Manila Hospital Slashes Infection Rate

By Claire Swedberg

The Medical City has seen a 48 percent reduction in infections in one year since installing an RTLS-based hand-washing compliance system.

Manila Hospital Slashes Infection Rate

The Medical City has seen a 48 percent reduction in infections in one year since installing an RTLS-based hand-washing compliance system.

The Medical City (TMC), a tertiary-care hospital in the Philippines, reduced the rate of hospital-acquired infections (HAIs) at its intensive-care unit (ICU) by nearly half when it implemented a real-time location system (RTLS), according to Excelion Technology, a provider of hand-hygiene compliance solutions. TMC is using Excelion Technology's Real-Time Hospital Measurement System, consisting of Excelion's Accreditrack software and CenTrak's Gen2IR and RFID RTLS technology, in order to ensure that personnel wash their hands before and after visiting patients. CenTrak's RTLS consists of tags combining infrared (IR) and RFID technologies to identify staff members, as well as CenTrak infrared (IR) emitters to determine an individual's location. Excelion installed the system and provided integration services.

TMC, which houses 600 beds and employs a staff of 1,000 physicians, serves 40,000 patients, as well as 400,000 outpatients, annually. When Excelion approached the hospital with the idea of implementing a hand-hygiene solution, the facility's management had already been considering such a solution, says Nestor Cruz, Excelion's president and CEO. The medical center's goal was to change the behavior of employees to ensure that they washed their hands regularly, both before and after they visited patients. The solution would not only track each individual's hand-washing compliance, Cruz explains, but also make that data available to each worker in Excelion software, based on location data culled from the CenTrak system. "Part of our method to sustain the habit of washing is intervention by the unit supervisors, as well as self-monitoring," he states. "Individuals are able to retrieve their own compliance history."

Nestor Cruz

Installed outside and within each patient room are hand-sanitization stations for staff members to use before entering and after exiting that room. However, it wasn't clear if the sanitizers were being used as required by management.

In November 2011, Excelion installed the hand-hygiene solution at TMC's flagship hospital near Manila, above each sanitization station within its general and pediatric ICU and, at a later date, in the acute care stroke unit (ACSU), for a total of 22 rooms. The hospital is now looking into installing the technology at its Institute for Personalized Molecular Medicine (IPMM), which includes 13 additional rooms.

With the Excelion system in place, each staff member is provided with a CenTrak Gen2IR Staff Badge. CenTrak monitors were installed at hand-sanitization stations. The badge receives the monitor’s signal, which, in essence, informs the badge that the person wearing it is within the vicinity of a particular sink or sanitization station. The badge then transmits its own ID, along with that of the monitor, to an RFID reader cabled to the back-end system. CenTrak software interprets location data and based on that signal, forwards the badge's ID and location to the Accreditrack software on the hospital's server, which stores information regarding users and when they washed their hands.

However, the system also needed to track where staff members went before and after washing their hands, particularly when it came to patients. Therefore, in addition to monitors at hand-washing or sanitization stations, the hospital has also installed Virtual Wall monitors and RFID readers in other areas near or within the ICU. The VW monitors emit an IR signal that covers an area around a bed or other location. The VW monitors can transmit a signal across a narrowly defined area, in order to cover a location such as a patient's bed. When a staff member comes within range of a VW monitor's signal, that individual's CenTrak tag transmits the VW's ID number and its own ID to the RFID interrogators, and the software then stores data indicating that the staff member is visiting a particular patient. If that individual was not detected at a hand-washing station, the software could send an alert to management indicting that he or she had failed to use proper hand-washing protocol.

In addition to deploying the CenTrak emitters throughout the entire ICU, Excelion installed monitors at sanitizer dispensers within the ACSU, along with VW monitors and RFID readers. Thanks to the system's deployment, ICU and ACSU managers can now contact staff members who have not been washing or sanitizing their hands as required by hospital protocol. What's more, individuals can monitor their own compliance by logging into the software and viewing their personal history.

Since TMC installed the system, its rate of hospital-acquired infections has dropped by 48 percent, Cruz reports. The hospital did not respond to questions about the system.