Sandra Esquivel couldn’t believe how easy it was. The Pembroke Pines, Fla., mom was extremely apprehensive when she took her three-year-old, Katarina, to the emergency department at Memorial Hospital Miramar.

“She was screaming in pain from an earache and high fever. I was fearful about having to spend hours and hours waiting when my daughter was in pain,” said Esquivel, recalling a previous ordeal at another emergency department when she walked out, in tears and unseen by a physician, after a long, uncomfortable wait.

But this time was different. “This last experience was the best emergency room visit I’ve had in my life,” she said. “It was the shortest and fastest visit I’ve ever had, and it was actually pleasant.”

The stark contrast was all because of a little badge Esquivel was handed when she checked in. The badge used radio frequency identification, RFID, to monitor Esquivel and her daughter as they made their way through the emergency department.

“You’re used to people saying, ‘We’ll be right with you.’ But they said, ‘The doctor will see you in 20 minutes.’ And sure enough, the timing was exactly right,” said Esquivel. “They know where you are and where you need to be next, and how long you’ve been where you are. If you’ve been waiting, they know for how long.”

Automatic nurse assignment
Miramar, which opened in 2005 as a completely digital facility, uses combined infrared and radio frequency signaling technology from Versus Technology in Traverse City, Mich. with GE Healthcare Centricity Enterprise electronic medical records system (formerly IDX Carecast).

The system tracks patients and staff members, associating them with one another and their environment. When a nurse spends a certain number of minutes with a patient, the system automatically “assigns” that nurse to that patient on the computerized record—no need to note it manually in a chart or on a whiteboard.

The system logs who came in contact with each patient and for how long, eliminating the need for guesstimating and creating an exhaustive record for patient safety or contamination purposes.

The technology is expandable based on the creativity of its users, said Stephanie Bertschy, Versus’s marketing director. Call buttons on individual staff badges can be programmed to signal different functions in different environments.

When a member of the housekeeping staff presses his button in a patient room, it can mean that the room is ready for the next visitor. When a nurse presses her button in a prep room, it can mean that the patient is prepped for surgery.

In the recovery room, it can mean that the patient is ready for discharge. A transducer slapped on piece of mobile equipment means that wheelchair, gurney, or crash cart will never go missing again.

“It saves a lot of manual data entry on so many of these mundane tasks that are so vital,” Bertschy said. “It frees up the caregivers to really concentrate on listening to the patient and not feel as rushed to get through the process.”

Staffers love it, said Anna Airy, nurse manager for Miramar’s pediatric emergency department. “We used to use a white board, and we’d have tabs labeled lab, X-ray, etc., and we’d always have to be tagging what’s going on with a patient. Now, if the patient was sent to radiology and the doctor is ready to see that patient, he can look on the tracker and see that the patient is in X-ray. He can see the next patient in the meantime.”

According to Versus, patient treatment times at Memorial Healthcare System’s five hospitals, including Miramar, were reduced by as much as 37% after installing the tracking system. A process for reclaiming the badges after treatment increased cash collection by as much as 60%.

Lower elopement risk
Although RFID technology integrates well with electronic medical records, it can also be used independently. Since 2003, Mercy Hospital in Coon Rapids, Minn., has used RFID tracking in its emergency department for one purpose: keeping an extra eye on patients at risk of elopement.

Before the hospital installed RF Technologies’ tracking system, it would require security personnel to sit with any behavioral health patient determined to be at risk of walking out without treatment.

“They would sit eight to 12 hours waiting for a patient bed, and it was such a burden on our people,” said Deborah Macy, director of emergency, trauma, and critical care services for Allina Health System’s Mercy and Unity hospitals. “We looked around and said, ‘We’ve got to do something different.’”

Decisionmakers considered building a special wing, but that would have cost millions of dollars. Instead, they contacted RF Technologies in Brookfield, Wisc. and ultimately opted for a focused system that checks on the whereabouts of certain patients.

Elopement-risk patients are asked to wear a band equipped with a transducer. Staffers can track their whereabouts by checking a computer screen that shows the layout of the emergency department. “If a patient with a band gets too close to a door, alarms will go off,” Macy said. “Staff will go to that door, turn the alarm off, and escort the patient back to his room.” The
highest-risk patients are still assigned a one-on-one security watch as well.

In addition to freeing up security personnel, the technology has had some unexpected benefits. “We’ve found there is more privacy for our behavioral health population,” Macy said. “If a visitor comes in, they don’t see a security officer sitting outside the patient’s door. We’ve heightened our HIPAA compliance around protecting those people’s privacy.”

Patients are also less likely to become agitated by a simple band than they are by a guard. “When you put that band on, they’re not as scared,” she said. “They’re able to go to the bathroom, or whatever they need to do, without having to have a security officer on them.”