When TLC Care Center, a rehabilitation, therapy and long-term nursing facility located approximately 20 miles southeast of Las Vegas, opened its new memory wing for residents with Alzheimer’s disease or other forms of advanced dementia, it provided an RFID-enabled bracelet to each of the wing’s residents, to ensure they don’t wander away. By installing the system with the wing’s very first residents, and by tweaking it as the number of residents grew, the center was able to customize the read range as necessary, to be sure alarms were sounded only when patients attempted to leave a secured area. Now, as the facility continues to grow, the system is tracking the locations of the wing’s residents (it can accommodate a total of 50) with few false alarms.
Before the wing opened in February 2010, TLC Care Center sought an appropriate resident-tracking system that would ensure the safety of those in its care, preventing them from wandering away. The company narrowed down its choices to four RFID vendors, before eventually selecting Accutech‘s ResidentGuard wandering system—because Accutech proved to be so responsive to its needs, the center indicates, answering questions more quickly and thoroughly than its competitors.
With that system in place, TLC was able, during the first few months, to eliminate false alarms and adjust the system as its resident population grew. This, says Al Arzola, TLC Care Center’s facility manager, was due, in large part, to Accutech being quick to respond to problems with false alarms, and solving them by adjusting antennas and read-range thresholds.
TLC opened the new memory wing in February as an extension of its existing nursing facility. The wing has two units—one for those who are physically active, and another for those requiring the use of a wheelchair or a walker to get about, or who are unable to leave their beds. A door separates the two units. TLC wanted a non-intrusive system that would allow employees and visitors to pass through the door between the units, but that would automatically lock it if a resident of either unit approached. “We don’t want there to ever be a situation in which one person could cause harm to another,” Arzola says—by passing through the door, for example, from the active unit to the less active unit, where he or she could potentially be aggressive to, or accidentally injure, another resident.
The care center also wanted to ensure that residents did not leave the memory wing and wander into the rest of the facility, such as the respiratory unit, where patients receive other types of care. Finally, the center sought to make sure residents did not leave the facility without an escort and become lost. Although the wing has many staff members, Arzola says, including spotters—whose sole responsibility is to monitor residents’ location and safety—they can not watch every resident all of the time. As such, he notes, an automated system would provide an additional level of security.
The Accutech ResidentGuard system comes with eight RFID readers deployed throughout the facility—each representing a zone within the wing where doors are located—and Accutech’s Cut Band wristbands, which contain an active RFID tag that constantly transmits a unique ID number at 418 MHz, using a proprietary air-interface protocol. The 418 MHz frequency, says Chris Konicek, Accutech’s marketing manager, is lower than the electromagnetic waves emitted by other electronic devices, such as IV pumps, heart monitors, televisions or exit signs, thereby ensuring the tags’ signals do not interfere with the multiple other transmissions typically being sent within health-care environments.
Upon being admitted to TLC, each new resident receives a wristband with an RFID tag attached. The tag’s ID number is input by TLC’s staff into the standalone Accutech software system, which stores information regarding the residents. The software can also issue alerts, triggering the locking of doors and the sounding of audible alarms. Employees input each resident’s name, digital photograph, room number and any health information that may be vital during an emergency. The staff uses a handheld interrogator to read the tag’s ID number and then load that number into the back-end system via a USB cable. The reader can also be used to turn the tag on and off, thereby enabling the center to conserve the battery life of its tags—which continually transmit RF signals while in use.
Once the waterproof tag and wristband—which snaps permanently around a patient’s wrist—is being worn and activated in the system, if that individual then gets within a certain preset distance (typically, 4 to 8 feet) of a door that he or she should not access, the ID number is captured by the RFID readers and sent to the Accutech software, which triggers an alert and causes that particular door to lock. Simultaneously, the individual’s name and picture, along with other information, are displayed on the computer monitor at nursing stations in both memory units, indicating where in the facility he or she is located.
An audible alarming device installed by TLC at the doorway alerts the staff throughout the area. What’s more, because there are a large number of workers, including spotters, there are typically many people in the vicinity who can hear and quickly respond to the alarm. If an individual were to attempt to remove the tag by cutting off its wristband, a wire running through that band and connected to its tag would be severed, and the alarm would be sounded as well, with data displayed on the screen indicating whose wristband was tampered with, and where that person was located at the time the tampering occurred. A cut wristband could not be reused, though the active RFID tag attached to it could be affixed to a new wristband so it could be re-issued to a resident.
The software, known as Accutech 6.0, not only issues alerts but stores data for historical purposes—for example, tracking the times of day when a patient has a tendency to wander, as well as which residents are more likely to do so. Because staff members must input their own ID to unlock the door in response to the alarm, the system can also track which employees respond to each wandering incident.
When the system was first installed, Arzola says, TLC Care Center did some tweaking—tuning antennas, for example, in order to ensure adequate coverage. The software was also adjusted to reduce false alarms. One function is the loitering alarm, an alert that is sent if tags remain too long near a doorway. However, Arzola says, on sunny days, residents often sit by a window near a doorway, so the loitering function was creating false alarms. That problem was resolved by resetting the system to issue a loitering alarm only when a patient comes within a few feet of the door and remains there for a preset span of time (at least five seconds).
“We’re very happy with [the system],” Arzola states. “I’m glad we were able to make the adjustments we needed to before we were full. What we have now is a customized system that fits our needs.”