During the past decade, patient safety and high-quality patient care have increasingly become the focus

for healthcare organizations across the country. safety is an area of great concern for consumers and health care providers. Technology is a strategy to enhance patient safety. RFID technology has great potential in healthcare to significantly reduce cost, and improve patient safety. Baptist ospital has been frequently recognized for providing a quality !or" environment, as !ell as demonstrating a commitment to quality care by implementing processes, procedures, and technology to reduce medical errors, eliminates inefficiencies and errors, and improves quality patient care and safety Taking an Infrastructure Approach to RFID #any hospitals are implementing one-off systems to achieve a specific goal, such as trac"ing assets and managing inventory. today as !ell as insights into ho! to move from one-off applications to an infrastructure approach to RFID. $pplication of RFID for counting surgical instruments !hich !ould improve safety, time and inventory control. #any hospitals are implementing one-off systems to achieve a specific aim, such as identifying patients or trac"ing one type of assets. %hile these system can achieve significant benefits, implementing RFID infrastructure that can be used to trac" patients, assets, surgical instruments that need to be decontaminated and other applications can profoundly improve a hospitals bottom line. I propose !e ta"e an infrastructure approach to RFID and implement for applications of patient identification, trac"ing surgical instruments and asset management. I &R'&'() * $* %) I#&+)#),* RFID as a trial base in our surgical department for -. #onths. I propose that to increase patient safety, reduce cost and enhance the overall patient care !e implement RFID technology use in our surgical unit. I propose that !e plan for implementation in our surgical department since it

enhance the most benefits

-. *a"e your time, and formulate a strategy. /*he challenge most organizations are facing is choosing a short-term or long-term plan,/ says 0eff Richards, of 1eri(ign

Radio Frequency Identification 2RFID3 is a subset of a group of technologies, often referred to as automatic identification, that are used to help machines identify ob4ects, and !hich include bar codes and smart cards. RFID refers to the subset of automatic identification that uses radio !aves to automatically identify bul" or individual items $n RFID system consists of three components5 a tag 2or multiple tags3, a reader or interrogator and the necessary supporting infrastructure 2both hard!are and soft!are3. $n RFID reader, or interrogator, is a device to communicate !ith the RFID tag. It broadcasts a radio signal, !hich is received by the tag. *he tag then transmits its information bac" to the reader. Readers can either be portable handheld terminals or fi6ed devices that can be positioned in strategic places such as loading bays in shipping and receiving facilities, or the doors in transport truc"s. RFID tags, also "no!n as transponders, are usually small pieces of material, typically comprising three components5 an antenna, a microchip unit containing memory storage and an encapsulating material. *ags can be either read-only or read-!rite tags. *hese terms refer to !hether or not the information stored on the tag can be changed or erased. $ Read-only *ag is a form of RFID tag that has an identification code 2more specifically, an )lectronic &roduct 7ode3 recorded at the time of manufacture or !hen the tag is allocated to an ob4ect. 'nce programmed, the data on the tag cannot be modified or appended but it may be read multiple times. $ Read-%rite *ag is a tag that can have its memory changed, or !ritten to, many times. !hich ma"es them effective for identifying and locating people or items that move frequently and over large distance indoors. &assive-RFID systems are effective for uniquely identifying things and people in controlled settings. *he most important component is the RFID-specific soft!are that translates the ra! data from the tag into information about the goods and orders that are represented by the tags. *his information can then be fed into other databases and applications 2e.g., inventory management3 for further processing. #iddle!are

#iddle!are is a generic term used to describe soft!are that resides bet!een the RFID reader and enterprise applications. It8s a critical component of any RFID system, because the middle!are ta"es the ra! data from the reader9a reader might read the same tag -:: times per second9filters it and passes on the useful event data to bac"-end systems. #iddle!are plays a "ey role in getting the right information to the right application at the right time. #iddle!are is the interface needed bet!een the interrogator and the e6isting company databases and information management soft!are.

