Healthcare's First Autoclavable Active RFID Tray Tracking Application

Significant installation success at UCSD highlights capital budget savings Medical Center

Awarepoint quietly launched the first-to-market Sterilizable Active RFID Real-time Location System (RTLS) asset tag a year ago, and has seen tremendous installation successes to date. Awarepoint has produced the first RTLS asset tracking tag that can be sterilized and disinfected without removing it from equipment. Without the need for manual bar coding or hard-wired RFID "chokepoints", RTLS provide the real-time location, status and movement of mobile equipment anywhere through-out the hospital's enterprise.

Traditionally, RTLS is used for enterprise-wide hospital equipment management – from wheelchairs and gurneys, to IV pumps and pulse oximeters. To date, medical instrumentation trays have been left out as an entire asset category, as the asset tags themselves could not withstand the cleaning and sterilization process. Medical instrumentation trays are critical to patient care, and designed for reuse only after adequate cleaning and sterilization. Value to the hospital in applying RTLS to these assets is multifold:

Reducing Surgical Case Delays and Cancellations
In an average hospital, thousands of medical instrumentation trays are processed every month. Identifying the location and status of these trays reduces surgical case delays, and worse, cancellations - costing the hospital thousands in surgical team idle time, and impacting the efficiency of patient care. For University of California San Diego (UCSD) Medical Center, who implemented RTLS tray tracking a year ago, a primary goal was to "reduce the outliers" that cause long delays or cancellations. According to Tom Hamelin, Director of Perioperative Services, "A delayed or cancelled case can result in 2-3 hours of idle time for the surgical team. At an average cost of $84 / minute, savings to the hospital in avoiding as few as two per month is estimated at over $275,000 / year. Further, these delays, especially if it's the first case of the day, have a domino effect on the entire day's schedule. The resulting overtime can add significant cost to the department and intensify surgeon frustration."

Staff Efficiency
Equipment problems that cause case delays include situations where the proper instrumentation simply cannot be found; or the needed equipment has not been processed through sterile processing. Solving case delays caused when instrumentation cannot be found or is not ready, is immeasurable. With Awarepoint, much of the equipment searching for the day's surgical cases is handled through a central work station. When preparing for surgical cases, SPD technicians can now view the location and status of instrumentation trays right from their computer. This allows them to identify trays that are immediately ready for use.

Surgical Case Changes Once the Procedure has Started
Another significant challenge in managing instrumentation trays is case changes that happen once surgery has begun. Although surgical teams prepare the operating room for anticipated patient needs based on the procedure being performed, it's impossible to plan for every clinical situation. "When an unanticipated clinical need arises during surgery, the urgency to find needed instrumentation is enormous," added Hamelin. With Awarepoint, the location of needed instrumentation is viewed at the click of a button from the workstation within the OR. Staff can instantly see if needed instrumentation is available in clean storage, and be dispatched directly to retrieve it. If the equipment is not available, staff knows this too, and can advise the surgeon at once so that he or she can immediately determine the appropriate medical choice for that patient.

Equipment Utilization and Capital Budget Savings
Medical instrumentation trays can be among the more expensive equipment in the hospital, ranging in cost from $1,000s to $100,000s. Determining proper inventory levels is an ongoing challenge, and is exacerbated when trays are shared between hospital campuses. Adding to the challenge is the fact that many types of sterilized instrument trays are centrally processed by SPD and distributed throughout the hospital, not just in the OR. Examples include tracheotomy and resuscitation trays that are held in store rooms throughout the facility for immediate use.

