St. Andrew’s Healthcare, the United Kingdom’s largest nonprofit provider of mental-health services, has implemented an RFID-based real-time location system (RTLS) to enable staff members to send alerts, and to route them to the appropriate personnel. The organization is doing so prior to the establishment of government rules expected to require U.K. mental-health facilities to install RTLS technology.
St. Andrew’s includes four campuses—Northampton, Essex, Mansfield (known as St. Andrew’s Nottinghamshire) and Birmingham—with multiple buildings on each campus to house patients with mental disabilities, brain injuries and neurological disorders. Approximately 3,000 staff members work in the facilities, and when a dangerous situation or emergency occurs, such as a physical attack or a fire, they need to be able to quickly alert co-workers in the area. Previously, that had been accomplished using a system in which employees pressed a button on a badge, causing the device to emit an infrared signal indicating an emergency. The signal was received by IR sensors, and was then forwarded to a series of panels installed throughout each building. The panels emit an audible alarm and display text indicating where that alarm was set. Upon hearing such an alarm, the staff could then hurry to the panels to determine where help is needed.
The infrared system, however, requires an unobstructed line of sight between the badge and the sensor; otherwise, the alarm will not be triggered. Moreover, an employee may have left a location after pressing the alarm button, and responders would have no idea who called for help, or why, nor would they have any way to let that employee know they are responding to the call. In addition, the loud alarms—which are triggered 160 to 200 times each month—are disruptive to the staff, as well as to patients. In some cases, the frequent sounding of alarms has unsettled some patients.
Consequently, about 18 months ago, St. Andrew’s, through its technical partner, Comtact, began seeking an alternative solution, according to Paul Kirkpatrick, the organization’s director of IT. During that time, the U.K. government legislature was discussing the possibility that it might eventually require the installation of RTLS technology in health-care settings. St. Andrew’s wanted to be proactive and implement such a system at all of its facilities.
“We spoke with Motorola, as well as other manufacturers,” Kirkpatrick explains. Ultimately, St. Andrew’s opted for Motorola’s Wi-Fi routers, as well as Ekahau tags and software to determine the location of any employee who triggered an alert, and then forward that alarm to the appropriate staff members. While other wireless companies offered RTLS solutions, he says, St. Andrew’s preferred the Motorola system because it believed it provided greater granularity, by building a mesh network with access points that send data to each other, working in conjunction with the Ekahau Positioning Engine software, which determines a tag’s location by comparing signal strength data from the multiple access points. The solution also offered a self-healing functionality in the event that one access point failed, by transmitting data to the next working access point within the mesh.
In several of its buildings, St. Andrew’s installed dozens of Motorola Wi-Fi access points, which do not require an Ethernet cable to connect to a building’s computer system. Instead, they form their own wireless mesh network, employing the Wi-Fi protocol to communicate with other, and eventually the building’s computer network. Access points on the edge of that wireless mesh network are powered by an Ethernet cable using Power over Ethernet (POE), and act as gateways to the wireless access points.
With the Motorola system, an employee reporting for his shift first presents his ID badge, which contains a separate passive RFID tag and acts as a proximity card. Once the badge’s tag ID number has been read, a staff member at the entrance scans a bar-coded serial number printed on the back of an Ekahau RTLS tag attached to a lanyard. In the Ekahau Vision software system, residing in the St. Andrew’s database, that bar-coded number, the person’s badge tag ID number and the unique ID encoded to the RTLS tag are linked together. Instead of being given an Ekahau tag, some employees, such as ward managers, receive a Wi-Fi-enabled voice-over-IP (VoIP) phone provided by Ascom. That device, however, acts like the Ekahau tags, regularly beaconing a unique ID number linked to that staff member’s identity.
If a worker requires emergency assistance during the shift, he simply presses a button on his lanyard tag or Ascom phone. The tag then transmits an emergency signal that is received, on average, by three or four Wi-Fi access points in the vicinity. If that employee is moving, his location continues to be tracked based on the signal strength as received by nearby access points. If one of the Wi-Fi routers is not working properly, the mesh network is designed to forward the transmission to the next router.
The Wi-Fi access points transmit the tag’s or phone’s ID number and emergency status, along with the signal strength and their own IDs, to the Ekahau Positioning Engine software, which determines the location of that individual’s tag. The Ekahau Vision software then issues an alert to other staff members’ badges or handheld devices, based on how close those individuals are to the site of the problem. The alert appears as text on a display screen on the Ascom phones and Ekahau tags, indicating which person has triggered the alert, and in which room.
The system was first tested at an adolescent unit in Northampton for six weeks. After completing that proof of concept, the system was then installed in the hospital’s new Mansfield campus building as it opened last month. St. Andrew’s installed 250 access points throughout the Mansfield building, and 90 in the adolescent facility, where two wards have currently been installed for the proof of concept, and six more are being completed. Another 350 Wi-Fi access points are being installed in the new William Wake House, in Northampton, which is slated to open in December 2010.
To date, Kirkpatrick says, staff members report that they prefer the RFID system to the infrared version, as it provides them with greater security in knowing that responders are on their way, while not sounding alarms that can be heard throughout the building. The system could also be used to identify the nature of an emergency, and thereby send alerts specifically to staff members trained to respond to that type of problem. A physical attack, for example, could be signaled by pressing the button once, while pressing it twice could denote a fire, which would require different responders.
Within the next two years, Kirkpatrick says, St. Andrew’s intends to install the system throughout each of its four campuses, including outdoors on the facility grounds. Once fully in place, the system will comprise around 3,000 Ekahau tags and up to 5,000 Motorola access points. Although safety is the primary goal, the hospital expects to see financial gains by not requiring wiring, which would be necessary for Wi-Fi, phone and paging infrastructures.
“As we become more mature in our use of the system, we will be looking at other opportunities,” Kirkpatrick says, including possibly utilizing the Ekahau tags to control access to locked doors. In the adolescent unit, the system can be used to provide children with a transmission of classroom instruction within their own rooms if so required. What’s more, St. Andrew’s hopes to use the system for self-service for employees in staff restaurants. The organization might also utilize the solution to provide a record of the alerts triggered by each staff member, thereby enabling a facility to provide appropriate training if, for instance, that individual seemed to press the alert button more frequently than was considered necessary.