&atient id &atient 7are and #anagement 2providing a means to rapidly and accurately verify information concerning patient allergies, prescription history, etc. to prevent surgical errors3. 7linicians achieve greater efficiencies, patients realize a better overall surgical e6perience, and !aiting loved ones are engaged !ith relevant surgical status information. &aper!or" is time consuming, patient transfers are often poorly coordinated, and busy providers 4uggling multiple responsibilities do not al!ays communicate !ell !ith each other or !ith the patient and their family. *hese system inefficiencies create opportunities for medical errors and safety gaps, potentially harming a patient. *he system reduces the time nurses spend entering data about the patient, leaving them more time to provide care. *he system also reduces misidentification of patients and allo!s for more accurate.$mong the fears are a mista"e such as the doctor operating on the !rong leg or performing the !rong procedure. $lthough such mista"es are rare in the thousands of operations that ta"e place in the ;nited (tates each day, they do happen. <overnment estimates indicate that five to eight !rong-site surgeries occur each month. ,e! RFID technology approved by the Food and Drug

$dministration last ,ovember is starting to help some patients rela6 and doctors and surgical staff to be more secure that the correct operation is about to be performed on the right person and on the correct place on the body. *he ne! RFID verification system, called (urgichip, is being sold by $#*(ystems as part of its suite of &atient(afe patient-safety systems, !hich also include medication-verification products. (urgichip is an RFID tag that gets encoded by medical staff !ith the patient8s name and other identification such as date of birth and medical-record number, as !ell as information about the type and
site of procedure and other surgical instructions. *he tags also are I&$$-compliant and meet national patient safety standards of the 0oint 7ommission on $ccreditation of ealthcare 'rganizations, says *odd (te!art, $#*(ystems8 1& of business development. *he .-inch-by---inch nonallergenic label gets stuc" to a patient8s s"in near the surgical site, such as a left "nee, before the operation. Before surgery begins, the tags are read by operating-room staff !ith handheld readers to confirm the patient and procedure. /*his is one more !ay for us to be super-sure/ that the correct patient is about to undergo the right surgery, says Dr. Fran" 7oo", an orthopedic surgeon at *he &alm Beach 'rthopedic Institution. During the first year use of (urgichip, the cost of the system comes to about => to =? per surgery, including the costs of soft!are installation, says (te!art. o!ever, by the second year, the cost drops to about =@ per procedure. untsville ospital decided on an RFID-enabled system mainly because it !anted to improve efficiencies and communications that !ould directly improve surgical start times, 7athcart says. /*he surgery department had identified several components to the patient throughput and staff !or"flo! that often creates a bottlenec" throughout the continuum of care,/ she says. *he hospital specifically !anted to improve communication among staff via real-time updates of patients8 status, provide caregivers !ith visual cues via an +7D monitor of scheduled procedures and their status, as !ell as provide a mechanism that !ould correctly identify patients being prepped for surgery. /07$ ' Athe 0oint 7ommittee on $ccreditation of ealthcare 'rganizationsB is reporting five to si6 !rong site surgeries per month,/ said Debbie #urphy. *he product could provide a useful means for health care organizations to avoid surgical errors and assuage patient concerns, she said. $ccording to (tanchfield, end-to-end setup of the standalone (urgi7hip system !ill cost health care organizations any!here from =.C,::: to about =DC,:::, including soft!are, hard!are, installation, labels and staff training.

identify and manage the inventory ;sing RFID technology, %ave#ar" 7I#( collects, reports, and manages usage and inventory data in real time. *his information allo!s hospital staff to accurately manage supply levels, easily monitor e6pired products, and efficiently trac" product usage. %ith %ave#ar" 7I#(, clinical environments can improve operating efficiency and reduce costs. aving the right products, for the right doctors, at the right time, is increasingly complicated and challenging, potentially trade-off patient safety, staff 4ob satisfaction and overall productivity. By monitoring the status and !hereabouts of critical medical equipment used in the operating rooms, doctors and nurses can ensure that equipment and rooms are ready for surgical procedures. #any hospitals are using RFID to trac" high-value assets !ithin their facility so that care givers spend less time loo"ing for assets, utilization is improved and routine maintenance can be scheduled and managed automatically. By automating the storage, trac"ing, utilization, and billing of clinical resources through RFID, healthcare providers realize enhanced care quality, increased productivity, accurate billing, and significant inventory cost savings. (urgical equipment *hey can help prevent sponges and other materials from being left inside a patient during surgery. $ccording to a recent study at the (tanford ;niversity in 7alifornia, involving eight patients !ho under!ent abdominal and pelvic surgery, RFID-tagged or untagged sponges !ere placed by a surgeon. $nother surgeon, !ho did not "no! !hich of the sponges contained the tags, ran a !and over the patients8 abdomen to loo" for the sponges. *he !and could identify all the tagged sponges and never reported the presence of a tagged sponge !hen there !as none. It too" 4ust three second for the tagged sponge to be identified. *his manual process is time consuming and sub4ect to human error. %hen there is a discrepancy in the counts, at most hospitals, an E-ray is required before leaving the operating room. $dditionally, many hospitals call for E-rays for high ris" cases such as emergencies, transplants and surgeries greater than five hours in order to assure no retained ob4ects. $pplication of RFID for counting surgical instruments !hich !ould improve safety, time and inventory control. %hy not put rfid tags into all the instruments and sponges. *hen after surgery, run a scanner over the patients body - anything left inside should sho! up quic"ly. $ccording to 7lear7ount, recent studies have estimated that cases of retained foreign bodies occur bet!een - out of every -:: to - out of every C,::: surgical procedures, and studies have sho!n that t!o-thirds of all retained foreign bodies are surgical sponges. (mart(ponge, surgical teams !ill be able to scan the patient !ith an RFID interrogator in the form of a !and during postoperative safety chec"s to find any sponges mista"enly left behind. *he technology could supplant time-consuming manual counts done by at least t!o nurses several times during the course of a surgery, or costly and time-consuming E-rays that can detect threads se!n into the sponges. *his seems li"e a really clever use of RFID. *he idea is to embed chips in surgical equipment, and then !ave a detector over surgical patients to ma"e sure the doctors didn8t accidentally leave something inside the body. $nother advantage is that the technology may help minimize staff time in the operating room not dedicated to patient care through use of RFID for instrument counting before and after procedures.
Many of them are not discovered until years later. Infections around the sponge cause them to be detected earlier. This required an additional operation, causing unnecessary worry to both doctors as well as patients.

