More than five years after installing a real-time location system (RTLS) to track assets, as well as temperatures, Tallahassee Memorial HealthCare (TMH) will begin piloting the technology next month to track patients moving through the facility’s operating rooms, thereby automating the process of updating each patient’s status on reader boards posted for employees and patients’ loved ones. By leveraging its existing Wi-Fi based RTLS from AeroScout, the hospital hopes to gain automated information regarding patients’ movements into the pre-operation area, the ORs and the recovery area. That data could then be displayed on TMH’s existing reader boards, which would automatically update the location of every patient wearing an RTLS badge.
Since it began using RTLS technology in late 2006, the hospital reports that it has reduced its annual equipment replacement and rental costs by $85,000, while also reducing the amount of labor hours spent by nurses and the biomedical staff searching for missing assets, or checking the temperatures of cooling or warming devices throughout the facility (see Increasing Efficiencies by Using RFID to Track Assets). The original RTLS was provided by PanGo Networks, but the hospital replaced that system it 2009 with a solution consisting of AeroScout’s tags and MobileView software, residing on the hospital’s back-end system, at the same time that it upgraded its Wi-Fi infrastructure.
TMH is an 800,000-square-foot acute health-care facility containing 770 beds and employing a staff of 3,500. The PanGo solution was installed to track the locations of such high-value mobile assets as infusion pumps, wheelchairs and beds, thereby reducing the amount of time workers spent looking for those items, as well as ensuring that equipment did not end up missing, or require replacement in the event that it could not be located.
In 2006, the hospital had just deployed 225 Cisco Wi-Fi access points, which failed to provide sufficient coverage to pinpoint the Wi-Fi RFID tags’ locations, says Jay Adams, TMH’s IT enterprise architect. With the RTLS solution in place, he says, the hospital was able to identify an object ‘s location only to a specific wing, which did not provide enough granularity. Moreover, TMH wanted to install exciters at doorways to identify when an item left the premises, and to then issue alerts to employees indicating what was leaving, and through which door. At the time, however, PanGo’s future seemed uncertain (the company was later acquired by InnerWireless, which has since discontinued its RTLS solution).
So in 2009, Tallahassee Memorial HealthCare adopted the AeroScout system, which includes T2 and T2u tags for tracking assets, T5 tags with temperature and humidity sensors for monitoring temperatures in coolers and warmers, and T3 badges for people tracking. The hospital had recently added Cisco access points, of which it now has about 700 deployed. TMH also installed AeroScout EX4100 exciters at doors, in order to prompt a transmission from any tag within read range, thus indicating the tag had entered the area defined by a particular exciter. With this upgrade to the Cisco system, as well as the transition to AeroScout tags and software, the facility can now ensure location data to within 15 feet—and with the exciters, it can identify when an item is leaving a particular area, and send a page to the appropriate staff members. The system is also used to monitor temperatures, by employing the temperature sensors built into AeroScout tags installed in refrigerators and warmers. If a temperature exceeds a specific threshold, a page is continually sent to employees until the problem is addressed and a worker inputs the corrective action into the MobileView system.What’s more, Adams says, the hospital has learned how to ensure the best read rates according to tag position. The location to which a tag is installed is important, he adds, noting that the hospital found chest height from the floor to offer the best read reliability for most tags.
At present, the hospital is tracking approximately 3,100 tagged items, as well as 1,500 laptop computers or other wireless devices that have their own Wi-Fi transmission abilities and thus need no tags to be tracked. A handful of AeroScout T3 personnel badges are also being used sporadically, Adams says, in order to help employees locate each other within the building. With the data culled from the tag reads, the equipment can be more quickly located by the staff, and thus need not be replaced as often, which saves time for the nurses and biomedical staff. Each battery-powered tag transmits its unique ID number at a preset rate, and the closest access points transmit that ID to the MobileView software, which determines the location of that tagged piece of equipment, displaying information about that item for hospital users logged into the MobileView system. For example, a display on the MobileView software enables a user to click on a specific type of equipment, such as recliners, and then indicates where all such items are located within the hospital, to within about 15 feet.
Prior to the asset-tracking deployment, Adams says, TMH spent approximately $125,000 annually to replace lost or missing equipment. During the most recent 12-month period, he indicates, the hospital has spent $40,000.
According to Adams, an exciter at the laundry area entrance eliminates incidents of accidental damage by washing equipment. While small pumps, for instance, did occasionally become tangled in bedding and end up in the laundry (at which point, they were destroyed by water), the RTLS caught those errors by identifying the presence of a tag and the item to which it was attached before that asset could be washed. Initially, he says, hospital management discovered that equipment ended up in the laundry room fairly often. But the system continued to detect the presence of tags arriving at the laundry area, he says, and the problem of tagged items inadvertently being moved to that room along with soiled linens has tapered off, due to that greater visibility.“We continue finding more use cases,” Adams reports. For example, he says, some material-management workers are now wearing T3 badges so they can locate each other within the hospital when needed.
AeroScout is currently providing some upgrades to the MobileView software, in order to enable the tracking of patients through the hospital’s surgical suite. Exciters will allow the system to know when a patient leaves a pre-operating area to enter the operating room. The software interprets that data, enabling the reader board to show a new status for that individual as being in the OR. Previously, the reader board had to be updated manually, by having staff members key status changes into the system.
Once the hospital determines that the patient-tracking solution functions properly, it may begin using the badges for additional members of the staff, such as environmental services workers (for housekeeping and linen management) and the transporters who move patients from one location to another within the facility. In that way, management not only knows where workers are located, but also has the data necessary to perform analytics, such as determining locations and times when, for example, there may not be enough transporters within a specific part of the hospital.
Adams estimates that Tallahassee Memorial HealthCare will recoup its investment over the next two to three years, based on the reduced need for equipment replacement and rentals. The amount of time that the staff saves thanks to the system, he says, is more difficult to measure.