Feb 17, 2012When the nursing staff at Sacred Heart Medical Center at River Bend was presented with the hospital's new plans to implement a real-time location system (RTLS) for tracking infusion pumps, the nurses were unenthused. Frustration levels were already high among employees, due to the difficulty of locating pumps and other assets required for use. So when Christian Buchsteiner, the hospital's health-care improvement engineer, met with dozens of nurses to discuss the RTLS project, he was met with skepticism, he says. "I stood in front of 50 nurses," Buchsteiner recalls, "and told them, 'We will be reducing the number of pumps by 30 percent,' and the nurses said, 'Are you crazy?'"
Since the system's two-phase installation, however—in 2010 and 2011—the technology has proven to enable the reduction of pumps to the level Buchsteiner had aimed for (from 923 units down to 700), while also increasing the equipment's availability to nurses when needed. The RTLS data is first used to establish the periodic automatic replenishment (PAR) level—the minimum acceptable number of pumps on-hand—for a particular location. Once the PAR level is determined, the RTLS will monitor the quantity of available pumps, issuing alerts to necessary staff members employed in the distribution and clinical engineering department, to retrieve assets before numbers could dwindle to the point at which nurses would have to begin searching for them.
Sacred Heart Medical Center, owned by PeaceHealth, had already been using an RTLS solution from Versus Technology to track patients through its emergency department, since the hospital opened in 2008 (see New Oregon Hospital Adopts IR-RFID Hybrid System. The facility recently expanded its use of the Versus system—which employs RFID and infrared technologies—to its labor and delivery unit, in order to monitor the locations of staff members and patients, as well as some equipment. This, however, would be the first asset-tracking system in use at the hospital, Buchsteiner notes. Although he says he recognized the value of RTLS technology for tracking assets' locations, he wanted to take the system a step further than simply providing location data. Specifically, he wanted the system to inform the hospital when it needed to replenish its equipment supply at certain central locations at which nurses could quickly access assets.
Sacred Heart Medical Center at River Bend is a Level II trauma center covering an eight-county region. The hospital has hundreds of different types of assets requiring management, Buchsteiner says, but in July 2010, it opted to start (as the first phase of its asset-tracking project) with tracking just one highly coveted type of equipment—infusion pumps, building on the existing Versus RFID/IR infrastructure (the facility added approximately 20 RFID readers and IR sensors to accomplish hospital-wide coverage). First, the staff attached Versus tags to about 700 infusion pumps, and then began tracking their movements. The location data was available to workers in real time, but Buchsteiner notes that labor was still necessary on the part of nurses—first to log into the Versus system to search for a required piece of equipment, and then to walk to that area of the hospital to retrieve it.
Instead, Buchsteiner wanted to take another step (Phase Two), by using the technology to spare nurses from the searching task. Rather than logging into a system to find equipment, an employee would simply go to a unit's central storage area, and the asset sought would be there and available for use.
With the RFID system in place, every pump has a Versus tag attached to it. The tag's infrared chip transmits a unique ID number that is received by an infrared sensor within its range. The tag's RFID chip—which transmits at 433 MHz using a proprietary air-interface protocol—provides a signal with a broad read range that (unlike infrared) can penetrate walls. The RFID functionality is used for redundancy, explains Tom Ott, Versus Technology's regional director, the IR technology being the primary source for location data. The hospital knows, in real time, where each piece of equipment is located within a room—or, in some cases, at the bed level. As tagged pumps are moved around the hospital, the software is updated based on the location data, and can thereby determine if inventory has reached PAR levels within each specific unit, or if it is at risk of dropping below PAR, thus necessitating that the engineering staff round up unused equipment and bring it to the central location for that particular unit.
The software can then not only issue alerts via e-mail, text message or phone call, but also display a full listing of the asset levels of each individual unit and facility-wide. Additionally, the software can display the PAR level and critical low levels (a predetermined minimum at which equipment must be immediately replaced) for comparison purposes.
"My biggest surprise has been the accuracy of the system," Buchsteiner states. "We were concerned whether the [Versus] network would catch everything. I was overwhelmed by how accurate it is. We had about 700 pumps, and we came up with about 699. The accuracy was amazing."
Buchsteiner's return-on-investment (ROI) study has found that the hospital saved $600,000 almost immediately, by avoiding the cost of equipment leasing and purchasing, with a projected savings of $2.7 million over a 10-year period for the infusion pumps alone.
Sacred Heart Medical Center at River Bend is now tagging other assets in addition to the infusion pumps, Buchsteiner says, such as syringe pumps, feeding pumps and PCA pumps. To date, approximately 1,500 tags have been used for monitoring assets.
Last June, PeaceHealth's labor-and-delivery ward (where mothers stay prior to and during delivery) began using a new, custom application from Versus Technology that provides a view of patient and staff locations, as well as room status (empty or occupied). These new views communicate the status of laboring moms—whether in pre-labor or active delivery—to the staff. The Versus software also displays when services, such as lab work, electrocardiography (EKG) or epidural, have been completed, since that data is input by workers as such a service occurs.
The system enables the hospital staff to know where doctors and nurses are located, both within patient rooms and throughout the department. Initially, the solution was installed to track the movements of patients and personnel as a patient enters the labor and delivery unit, and then delivers her baby.
The mother-baby unit, to which mothers and their newborns are moved post-delivery, also began utilizing the Versus Advantages solution in August 2011—in this case, to allow the staff to quickly identify each mother and infant, as well as track the movements of patients and employees. The software's iconography displays data about a particular baby and his or her mother, such as whether the latter delivered multiple children.