With RTLS tray tracking; location, status and movement of trays can be viewed enterprise-wide across multiple campuses. This real-time information provides business intelligence that allows efficient sharing of equipment and proactive management of lost, stolen and misplaced items. "At UCSD, I manage surgical services across 4 campuses – Hillcrest, Thornton, the Shiley Eye Center and our Cancer Center, I simply cannot afford to stock each campus with a sufficient amount of inventory, nor efficiently manage their whereabouts at all times, " stated Hamelin. With RTLS, staff can determine exactly where needed equipment is, or is not, and arrange dispatch to the appropriate campus. Further, by proactively managing alerts that tell the hospital if equipment has moved into, or out of, its designated area, shrinkage is reduced significantly. Scott Sullivan, Business Manager of Perioperative Services at UCSD Medical Center adds "Because we don't have immediate insight into the location and status of these items, we replace more than we should. I anticipate we'll reduce our replacement inventory budget by over $100,000 in the first year alone."

With RTLS tray tracking, autoclave cycle count reports assist in equipment utilization patterns and manage life cycle maintenance. "When reviewing requests for additional inventory, I now have a tool to easily review usage of each of our trays," continued Sullivan. : This information provides intelligence into what is used, and what is not, during the year, and identifies if some trays are over-utilized, while others sit idle. When new requests come in, I can use this information to analyze whether the equipment is really needed, or we just need to better manage utilization of what we already own. I expect to reduce our budget for new requests by about $25,000 in 2009."

Cycle count reports also allow the hospital to extend the life of equipment by normalizing usage across same tray types and better manage maintenance cycles. With it, the hospital can see if one tray has been used 50 times, while the same tray has been used only once. By better balancing usage across the entire inventory, life cycle of equipment is extended and the hospital can be more effective with preventive maintenance, sharpening and repair cycles.

Medical Instrument Management System Integration
The next step in RTLS tray tracking is integration with the hospital's medical instrument management system to help drive standardization of instrument sets, track instrument repairs and document sterilization history automatically. Systems such as Cardinal Health's Impress® allow hospitals to view images, descriptions and item numbers from a catalog database. This information is incredibly useful in processing complicated sets, and can act as a training tool on how each assembly should be completed.

Completing integration with instrument management systems will provide a full circle solution from Central Supply to the Operating Room, and further eliminate manual error and delays. Having a centralized management portal for complete instrument management is the goal. By adding RTLS to medical instrument management system, a new dimension in efficiency is achieved in knowing the location of tray sets, and ensuring they are being properly maintained and processed, "Not only does this improve staff efficiency and satisfaction, but this added time is now repurposed into both equipment maintenance and assembly, which leads to fewer errors," added Hamelin.

Another benefit to RTLS tray tracking is the ability to have historical information on where each instrument tray set has been used. When faced with locating a failed sterilization load, RTLS can provide immediate insight into the date, time and location a particular tray set was used to track that set back to the patient.

"Awarepoint continues to be committed to ongoing product enhancements that help our customers get the most value from their real-time location solution," said Kenny Woods, executive vice president of client operations at Awarepoint. "Ohio State University Medical Center has the largest deployment of autoclavable tags to date, tracking nearly 600 instrumentation trays. Advocate Good Samaritan Hospital in Downers Grove, IL, is employing 150 of the tags this month to track metal surgical trays of various sizes. Both Jackson Memorial Hospital in Miami, FL and Tri-City Medical Center in San Diego, CA are adding autoclavable tags. We anticipate this is just the beginning as the market sees the tremendous value of tray tracking with RTLS, and takes the next step in integrating with medical instrument management systems."

About Awarepoint
Awarepoint's Real-time Awareness Solutions (RTAS) include its real time awareness platform, firmware, RFID tags, sensors, and bridges. Awarepoint's technologies collect raw sensor data and transform that data into high-value positioning information that can be used to add location awareness to a variety of healthcare applications. Requiring no hard wiring, Awarepoint's "plug and track" network is a fully managed service, including hardware, software, remote monitoring and maintenance. The company is headquartered in San Diego, California and serves hospitals across the United States through an exclusive relationship with Skytron, an internationally known medical equipment supplier. Track us down at www.awarepoint.com or visit www.skytron.us.

SOURCE: Awarepoint