HCA Healthcare‘s Summerville Medical Center has boosted its hand-hygiene compliance by 25 percent, after installing a new radio frequency identification-based solution that identifies when and how often personnel wash their hands. The hospital measured compliance rates when the technology was installed in February 2013, and has since charted an increase in the rate at which staff members wash their hands before and after visiting patients. Previously, the facility had manually tracked compliance, obtaining 70 or 80 data points (each representing a single hand-washing event) per month—but with the RFID technology in place, it now acquires 8,000 data points daily.
The hospital expanded its existing real-time location system (RTLS) solution for tracking assets and patients. The system uses the same active RFID and infrared (IR) tags, along with passive low-frequency (LF) 125 kHz tags and readers, to monitor hand hygiene compliance at the hospital. The existing hybrid location-based technology and the hand-hygiene solution were developed and provided by GE Healthcare, and were fully implemented in February.
The hospital, part of HCA’s Trident Heath System in South Carolina, was already employing GE Healthcare’s AgileTrac RTLS technology to manage assets and workers, by identifying the locations of tags and badges throughout the facility (see Trident Health System Boosts Patient Throughput, Asset Utilization). The 94-bed hospital implemented the technology in 2008. Each RF Code tag has a built-in IR sensor that receives an emitter’s infrared signal and then transmits a high-frequency (HF) 433 MHz active RFID signal encoded with its own unique ID number, along with that of the IR emitter. RFID interrogators installed throughout the building can receive the tag’s signal and forward that data to the AgileTrac software residing on the hospital’s back-end server, via a cabled connection.
During the past year or so, HCA had been in dialog with GE Healthcare regarding other ways in which the RTLS technology could be utilized at its three Trident Heath System hospitals. “We had tremendous success with it,” says Louis Caputo, Summerville Medical Center’s CEO. For example, he reports, the asset-tracking system enabled the hospitals to reduce inventory levels by knowing where assets were located, and to decrease the amount of nurse labor required to seek out assets. Based on those successes, he says, “Folks at GE and HCA were looking at health-care reform and had brainstorming sessions” intended to identify additional solutions using the technology.
HCA opted to launch a hand-hygiene solution, Caputo says, to be designed by GE Healthcare, leveraging its existing RF Code technology, with the Summerville hospital serving as a pilot since it is a fairly small facility. HCA plans to expand the system’s use to its other hospitals as well, though a timeline for such a deployment ‘has not yet been decided.
The solution was intended to ensure that personnel meet hand-hygiene standards before and after every meeting with patients. The hospital already assigned staff members to track compliance, but the amount of data derived from such periodic audits was less than what could be gained using an automated solution.
Summerville Medial Center has provided 320 RTLS badges with built-in IR receivers and 433 MHz active RFID tags, as well as passive LF tags. The unique ID numbers on the active and passive LF tags are stored in the AgileTrac software, explains Fran Dirksmeier, GE Healthcare’s general manager for global asset management, with each ID linked to the staff member to whom a particular tag is assigned. Each mployee clips the RTLS badge over his or her existing ID staff badge at the beginning of a shift, and then proceeds to go about performing that person’s work. Upon entering a patient’s room, a worker is expected to wash or sanitize his or her hands, both prior to and after seeing that patient. The IR emitters and active RFID technology identify when a staff member enters a specific room, thereby updating the software to indicate that the individual has arrived to see a patient. The LF tag is then used to determine whether or not that employee washed his or her hands at the start and end of that visit.
When a worker proceeds to one of 362 soap or sanitizer dispensers, an LF reader installed at that dispenser reads the unique ID number on the LF chip built into the badge, and transmits that data to the software via a wired connection. The system is set to accept an instantaneous read, rather than requiring that the badge remain in front of that dispenser for a specified number of seconds (which some systems require, to confirm that hand washing is carried out in a thorough manner). That, Dirksmeier says, is because personnel use the sanitizer very quickly, often barely stopping as they administer the sanitizer to their hands.
Upon leaving the room, the worker should again go through the hand-washing process, creating a record of that event as well in the software. The software then calculates compliance results and identifies any instances of non-compliance events. That information will be used to analyze trends, Caputo says, specific to a department or individual, which could then result in education efforts.
The data is accessible to Caputo and department heads within the hospital, in addition to staff members using the technology.
“The data certainly is rich,” Caputo states. “We use it to identify which individuals are practicing hand-hygiene compliance, and it allows us to engage with those who are not.” The focus, he says, is not just on patient health, but also on employee health. What’s more, the technology can be used to perform an historical analysis after an infection occurs though this has yet to happen since the system’s installation. If a communicable infection were discovered at the hospital, the RTLS and hand-hygiene technologies would enable the facility to track who entered and exited the infected patient’s room, in addition to their hand-hygiene practices. This would enable the medical center to isolate the disease, by identifying which personnel were exposed and evaluating whether a hand-hygiene problem had taken place.
“We’ve been very transparent” about the technology in use, Caputo says, in an effort to help staff members understand what data is being tracked, as well as how and why. Personnel know that the system data is available to them, and that it is not intended as a disciplinary tool, but one that will enable education. “How that data is shared is up to each department,” he says. Some keep a dashboard open on a screen and accessible to staff, so that they can view their performance at any time.
“It’s worked well,” Caputo says, noting that HCA may also examine other ways in which the technology could be utilized to improve hospital efficiency. The RTLS data, he adds, could, for example, be used to analyze staff efficiency. One nurse may enter a patient’s room three times more often than another, he explains, and that data could be analyzed to determine if there are lessons that could be learned that would lead to the hospital changing its own processes.
“This fits GE Healthcare’s overall strategy,” Dirksmeier says. “We think of our solution as air-traffic control for hospitals.” The technology not only allows for asset, staff or patient tracking, but also hand-hygiene compliance for a broader solution. “The aim is to really improve operations of hospitals.”