presented a challenge, however, because these items are regularly put through a harsh sterilization process involving intense heat and significant moisture -- conditions most RFID tags couldn't survive.

But a number of hospitals have begun using a rugged RTLS asset tag that can survive steam autoclave and liquid sterilization processes. The Awarepoint T2S tag can be attached to medical instrumentation trays throughout the cleaning and sterilization process, providing hospitals with a way to track these critical operating room (OR) assets in real time.

"Because of what we put the instruments through, regular tags wouldn't work," Tom Hamelin, director of perioperative services at the University of California, San Diego (UCSD) Medical Center, told RFID Update. "We needed something that wouldn't melt."

UCSD is tracking between 200 and 250 trays at its 119-bed Thornton Hospital campus. The hospital was already using Awarepoint's technology to track assets at the Thornton location and the larger Hillcrest Medical Center campus for several years, and approached the vendor about developing a solution for surgical instrumentation. The hospital began working with the tags more than a year ago.

"The infrastructure was already there, so we didn't have to add any equipment," Hamelin said. "We just added another type of tag."

UCSD tested the tags over a three-day period, putting them through multiple sterilizations to ensure they could withstand the process. "We exposed them to six to seven times the amount of stress they would normally encounter," Hamelin said, adding that the hospital has not experienced a tag failure during the five months the new tags have actively been in use.

Awarepoint previewed the ZigBee-based (2.48 GHz) active tags last year at the Healthcare Information and Management Systems Society (HIMSS) conference. The tags have a battery life of five years, and can withstand autoclave cycles at temperatures up to 135 degrees Celsius.

According to Awarepoint, the T2S tags are also in use at the Ohio State University Medical Center (which is tracking 600 trays), Advocate Good Samaritan Hospital in Downers Grove, Illinois, Jackson Memorial Hospital in Miami, and Tri-City Medical Center in San Diego.

UCSD has four distinct ORs in three buildings, and instrumentation trays travel back and forth among them, which can make keeping track of the trays a challenge. They range in size from small sets (containing six or seven instruments) to large trays that include hundreds of instruments, and each surgical case may require multiple trays.

Each set has two components, an inner tray and an outer tray. The T2S tags are attached to the outer tray, and communicate over a network of Awarepoint readers that are plugged into standard AC wall outlets throughout the building.

Sterile processing department (SPD) technicians use a central work station to access the Awarepoint system and view the location and status of instrumentation trays prior to preparing for the day's surgical cases. Nurses also use the system to locate trays.

If trays have been dispatched to a different location, such as the Hillcrest campus, staff can easily locate them and, if necessary, have a courier retrieve the trays. If, during surgery, the medical team decides that a different instrumentation tray is needed, OR staff can easily determine if the equipment is sterile and available for use.

According to Hamelin, tracking the trays in real time provides benefits in two primary areas. First, medical staff no longer have to search for missing instruments trays, a process that could delay a surgical case or even cause a cancellation. While most of the trays are held in a central location, they are sometimes used in other areas of the hospital. Tracheotomy and resuscitation trays, for example, are held in storerooms throughout the facility for immediate use and don't always arrive back at the SPD in a timely fashion.

"Those trays tend to be harder to keep track of because they do leave our area, but we're still responsible for processing them," Hamelin said. "If the communication isn't very good between departments, the trays may not get sent back and we find ourselves getting low on certain sets."

At an average cost of $84 per minute, Hamelin estimates that the hospital could save as much as $275,000 per year in OR idle time. Delays also back-up the surgery schedule for the day, resulting in additional overtime.

Second, the hospital is able to better track equipment use and better manage its instrumentation inventory. The hospital will be able to track which trays are over- or under-utilized, allowing management to evaluate equipment requests based on usage patterns. Since a number of surgical instruments cost thousands of dollars each, this could lead to significant savings.

"Because we don't have immediate insight into the location and status of these items, we replace more than we should," said Scott Sullivan, business manager of perioperative services at UCSD in a press release. "I anticipate we'll reduce our replacement inventory budget by over $100,000 in the first year alone." Sullivan added that he expects the budget for new requests to be reduced by approximately $25,000 in 2009.

"We need to have the right amount of sets, but they can be very expensive," Hamelin said. "We already have redundancy in our inventory because the ORs are not all in one location. We don't want to put money into the wrong resource, so we can now track how often the sets are used and how often they sit idle."

The hospital plans to integrate the tracking system with its IMPRESS surgical instrument management system from Cardinal Health's V. Mueller Surgical Products and Services division, as well as deploy the new tags at the Hillcrest campus.
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