The case study
Who are Hull University Teaching Hospitals NHS Trust?
Hull University Teaching Hospitals NHS Trust, ‘The Trust’, is a large hospital with two main campuses spanning 120,000 square metres of clinical space. It covers all major areas of healthcare and is also a University Teaching Hospital. Its annual revenue is around £720 million.
Close to a million people attend the hospital each year for visits ranging from accident and emergency (A&E) and outpatient clinics to longer ward stays. Around 8,000 clinical staff provide services, with secondary care delivered to a catchment area of 600,000 people in and around the Hull and East Riding of Yorkshire area.
The first of a kind: NHS' Scan4Safety initiative
The NHS’ Scan4Safety initiative is the first of its kind in healthcare. It provides guidance to NHS trusts to deploy the GS1 standard to uniquely identify every person, every product and every place in healthcare. Pilots of the project ran across six “demonstrator” Trusts of the UK. Results showed the key benefits included enhancements to care and safety by, for example, improving implant traceability and the real-time locationing of critical equipment. Projected cost savings across the NHS are estimated to be £1 billion over seven years.1
The Trust initially planned to pilot RFID as part of the Scan4Safety programme in its Intensive Care Unit (ICU). Patients in ICU can be monitored and supported by a large number of machines such as ventilators, blood pressure monitors and electrocardiographs. If the patient needs to be moved, the equipment travels with them. It’s therefore hard to track its location as it moves around to many wards and departments.
“It’s clearly vital we have the right equipment available for patient use in the ICU so it made sense to look at this unit first. Also, a large deployment of RFID within the Scan4Safety implementation, across an entire hospital on this size and scale, had yet to take place in the UK. We wanted to make sure we could validate the technology in a confined area and have the evidence to see if it could be scaled across our two main sites within reasonable budgetary constraints,” said Ellis.
How did The Barcode Warehouse, Zebra Technologies, Tagnos and Hull University Teaching Hospital decide on the best solution?
A small number of vendors, deemed capable of supporting such a large deployment, were invited to tender through a compliant NHS procurement process. But if one word could sum up what The Trust was looking for it was ‘flexibility’. It needed the technology to be in place for many years and knew that, over time, the scope of what it wanted to track and trace might change.
As part of its discovery process, the project team spoke to Zebra customers from other sectors, including retail and logistics, who typically deploy RTLS solutions across numerous sites and to track many thousands of items. These discussions increased confidence in an RFID-led solution.
“We quickly realised that asset tracking can cover pretty much anything, and we looked for the solution to seamlessly track a much wider range of assets than we initially anticipated,” said Ellis. “After speaking to vendors, it was Zebra who were most open to accommodating our changing needs, with its cloud-based Zebra MotionWorks™ healthcare medical equipment tracking solution. As far as it was concerned, the solution was a blank canvas. This willingness to listen to our requirements and be versatile was the primary reason we went with Zebra, along with its customer references and its ecosystem of technology and support.”
Building Europe's largest RFID RTLS solution
The Trust worked closely with Zebra, Tagnos and The Barcode Warehouse to specify its solution. It looked at how many items needed to be tracked, what types of items they were, whether they needed to withstand hot or cold temperatures, the type of materials the labels would be applied to, the number of users on the system and how to zone the hospital to make it intuitive for staff to use the software. It also evaluated whether to use passive or active RFID technology and Wi-Fi versus a networked solution to connect RFID readers. The Trust opted to use passive RFID technology to label its items. It cites the primary driver behind its decision as lower cost and easier maintenance compared to an active RFID solution, where label batteries need to be changed more frequently.
Passive RFID labels need to pass under readers, so The Trust installed over 650 FX7500 fixed RFID readers plus over 400 antennas across its campuses to provide comprehensive tracking coverage. The Trust determined that each patient entrance and exit would be required to be visible. Readers are networked using Power over Ethernet (PoE) cables to mitigate future changing Wi-Fi standards and technology which might mean the readers would need to be updated to work with any new wireless network standard. (This required over 6.2 miles of cabling to make all of the readers connect).
How has the solution positively impacted Hull University Teaching Hospitals NHS Trust?
The project is delivering a wide range of benefits across three key areas: day-to-day operations, procurement and patient care.
In terms of daily workflows, clinicians now spend much less time looking for equipment. They can track items to wards and use the wands, which are waved around, to quickly identify what they’re looking for.
It’s estimated that around 2,500 staff spend approximately 56 minutes a week (equivalent to 14 minutes per shift) looking for items. Each search now takes less than 4 minutes on average. This saves about 35 hours per employee per year, equal to 87,500 hours across 2,500 staff, the equivalent of 2,187 weeks of time.
Clearly, this is a massive gain and central to the projection that return on investment will be achieved in around 24 months. The Trust also aims to eradicate global emails sent to all staff to request they search for items. The Trust estimated that, of the 5,500 people who receive the global email, 50% open it (2,750 people). If each took 3 minutes to read this email and determine next steps, this would be the equivalent of 8,250 minutes, or 137.5 hours, of wasted time per email.
With procurement, The Trust can use real-time data to understand exactly what stock it has and where. It can also buy what’s needed without overcompensating and, as it knows which items are most commonly used, it can buy more of these. Further cost savings will come by better managing the return of rental assets. For instance, The Trust may hire expensive items such as bariatric beds and chairs for specific patients. Sometimes, the beds are moved and misplaced.
For example, surgical trays are sometimes misplaced and, if not found, operations may be cancelled. Now the tray can be searched for on a desktop PC or a medical grade tablet and the wand used to locate it in storerooms or theatre corridors. Even if it is in the wrong place, it will be found. This is a huge benefit to patients, as their operation will not be cancelled due to missing sterile trays and instruments. Furthermore, mitigating risk is key as well. For example, should a heart surgery instrument tray be dropped, another one can be located in seconds, ensuring minimal delay to vital surgery.