Many hospital EBME departments will be familiar with the problem of locating key medical equipment. A typical hospital can have anywhere between a few thousand and fifty thousand pieces of medical equipment, 90% of which need to be maintained or calibrated on a regular basis (either every 3, 6 or 12 months). With a hospital site often covering vast areas, finding this equipment can be a logistical nightmare.
The typical hospital EBME department has tried a number of approaches to locate the equipment when it is due for planned maintenance (PPM) which include:
- to go and look for it: to search the hospital by foot can be extremely time consuming and frustrating and the term 'needle in a haystack' comes to mind.
- to perform a hospital sweep: many departments perform regular ward by ward sweeps of the hospital (perhaps bi-annually). The problem is that equipment moves ward during the sweep and the success rate can be as low as 20%
- to implement ward ownership: by making each ward responsible for its equipment, the location is better known. The problem is that assets are not shared efficiently across the hospital - one ward may be in desperate need of an infusion pump, whilst another has 3 not being used.
- to implement an equipment library: this has the benefit of proving more visibility to EBME of the asset base, but is only effective if well policed using dedicated resources and some kind of fine system. Again assets are not used effectively as they spend time in a library room, rather than out on the wards being used.
All of these methods are less than perfect in terms of staff utilisation and/or asset utilisation. The situation is often further complicated due to a number of other factors
- hoarding of equipment: medical staff begin to 'squirrel' away common used equipment in drawers and cupboards so they have it when next required
- broken equipment: often broken equipment is not reported and gets left in a corner
- lost equipment: equipment is misplaced in a corner of the hospital and forgotten about
- stolen equipment: the rates of theft has been increasing steadily, especially high end equipment such as endoscopes
There is now an effective way to efficiently find and track these assets across the hospital. Over the past year, a number of technology advancements and reductions in manufacturing costs have meant that it is now possible to tag assets, using Radio Frequency identification (RFID) technology, effectively and efficiently at a much lower cost. RFID based asset tracking may now be a viable proposition for UK hospitals because of....
- technology standardisation: in 2005, active tags were produced which work over industry standard 802.11 Wireless LAN networks, avoiding the need for expensive proprietary infrastructure such as antenna and receivers
- tag mass production: in the last year, the cost of active tags has fallen significantly due to mass production in the Far East
- tag technology advancements: recent technological improvements have reduced tag size significantly and increased the battery life to 3-5 years
All of these factors have combined to make Wi-Fi based asset tagging a viable and justifiable solution for the hospital. The Wi-Fi tagging solution comprises of three core components, the tags, the wireless network and the application user tools.
The new 802.11 RFID tags are about the size of a matchbox and likely to reduce further in size over the next year to the size of a watch face. The tags emit a signal at preset intervals (i.e. every minute) and have new functionality built in such as a call button, motion sensor and anti-tamper alarms
The tag transmits over the hospital wireless LAN and intelligence in the LAN triangulates to work out the location within the hospital, to about 5m. The frequency used is the IEEE worldwide standard wireless LAN frequency which is already used in a large number of UK hospitals and is different to that used by medical devices.
A simple search facility on a PC or PDA enables users to easily find the asset position in real time. Historical information can be stored so the asset utilisation over a period of time can be understood. A rules engine enables alarms to be triggered, for example when an asset leaves a certain location or moves when it shouldn't. The system can be easily integrated with existing applications such as asset management and security alarms
The benefits to the hospital of having greater visibility of key assets are clearly numerous. There are a number of benefits related to cost reduction:
- reduced equipment costs: purchase and rental costs can be reduced as faulty/unused/misplaced equipment can be identified and brought back into service. Better information is available to support procurement decisions. Additionally, improved maintenance by due dates can help avoid legal liability claims
- reduction in theft: theft can be reduced as alarms can be triggered when assets are moved, CCTV can be started and thieves are discouraged by the knowledge that items are tagged
- reduction in staff time: the staff time spent searching for assets can be reduced
Additionally, and perhaps more importantly, there are a number of non-tangible benefits directly affecting the patient:
- improvements in patient safety: audit trails of equipment use can be used to track MRSA outbreaks, patients will be treated with better maintained equipment
- improved patient care: more time is spent by medical staff spend treating the patient, faster responsiveness to critical events through faster access to medical equipment
- increased patient turnaround: reduction in average patient stay through improved equipment availability
- improved employee satisfaction: and morale improved, which all helps to reduce staff attrition
All of these benefits combine to make asset tracking a realistic alternative to manually locating assets. Many hospitals in the US have adopted this new technology in the last year and have already seen significant cost reductions and key improvements to patient safety and care and employee satisfaction.
Locating key medical equipment within a large hospital has always been an inefficient process and a major area of cost. It is now possible to implement an effective asset tracking solution that not only reduces this cost, but provides significant additional benefits to the EBME department and the hospital.