Scotland’s National Health Service (NHS) Forth Valley Hospital is expanding a hybrid RFID system, which enables its main Forth Valley Royal facility to manage its medical devices, to two of its other community hospitals. The solution already includes 14,000 passive RFID tags on assets, along with 4,000 active RFID tags on the highest-valued of those items.
Those assets with active tags attached can be tracked in real time as they move around the facility, while the passive tags on all assets items them to be located via mobile readers. The solution, known as RFID Discovery—includes passive and active readers and tags, as well as software, and is provided by U.K. technology company Harland Simon.
Since the system’s installation three years ago, the hospital has found that it has prevented $455,000 in expenses related to asset purchases and maintenance. That savings resulted from both real-time and historical data provided to the hospital that identifies both where equipment is located and how often it is used.
NHS Forth Valley Royal opened in 2010. The facility spans approximately 113,600 square meters (1.2 million square feet), —with 860 beds throughout 25 wards. The active RFID system is installed at that main hospital, while Forth Valley also includes four smaller community hospitals, two of which are slated to be taken live with the same technology later this year. In the meantime, the passive RFID system is already in use at the main hospital, as well as at the two community hospitals.
The main hospital manages 14,000 medical devices, including electrocardiogram (ECG) monitors, beds, syringe drivers and pumps. Like other NHS Trust facilities throughout the United Kingdom, Forth Valley Royal was challenged with managing and locating its medical devices and meeting legal, regulatory and policy requirements related to those devices.
Having thousands of medical devices in a busy hospital, where hundreds of staff members must vie for their use, has made asset management too complex for manual tracking, says Bryan Hynd, NHS’s head of medical physics. NHS estimates that at any of its health-care facilities, 85 percent of nurses spend up to an hour each shift searching for supplies, such as wheelchairs and pumps. The average hospital loses up to 15 percent of its assets annually, it found.
In addition, Hynd says, there were areas in which equipment tended to collect, while it would disappear from other areas. Equipment sometimes went missing and had to be reordered, even if the missing items were simply sitting on a shelf somewhere in another department or ward.
To address these concerns, the hospital trialed a Wi-Fi-based solution seven years ago, utilizing the existing Wi-Fi network at its new Forth Valley Royal hospital. However, Hynd says, the technology fell short of its expectations. For one thing, he explains, “the tags were too large, while their battery life was too short.” In addition, he says, the facility’s existing access points for Wi-Fi were insufficient to identify where the tags were located—in fact, they were often on a different floor than the one on which the system indicated them to be.
Instead, in 2014, the hospital deployed the active RFID system using the Wi-Fi frequency and a proprietary air-interface protocol. The active system was installed initially with just five readers, and has since been expanded to 170 fixed Harland Simon RFID Discovery readers—one in each operating room, four in each ward and the remainder in corridors.
With the active system, an RFID Discovery active tag is attached to each asset, and is linked to that item in the software, residing on the hospital’s database. The batteries have a longer life than the previous Wi-Fi tags, Hynd reports. They were put into commission three years ago and most are still functioning. He adds that the battery replacement costs about 12 pence ($0.15) each.
As each asset moves around the hospital wards, its tag transmits its ID number and readers in the area capture that information. Because there are four readers within each ward, they can approximate tag location to within a quarter area of the ward.
For lower-value assets, the hospital has applied passive UHF RFID tags. Staff members push wheeled carts around the facility, with an RFID Discovery reader installed on them to read those tags.
First, the hospital uses PervasID and Impinj readers to interrogate tags as they are applied to new assets. The hospital already printed and affixed an adhesive serial number label to every asset it received, so it replaced that process with a printed EPC UHF RFID tag.
That tag ID, like the active tag ID numbers, is saved in the RFID Discovery software, linked to the product’s description and serial number. The tag can be read during scheduled inventory checks, at which time employees simply roll the cart through wards and corridors to count and identify items in each location. A Zebra Technologies handheld reader can also be used in Geiger counter mode to locate a specific asset.
The software not only determines asset locations, but provides analytics regarding where and when equipment was used, cleaned or maintained. That data helps the hospital to identify not only where the assets are when they’re needed, but also how often they are used, and thus whether they have a sufficient number of assets or too many of specific kinds of equipment.
With the active and passive RFID solution, Hynd says, the hospital has reduced the need to order new devices by optimizing management of the devices it has on hand. Two years after the deployment, it found that it had removed 75 syringe drivers and eight PCA drivers from service, at a total value of about $200,000.
It avoided the purchase of scores of pumps, bladder scanners, humidifiers and syringe drives at an added value of about $233,000. For instance, when four syringe drivers used by the children’s ward and neonatal unit were due for replacement, the hospital was able to view equipment usage data and determine that they could be removed from service and not be replaced. That decision alone saved the hospital around $10,000 for the purchase and $866 annually for maintenance.
The daily time savings for staff members has been difficult to quantify, Hynd says. However, the last hospital-wide non-RFID-based inventory count required three months to complete. With RFID, he explains, it was accomplished “in a few days.”
The maintenance and repair of equipment has also become more efficient. While it used the hospital to take eight to nine weeks to maintain 90 percent of its entire fleet of 200 blood-pressure monitors, due to the amount of time employees spent searching for them (10 percent simply couldn’t be located), that process can now be accomplished within five weeks and includes 100 percent of the monitors.
The software can also track—and thereby prevent the erroneous use of—damaged equipment. It avoids fines by preventing delays in patient care in its emergency department. In addition, the system ensures that the hospital is in compliance with the Care Quality Commission‘s guidelines for managing medical devices, which lowers insurance premiums.
The system combines data from active and passive RFID in a single system, explains Andy James, RFID Discovery director of commercial operations – healthcare. Clinical staff use a pictorial search screen to locate devices. The software also allows users to set PAR levels (pre-determined level of specific types of devices for each critical area), and alerts the user when areas are low in stock or overstocked. What’s more, the software provides reporting such as when devices were last detected by a reader, what type of reader they were detected by, and whether they are high, medium or low risk devices.
Additionally, Hynd says, the incidence of hoarding equipment by health-care providers is eliminated, since nurses know that the technology will locate any hoarded items, and that they can find available equipment whenever they need it.
“A total investment of around £200,000 in both passive and active RFID tracking has resulted in £360,000 ($456,000) of cost avoidance,” Hynd states. He adds that he expects “further savings of £200,000 ($253,000) in the next financial year.”
The hospital next plans to expand the active RFID system’s use to the two largest of its community hospitals, which average 90 beds each. In the future, it may provide active RFID wristbands to vulnerable patients who are at risk of wandering away. Hynd says the hospital may also explore the option of tracking surgical trays to automatically identify in which hospital the trays are located, as well as their status, such as cleaned and sterilized for reuse in surgery.