Health Service Focus

Beyond asset management

CUH NHS FT medical equipment library supervisor Simon Dawkins discusses how the benefits of RFID can reach far beyond asset management.

Keeping track of huge numbers of vital medical devices is becoming increasingly important – hospitals can no longer afford to simply buy more assets when they are lost or misplaced. RFID (Radio Frequency ID) allows the NHS to tag any item, ensuring it can be easily located at all times.

NHE spoke to Simon Dawkins, medical equipment library supervisor at Cambridge University Hospitals (CUH) NHS Foundation Trust about the implementation of RFID at Addenbrooke’s hospital.

A moving target

Dawkins described losing track of assets from key areas such as A&E, where devices can easily go off the grid – “from that point onwards, we have no idea where that device is going to”.

When devices are used with patients, they are transferred throughout the trust.

RFID can’t report who the device is attached to, but on a huge campus “a device will travel”. 40% of devices come back from another location to the one they were supplied to, and Addenbrooke’s supplies and delivers to just under 100 locations.

Wards also have a habit of “borrowing” from each other, Dawkins noted.

As well as proving a hindrance to utilisation, maintenance and even patient safety, CQC, MHRA and NHSLA regulations require trusts to accurately track devices and record where they have been in use.

This is where RFID can dramatically improve management of devices. Addenbrooke’s hospital originally implemented 900 tags, which went live in January 2012.

The system was integrated with the asset management database, which makes it “very efficient”.

The trust is now reporting 90-95% accuracy for locating all medical library devices.

Track and save

One of the most useful impacts of RIFD is being able to find and make the best use of existing assets, rather than having to purchase new devices when the old ones are lost.

This saves the trust money and time, and boosts efficiency.

Dawkins estimated that within the first year, overall savings are already “well over £100,000” in capital savings. “We’ve not had to buy more equipment, because we’ve been able to improve the utilisation of what we’ve already got.”

Using every available device is essential to meet burgeoning demand, particularly in A&E, where demand increased from an average of 222 units in April 2012, to 432 devices at the end of March 2013.

“We’ve had no real increase of medical devices to meet that demand, but we have been able to increase our utilisation of these devices,” he explained. Tagging is “by far” the cheaper option when compared to buying new devices, saving the hospital thousands.

Time = money

Dawkins said: “The NHS is [coming under] more and more financial restraints; one of the biggest issues is to make sure that equipment is being utilised and is in the right place at the right time.

“The NHS can’t afford to just keep putting equipment in. It’s not just buying more equipment, it’s all the associated costs that go with it; the maintenance, the technicians, and everything else.”

An RFID trial in four of the trust’s theatres is helping to locate devices required in theatre, where delays can be very costly.

He said: “With the four theatres we’re running the trial in, within a short period of time we’ve managed to track [items] going there and then disappearing. People are removing them and not putting them back in the right place.

“This has a knock-on effect; if they are then required for the next surgery, they’ve got to go around and find them. That delays theatres, which has a high cost attached. We’re showing where they are moving to and nurses and surgeons have been able to go ‘there’s one there, that’s where we need to go to find it’.”

No limitations

RFID systems “definitely” have applications wider than just asset management, he added: “There is no limitation to what you can tag.”

Known assets can be properly maintained, and allow any minor faults or issues to be sorted out very quickly. Device failures can also be more effectively understood when their previous use can be identified.

Dawkins said: “If it takes you two years to find a device, it’s going to be in a worse condition by the time you get your hands on it to do the repair.

“From a patient safety point of view, all the devices that we have out there are being serviced on a regular basis.

“It also allows us, when there is an incident, to backtrack the history of those devices, their locations and where they’ve been.”

Addenbrooke’s has expanded the scheme to just over 4,000 devices, with aims to bring this up to 10,000 by the end of the year.

Beds and air mattresses are now tagged, so the time at which a bed was cleaned or maintained can be checked and staff can see how many are available at any time through the system.

The trust is considering tagging hired devices, with huge cost savings available.

“It gives you an awful lot of auditing information, as well as data, to predict where you’re going to be in six months with device uses.

“It helps with identifying very quickly which areas’ clinical needs may have changed, and being able to react proactively to the demands of the service rather than suddenly finding yourself running out of devices. “I can easily predict what demand is going to be in a year’s time.”

Lost and found

The only challenges in implementing RFID was the original tagging – trying to find the assets you want to keep track of can be problematic, hence the need for the new system.

Dawkins said: “We’ve been working very closely with Harland Simon to develop the system and improve it, so there have been various upgrades. One of the upgrades was the interface with our asset management system, which makes life far more automated, so there’s less of a human input. The system is web-based, so it can be seen by anybody within the trust.

“It’s a very flexible and user-friendly system; you don’t need to have a degree in IT to work out what you’re doing.”

It was an intuitive solution for staff, with no need for training, and Dawkins said it was “definitely” something that will be seen more frequently across the NHS over the next few years.

Encouraging returns

Implementing tracking has also made staff “far more proactive” in returning devices once they have been used.

“Staff now understand that we can actually see in their cupboards and their drawers and they’re a lot more proactive in returning the items,” Dawkins said, but cautioned: “RFID is one of the very small sections in encouraging staff to return items.

“It helps us, but it’s not the key to ensuring staff do return [devices].

“It doesn’t cure all your problems, but it does help you with the huge amount of time and effort that you waste running around looking for devices.”

Other trusts are understandably curious – around 26 have already been around to see the system for themselves.

“It is something that’s growing, but it’s got to be a cost-effective way of doing it.

“There are some systems out there that are fantastic, but the infrastructure cost is huge. The system we are using is very low capital cost, with very big returns very quickly. But it does take a bit more effort, manpower, to get the system up and running.”