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The case study

Hull University Teaching Hospitals NHS Trust is a large acute NHS Trust situated in Kingston upon Hull and the East Riding of Yorkshire. The hospital receives approximately one million patients annually, which brings pressures on teams and budgets. An "All-In-One Solution" combining inventory management and patient care digital records with real-time location system (RTLS) tracking has been implemented by The Barcode Warehouse, Zebra Technologies, and Tagnos, to reduce the time and cost implications of locating equipment and sterile instruments across its clinical space. The successful implementation of this project has yielded significant benefits, including a remarkable 88,000 hours of time saved for staff, real-time visibility of all assets, and access to better data to make more informed purchasing decisions.

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Who are Hull University Teaching Hospitals NHS Trust?

Hull University Teaching Hospitals (HUTH) 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.

Improving patient safety and saving money using digital technologies has been a key focus for HUTH NHS Trust since they embarked on their Scan4Safety Journey.

More recently, the Scan4Safety team, led by Rachael Ellis, Scan4Safety Programme Director, has taken their innovative thinking a stage further, by combining the proven benefits of barcode scanning with the powers of RFID (radio frequency identification).

The first of a kind: NHS' Scan4Safety initiative

In 2016, the Department of Health initiated the Scan4Safety Programme, to establish how consistent scanning of barcodes, present on patient wristbands, equipment used for care, implantable devices, and locations, would improve efficiency and safety within the NHS.

We took the decision to follow the patient pathway on their entire journey, which was a significantly different project approach. This means we scan many parts of the patient's pathway including products used on patients whilst they are on our wards pre-surgery and post-surgery, when anaesthetic is administered, when the surgical procedure takes place, then when the patient is moved from theatres to recovery or to ICU (Intensive Care Unit) and finally when the patient is discharged. This provides us with data-rich insights to improve patient safety, reduce waste and expenditure, and improve overall hospital efficiencies. said Ellis.

Scanning barcodes in this way makes it possible for HUTH to gain complete clarity on what products have been used on which patients, when, where, and which staff were involved, and supports contact tracing. 
 

 

How does the solution work?

By scanning products when they arrive as new stock, HUTH captures key information from barcodes produced to GS1 standards, including manufacturer, product codes, batch numbers, and expiry, all of which ensures consistent and reliable stock management procedures and improves patient safety. An example of this would be alerting and preventing a clinician in real-time during a surgical procedure if a product is out of date, recalled or is an incompatible implant prior to use on a patient all from their handheld device, and at the exact time when the risk is highest – i.e. during the patient procedure.

How did The Barcode Warehouse, Zebra Technologies, Tagnos and Hull University Teaching Hospital decide on the best solution?

Building on the success of their Scan4Safety Programme, Rachael Ellis wanted to find a solution that would not only manage their Inventory & Supply Chain – but also look to solve more of the day-to-day operational challenges that a hospital faces than a standalone system would allow for. This is where the use of RFID (Radio Frequency Identification) came into focus, and in late 2021, having tendered the requirements, and evaluating several supplier responses, The Barcode Warehouse was selected as the best-fit supplier with the optimum value-for-money for HUTH.

Ellis commented “We will only adopt a new solution or embark on a change programme if we’re fully convinced that it will help us improve the care we give to our patients. This was in the front of my mind when we evaluated our approach of how we build on our GS1 Scan4Safety Programme. We wanted a simple, easy-to-use system which would clearly show in a matter of a few clicks, exactly where to find the missing asset. This level of transparency is incredibly powerful to our clinical colleagues.

Today, GS1-approved RFID labels are applied to all medical assets, equipment, beds, mattresses and sterile trays. As these care critical items pass under fixed location readers placed within ceilings, the labels emit a signal that provides instant visibility of their location around the entire hospital. This is shown in 2 easy to use ways, either on a Zebra TC52 handheld device or via the Tagnos software on the desktop application, significantly helping to reduce the time spent locating medical equipment, reducing the loss of equipment, offering improved insight into usage, and streamlining pre-planned maintenance. 
Simon Hemingway, Healthcare Director at The Barcode Warehouse commented “The primary benefit of our all-in-one solution is the real-time control, visibility and situational awareness offered across the patient pathway. By combining RFID technology – with the proven benefits of point-of-care barcode scanning – we’re empowering healthcare workers to deliver the highest level of patient care and best possible patient experience.

How has the solution positively impacted Hull University Teaching Hospitals NHS Trust?

Patient experience has been significantly improved, as the right equipment is in the right place, at the right time. Another great example for the use of RFID is sterile tray traceability. This enables HUTH to locate all sterile trays in under six minutes, reducing stress and driving clinical efficiency.

HUTH were recognised as being exemplary for their efforts with this RFID project by NHS England and were awarded the prestigious honour of producing the Global Digital Exemplar (GDE) blueprint on ‘How to implement RFID & RTLS from planning to performing’. This bluprint is used and shared with all of the NHS Trust as being the best practice with key project documentation being shared.

“Clinical staff can spend a lot of time looking for items, and in a highly focussed, specialist environment where time is of the essence such as the operating theatre, the ability to locate items accurately and swiftly, especially those needed immediately for patients, which is, unfortunately, a regular requirement. Being able to offer staff an insight into the location of their equipment, extremely quickly is not only in the patients' best interest, but it also helps our “ecosystem” for managing equipment and maintaining them regularly all of which benefits our patients and staff." Ellis commented.

"With Our Scan4Safety and RFID All-in-One Solution, the potential is simply wonderful. We have consolidated our stand-alone systems, into a single easy-to-use platform! Our new solution offers up even more data transparency, with users able to view dashboards, reports, and details about specific locations, specific products, specific store rooms, or even specific pieces of equipment all at the touch of a button – and with great data – we feel empowered to help our staff make excellent decisions!”


It’s estimated that around 2,500 staff spend approximately 56 minutes a week (equivalent to 14 minutes per shift) looking for items as they may have unknowingly been moved to another ward or taken out for routine maintenance. A recent time and motion study across eight theatre teams and a 4-hour period, a total of 3 hours and 48 minutes was taken up by eight theatre team members including clinicians searching for assets.

By implementing the RFID Solution, each search now takes less than 43 seconds on average. This saves about 35.2 hours per employee per year, equal to 88,000 hours across 2,500 staff, the equivalent of 2,346 weeks of time per year.

Sarah Atkins, Scan4Safety Specialist Nurse at Hull University Teaching Hospitals NHS Trust commented “Whilst I was a sister in theatres, during the very beginning of the Covid-19 pandemic. We ordered a glidescope, which had cost around £10,000, and this had been delivered in several boxes and we couldn’t locate the monitor of the glidescope. It took over 10 days to try and find the missing pieces of the equipment, on an ad-hoc basis. It was eventually found but for 10 days we had a brand-new piece of equipment which we couldn’t utilise on patients. After many phone calls we did find the equipment, we had to manually trace the serial numbers then we could search the actual wards and departments, taking valuable time and resource. The new system brings me such confidence of finding equipment quickly in real time!”

With the RFID Infrastructure now in place, HUTH are positioned to build on the use of this RFID Technology and can look at further innovation around the potentials including Live Bed Management and Patient Tracking for Improved Hospital flow in key departments such as the Emergency Department. 

 

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