May 14, 2012When Johns Hopkins University School of Medicine opened its new 1.6 million-square-foot facility with two 12-story towers on May 1 of this year, the building featured a real-time location system (RTLS) that enables the hospital to monitor the locations of hundreds of nurses, as well as thousands of pumps, wheelchairs and other high-value moving equipment. Johns Hopkins is also utilizing the RTLS technology to track the movements of approximately 400 carts that are automatically transported via towlines to deliver food from the hospital's kitchen to patient units located throughout the building.
Johns Hopkins spent four years planning the RTLS solution, then tested the system within its simulations center and piloted it within operating rooms at its original facility. Now, the hospital has permanently installed the technology throughout its new building, which includes facilities for heart and vascular care, in addition to pediatrics.
The new building, consisting of the Sheikh Zayed Tower and the Charlotte R. Bloomberg Children's Center, occupies five acres of the hospital's East Baltimore campus, replacing half of the original site. In anticipation of this new growth, the hospital began looking into RTLS solutions that would enable it to track assets, locate staff members and, eventually, monitor patient workflow, says Mike McCarty, the senior director and chief network officer for Johns Hopkins University and the Johns Hopkins Health System.
"We became interested in tracking equipment about six years ago," McCarty says. After testing technology supplied by multiple vendors, he explains, the hospital selected Versus Technology's Versus Advantages system. According to Susan Pouzar, Versus Technology's VP of sales, the hybrid infrared (IR) and RFID solution includes assets tags, employee badges, IR and RFID sensors (readers), and software to manage read data. Tags transmit an IR signal to IR sensors located within the area, while also sending an RFID transmission via 433 MHz to RFID sensors, using a proprietary air-interface protocol.
The hospital piloted Versus' technology two years ago within several operating rooms, McCarty reports, in order to track the location of equipment. "It became clear there was a tremendous opportunity in savings of people time," he states, due to the information that employees could access in the software regarding the equipment's location before and after surgical procedures. By knowing where each asset is typically stored, McCarty speculates—as well as the demand for equipment within each operating room—the storage and movement of these machines could be optimized to make them more available to staff members as they are needed. "We believe there's a huge savings there," he says.
The hospital has attached Versus VER 1832 and 1853 tags to 8,500 pieces of equipment, including pumps and wheelchairs, and has also equipped 400 food carts with Versus IR/RFID tags. Approximately 800 nurses are presently wearing the RTLS VER 1952 badges, while the hospital ultimately expects 3,500 employees to do so.
Initially, the hospital's staff-locating system is focused on alerting workers in the event of an emergency. A patient in distress can press a nurse-call button located next to his or her bed, or in the bathroom, to issue an alert to the facility's GE Healthcare Telligence Nurse Call system. That system, in turn, will transmit that person's room number, along with a time and date stamp, to the Versus Advantages software. The Versus solution transmits the alert to the badges of all personnel within the immediate area, thereby activating a buzzer and a flashing light on the badge. In addition, the signal light installed outside each patient room is illuminated by the nurse-call system to indicate a patient within that room requires immediate assistance. With the solution in place, McCarty says, the hospital is now able to issue an alert without having to broadcast announcements over the public-address system.
The Versus system can also automatically cancel an alert when a nurse responds to a patient's call for assistance. Once the alert is dispatched via the nurse-call and Versus systems, at least one staff member is expected to respond. As that first individual enters the patient's room, the unique ID number of his or her badge is received by the IR and RFID sensors within the vicinity, and the system determines that a worker has arrived to the summoned location, and can automatically cancel the alert. McCarty says the hospital may opt to utilize this function in the future, but that initially, its staff will continue manually canceling calls via the nurse-call system, in order to ensure that no summons for assistance is cancelled when it should not be (for example, if an employee arrives, but not the correct individual required to respond to that emergency, such as a worker not on the nursing staff).
For the food-service system, towlines were constructed within tunnels beneath the hospital, in order to automate the delivery of about 400 food carts to the towers' rooms. The cart tags transmit location data at fixed intervals, and the sensors send back information to the RTLS software. The carts have hot and cold compartments; in the future, the hospital intends to use Versus temperature sensor tags to measure temperature fluctuations in each compartment. The software can be configured to detect when the temperature indicated by the sensors and transmitted by the tags exceeds an acceptable threshold.
While passing through the tunnels, the carts are moved to elevator doors at the patient towers, at which time the software determines each cart's location and issues an alert to the food-service staff when a cart has arrived at the elevator. Employees can then proceed to the elevator, travel to the basement floor and bring the cart to the appropriate level. The system will continue to monitor that cart's movements. If it waits too long at any given location—indicating a delay in food service—the Versus software can also transmit an alert to workers within that area.
McCarty says his team plans to evaluate the system's success in June or July, and to then determine the next phase of adoption. For instance, the hospital not only intends to eventually use the patient-call cancel functionality, but may also wish to issue tags to patients in the emergency department, enabling it to begin tracking workflow and determine how much time patients spend at each phase of their visit. What's more, he envisions employing the technology with other types of equipment, such as imaging devices. In this case, the RTLS technology could be used to identify when a specific machine is not in use, link to patient records to determine who is awaiting that device, and send alerts out to the nurses, indicating that the patient can now be taken to that machine. These types of solutions, he says, could not only improve staff efficiency, but also shorten hospital stays for patients who currently spend time awaiting the availability of machines.
