Nov 28, 2017Royal Cornwall Hospitals NHS Trust is launching a radio frequency identification system to track high-value implants used during surgery, in order to ensure that they can be accounted for at all times—before they are implanted into a patient, during a surgical process and after a patient goes home. The technology is part of the United Kingdom's Scan4Safety program, in which GS1 bar-code or RFID technology is used to uniquely identify parts and thereby ensure that the right products are used with the correct patients, and that they can be traced in the event of a recall. The aim is to reduce the incidence of errors, as well as the amount of labor time hospital personnel spend tracking products, including medicines and implants.
Royal Cornwall Hospitals is one of six early-adopter hospitals within the NHS that are using RFID or bar-code scanning as part of the Scan4Safety program. The organization is a teaching hospital that provides health care at its three locations: Royal Cornwall, in Truro; West Cornwall, in Penzance; and St. Michael's Hospital, in Hayle. The trust was founded in 1799 by King George IV to serve the Cornwall area mining community, and initially contained 20 beds. Since then, it has been expanded multiple times to its current size of 750 beds across its three locations. The trust includes 21 surgical rooms (known in Britain as theaters).
The hospital chose to use a UPC- and passive UHF RFID-based solution known as Atticus, from Ingenica Solutions, to manage its surgical implants. Atticus is a modular solution for inventory management that includes a range of data-capture options, according to Nicola Hall, Ingenica's managing director. Royal Cornwall is opting to begin with a focus on gaining visibility into implants as they are received at the Trust, and again as they are used during surgical procedures.
Inventory management is typically a manual process for those who order and supply surgical implants for use with patients. Tracking what inventory is on hand at any given time, as well as when it was used and on which patient, ensures that mistakes are not made, such as implanting the wrong device into a patient, running out of a specific product or allowing an item to expire before it can be used. But the management of this data via manual inputting takes time away from health-care providers.
A digital system using RFID to replace the paper-based system should be much faster and more accurate, says Nick Kyte, a project-management office member at Royal Cornwall Hospitals NHS Trust. "Our specific intention for RFID is to make it as easy as possible for theater and lab staff to scan implants they have used," he explains, by reading the tags on implant packaging at the surgical site.
Although products could be tracked via bar codes, he notes, several features of RFID make it the better choice. "RFID is more robust—no faded bar codes, for example," he states. He adds that the technology also spares employees from having to pick up a bar-code scanner and press a button. "It's hands-free."
With the Ingenica Solutions system in place, Hall says, the hospital will tag implanted products, such as joints, first because of their criticality to patient safety. As tags are applied to product packaging, each tag's unique ID number is stored along with identifying information, such as the date of manufacture, the manufacturer, the lot number and the product type and size, in the Atticus software, hosted in the trust's Microsoft Dynamics enterprise resource planning system.
Next, the implants are moved to the surgical suite storage area, where an Ingenica UHF RFID desktop reader is installed. Staff members place the product on the reader before it is implanted in a specific patient. At that time, the clinicians use the Atticus software to input a patient's ID and link that number with the implant as they remove it from storage. The software then stores that patient ID number, along with the implant data.
In the event of a manufacturer recall, the software can be used to identify all patient ID numbers connected to a particular product. What's more, the hospital's patient-management software can link those IDs with specific patients, so that they can be contacted. The system also enables hospital employees to identify and quarantine products that have not yet been implanted, then return them to the supplier.
The system is intended to be taken live at the end of this month. The trust then plans to evaluate the anticipated reduction in product wastage, extra stock and labor time, as well as the expected efficiency gains related to any product recalls. The technology will also be used to automate replenishment orders for products that have been used and need to be replaced.
Additionally, the hospital is using RFID technology for some inventory management. The solution used—provided by real-time transparency, traceability and data-capture technology company Lyngsoe Systems—provides a network of RFID choke points in the form of reader portals, in order to locate medical electronic equipment such as surgical stack systems, imaging equipment, syringe drivers and pumps. They use a combination of passive UHF and active Wi-Fi tags depending on the critical nature of the item.
In the meantime, the Ingenica Solutions system is intended to meet the hospital's Scan4safety objectives. This is the first stage in a long-term, phased-approach deployment, Hall explains, starting with just a few surgical rooms.
For Ingenica Solutions, the Royal Cornwall Hospitals installation is the first deployment it has offered that uses RFID technology in this manner. "We have some deployment of our RFID kanban solutions," Hall states, "but not RFID track and trace."
With the Scan4Sfatey Ingenica deployment, Kyte says, the hospital expects to achieve several benefits, including cost savings based on reduced wastage of products that might otherwise end up missing or expire before they can be used. The technology will save clinicians time that they previously spent recording manual data about each implant's stock and status, he predicts.
With regard to safety, Kyte says he hopes the system will help to ensure that patients always receive the proper implant for their procedure. In the meantime, he adds, the stock area in which implants are stored prior to use will be cleaner and better organized, since the technology will enable personnel to understand where items are located, which should be used first and how to consign them to patients.
In the long run, Royal Cornwall Hospitals is aiming for a system in which suppliers would also participate in the tagging of products before sending them to the hospital. "Our hope is that manufacturers and suppliers start to RFID-tag inventory before it arrives," Kyte states, "to remove manual intervention at our Good Inwards [receiving] area, and eventually to use RFID to its greatest potential for not just inventory management, but throughout the hospital."
