RTLS Provides Hospital With The Gift Of Time

By Susan Kreimer, contributing editor

A real-time location system (RTLS) helps Miami-based Jackson Memorial Health System efficiently keep tabs on 14,500 pieces of medical equipment, allowing staff to dedicate more time to patient care.

With 22 buildings covering 4 million square feet, it’s difficult to account for every piece of medical equipment at any given moment. That’s the amount of space occupied by sprawling Jackson Memorial Health System in Miami. What’s more, its buildings aren’t situated in one continuous stretch. Efficient and effective monitoring of inventory becomes a tall order in such a maze.

“We historically had a lot of issues with equipment being lost and with nurses hiding equipment behind desks in certain areas of the hospital so they would have it when they needed it,” says Cesar Acosta, manager of value analysis and equipment distribution at Jackson Memorial Health System. “As a result, we had to purchase equipment that we didn’t need because we couldn’t find what we already had.”

To resolve these issues, Jackson Memorial invested in real-time location system (RTLS) technology from Awarepoint in 2009. After a seven-week deployment, the health system unveiled a new platform for identifying and tracking medical equipment.

With this new system, there’s no need for fixed infrastructure or hardwiring. Instead, Awarepoint’s RTLS operates via ZigBee-based wireless sensors that plug into electrical outlets without interfering with the hospital’s Wi-Fi network. RTLS tags are attached to mobile items, and fixed reference points receive wireless signals from these tags to pinpoint their location within about 3 feet.

Other common approaches to RTLS use infrared and ultrasound sensors that employ Wi-Fi technology for real-time asset and location tracking. However, leveraging the available wireless LAN infrastructure can create an incongruous situation, raising concerns about accuracy, interference, network security, and cost.

Today, ZigBee technology has become a protocol specification and industry standard. It is relatively inexpensive to set up, and it requires minimal maintenance. The technology also delivers precise, room-level accuracy that eliminates “floor hopping,” which can be problematic in Wi-Fi-based deployments.

By tracking wheelchairs, ventilators, and IV pumps that sit idle, Jackson Memorial has been able to quickly return them to circulation and potentially decrease superfluous acquisitions or rentals, which could rack up thousands of dollars in additional expenses. “Now we have greater equipment utilization,” Acosta said after the installation. “The system reduced searching time for staff. Instead of looking for equipment, they can use the time to take care of patients.”

Before the RTLS rollout, the average search time for a piece of equipment was 38 minutes. “Our RTLS solution has reduced our average equipment search time to 3 minutes,” says Acosta. “This provides us with 35 more minutes per occurrence to dedicate to patient care.” In addition to optimizing healthcare workflow and averting delays of patient transfers to other departments, Awarepoint’s asset management software also helps Jackson Memorial automate temperatures in appliances containing perishable items. No longer is it necessary to rely solely on recording crucial data on paper. For example, wireless tags monitor and maintain logs on refrigerators, freezers, and warmers that store temperature-sensitive biomedical supplies such as blood, as well as lab cultures and tissue samples. Awarepoint sends real-time alerts for out-of-compliance situations to protect critical temperatures and allow maximum staff response time and accountability. Without this watchdog presence, a breakdown could disrupt service and result in a significant expense to replace the damaged contents.

THE BUSINESS VALUE OF RTLS
The business value of wireless asset tracking in healthcare is gaining momentum, albeit slowly, compared to other industries. For example, supply yards and warehouses are years ahead in using this innovation, according to an Awarepoint white paper published in 2009 (www.awarepoint.com/uploads/Wi-NotWi-Fi.PDF).

“With the added visibility into location and movement RTLS provides, hospitals have much better information regarding actual asset utilization,” the report notes. “Leveraging assets across the enterprise now becomes realistic. Moving assets from areas of low utilization to areas of higher utilization, when demand outstrips capacity, becomes a very real opportunity. Those hospitals can further avoid rental fees, reduce purchase of surplus equipment to meet demands, and reduce inefficiencies in asset processing.”

In the early 1990s, the initial RTLS platforms were installed in less than a handful of U.S. healthcare facilities. The term RTLS was coined later that decade to represent an emerging technology with the automatic identification capabilities of active RFID tags, as well as the ability to view the location on a computer screen. It had been utilized by military and government agencies but perceived as too expensive in commercial settings.

TAGGING 14,500 PIECES OF EQUIPMENT
Awarepoint’s education department assisted with the RTLS installation and launch at Jackson Memorial. Supervisors trained the health system’s employees in navigating the new technology. For each section of workers, the tutorial lasted 90 minutes.

“Overall, we spent a week or two to teach everybody how to use the system,” says Acosta. “We’re able to monitor equipment and see where it is located — which patient room, closet, hallway, stairwell, wherever.”

About 14,500 pieces of equipment have been entered into the database, and there may be more to add. As many as five identification numbers per item can be included for search purposes. For instance, an ID could stand for the model or serial number. It’s also possible to search by description or the equipment’s manufacturer.

To compile this inventory, Acosta and his colleagues went from one department to another, collecting information from medical personnel and attempting to identify equipment that belongs to each area. Among the most significant obstacles they encountered were an outdated inventory list and missing equipment.

In particular, he noted that, with so many buildings spread across a large area, Jackson Memorial’s Wi-fi is not dependable enough to support competing RTLS solutions that hitchhike on a hospital’s existing wireless network.

In the future, Acosta hopes Jackson Memorial will expand the use of Awarepoint’s technology to the emergency department and outpatient surgical services. And perhaps someday the health system may even extend these applications to tracking patients.