Zion Medical Center, a San Diego hospital operated by Kaiser Permanente Health, was losing its HoverMatt air-assisted transfer mattresses at a mysteriously high rate when it turned to a technology-based solution last year. The mats, which can cost up to $2,000 apiece, were disappearing at a rate of approximately eight per month. By attaching battery-powered real-time location system (RTLS) tags, provided by Awarepoint, to the mats—and by utilizing Awarepoint RTLS software already in use onsite—the hospital not only discovered what was happening to the mats, but also rectified the problem.
By tagging the mats, the medical center was able to identify their locations automatically, as well as set up an alerting system to detect if a mat left the premises. As a result, the hospital’s managers concluded that many of the missing mats had been placed into garbage compactors. It turned out that staff members, when cleaning up after a patient, simply were inadvertently throwing the deflated mats into garbage bins that were headed for those compactors. By understanding and addressing the cause of the mats’ disappearance, says Andrea Odom, a Kaiser senior financial analyst, the hospital has gained a return on its investment in the Awarepoint tags, and has since purchased more tags for additional mats it acquires.
The HoverMatt mattress is an inflatable mat that floats on a cushion of air, making it easier to lift with a patient lying on top. Patients are getting heavier and arrive at hospitals more immobile than they did 50 years ago, Odom explains, and hospitals have thus acquired lifting devices to ensure that personnel and patients are not hurt when individuals are being moved, for instance, from a stretcher to a bed. When not in use, the mats are deflated, making it possible for workers to confuse them with disposable items or with linens. Identifying the high-value mats can be made more difficult by the fact that hospitals also use disposable transfer mats when the reusable HoverMatt mattresses aren’t available, and they look somewhat similar.
The hospital initially acquired 500 reusable mats, in early 2013, but found, during an inventory count performed in August 2014, that they had only 162 left. The facility conducted an investigation, Odom says, interviewing its EMS personnel, as well as employees at satellite facilities, such as skilled nursing facilities. However, no one could locate the mats that had vanished.
Zion Medical Center was already using the first generation of Awarepoint RTLS technology to track its beds, wound vacs, pumps and other assets throughout its premises, so it spoke with the RTLS technology provider and opted to apply tags to the remaining mats. By the time tagging began in May 2015, another 74 mats had gone missing.
Zion’s Awarepoint RTLS deployment consists of 2.4 GHz RTLS tags that emit a signal employing the ZigBee protocol, compliant with the ISO 802.15.4 standard, says Bernard Lee, Awarepoint’s marketing VP. Sensors located at various points throughout the hospital capture the ZigBee-based tags’ transmissions and forward that data, via other sensors, back to Awarepoint software running on an onsite server.
According to Lee, Awarepoint’s next-generation RTLS solution employs Bluetooth Low Energy (BLE) technology instead of ZigBee. With the next-gen version, a facility installs Bluetooth beacons at various fixed locations, and the new Awarepoint tags (attached to assets) capture the beacons’ signals and forward that location-related data to the back-end server via Wi-Fi connection. Lee says the system can accomplish location accuracy within about one meter.
In both versions, the Awarepoint software interprets a tag’s location and makes that location-based data available to hospital personnel. This next-generation technology, as well as the previous version in use at Zion, Lee says, “aims to support asset management and temperature monitoring, as well as a broad range of mobility-focused use cases around workflow, wayfinding, workflow improvement, patient engagement and caregiver enablement.”
If a tagged mat passed an Awarepoint sensor installed in the trash compactor area, Awarepoint software issued an alert to authorized parties that included Odom and Rick Astone, a Kaiser ergonomic specialist for workplace safety. It soon became clear that mats were being placed in the trash at a fairly high rate. The hospital then traced back the mats’ movements prior to their journey to the compactor, and determined that staff members who stripped patient beds were inadvertently throwing the mats away.
“Once we’d identified the problem,” Astone says, “we could then focus on re-educating.” As a result, the hospital set up a system by which all transfer mats, whether disposable or reusable, are put in a dedicated bin and are later sorted. Now, he reports, the mats no longer go missing.
The technology posed a few problems when it was first used for this purpose, Astone says. For instance, the tags could not be directly applied to any part of the mattress in which a patient might come in contact, since they could cause injuries. Therefore, the hospital attached the tags to the flap covering the air nozzle. However, workers were then using the tag, attached to that flap, as a handle when moving the mat with a patient on it, and the tags thus sometimes ended up being torn off. Kaiser approached the mat manufacturer and asked that the mats be made with a larger flap that would include grommets to which the tag could be attached.
Like other objects containing metal, the tags cannot be taken into MRI machines, so Awarepoint programmed the software to issue an alert to management in the event that a tagged mat was in the MRI area, potentially entering the machine itself. The hospital uses disposable mats for the MRI-destined patients.
With the system, Astone says, the hospital intends to track such information as how often the mats are used, and thereby confirm that employees are complying with rules regarding the use of those mats to transport patients from one bed to another. The solution will also help the facility identify when a mat is not being used and, therefore, should be moved to a location where it will be utilized for often. For instance, Astone notes, if a department were to hoard a HoverMatt mattress to ensure that one would be available when needed, the technology would identify that action, and management could then provide the department with a disposable mat, for instance, so that the reusable version could be more regularly used for patients.
The technology also helps the hospital to automatically identify when mats are brought to the cleaning facility several blocks away, and when they return. When removing the mats from the medical center, couriers log into the Awarepoint system and indicate the mats’ departure so that alerts will not be sent.
The hospital is now considering affixing Awarepoint RTLS tags to wheelchairs and lifting equipment, such as slings that are attached to cranes.