Privacy #any RFID tags include a built-in 8"ill8 function. %hen provided !ith the correct pass-code, a tag can be either reprogrammed or told to 8self destruct8, rendering it useless 7ost Devices and enterprise systems need to integrate !ith your RFID soft!are. #ost companies !ill need to hire a systems integrator to install the readers, determine the right placement of tags for products and ma"e

sure that they are feeding data to the middle!are in the right format. 7ompanies !ill also need to invest in training for their employees, particularly engineering staff !ho !ill manage readers in manufacturing and !arehouse facilities, and I* staff !ho !ill !or" on the systems that manage RFID data. *he cost of middle!are varies from vendor to vendor and is usually based on the number of locations !here it !ill be installed, the comple6ity of the application and many other factors. Forrester Research put the cost of middle!are at =-F@,::: for a =-. billion manufacturer loo"ing to meet the RFID tagging requirements of a ma4or retailer. 7ompanies !ill also need to purchase servers to run middle!are !ithin a !arehouse, distribution center or production facility. *hat means that companies !ill need to invest in enterprise applications that can ma"e use of RFID data. %arehouse management soft!are providers, such as #anhattan $ssociates and Red&rairie, have upgraded their applications to manage the unique serial numbers in RFID tags. )nterprise resource planning soft!are providers, such as ($& and 'racle, are also !or"ing to upgrade their applications. It8s li"ely that soft!are !ill evolve as RFID adoption spreads and companies learn ho! to use RFID data to improve their operations. *he cost of these applications vary depending on the number of /seats/9ho! many users !ill access the application9the number of locations GGG and other factors $ctive tags have a read range of up to @:: feet 2-:: meters3 and can be read reliably because they broadcast a signal to the reader 2some systems can be affected by rain3. *hey generally cost from =-: to =C:, depending on the amount of memory. 'rderI,< a radio frequency identification system involves a lot more than purchasing the right tags and installing the right readers 2see Basics of RFID *echnology3. *o get business value from the all of the information collected, companies !ill need middle!are to filter the data. *hey may need to upgrade enterprise applications and integrate it !ith RFID middle!are. )ach component !ill have up-front costs and some une6pected costs. It8s not possible to provide a list of every element that every company !ill need and the cost of those systems, but !e8ll e6plain each of the ma4or components, provide some guidelines on costs and point out !here there might be some hidden costs. Heep in mind that every company8s needs9and every application 9are different, so costs !ill vary !idely from implementation to implementation. ; F readers range in price from =C:: to =@,:::, depending on their functionality. *he cost of middle!are varies from vendor to vendor and is usually based on the number of locations !here it !ill be installed, the comple6ity of the application and many other factors. Forrester Research put the cost of middle!are at =-F@,::: for a =-. billion manufacturer loo"ing to meet the RFID tagging requirements of a ma4or retailer. . RFID tag prices have fallen in recent years, but they8re still pricey. 7onsider buying tags in volume to negotiate a better price. If your RFID infrastructure is evolving, consider teaming up !ith other companies in your supply chain to buy together in volume. >. Heep it simple. $n RFID system !ill require you to collect more information about your enterprise, but don8t get carried a!ay. Don8t feel li"e you have to read a tag -: times per second, 4ust because you can *here needs to be bridge soft!are, or middle!are, incorporated into the overall architecture to prevent the amount of data that hits the system at the same time from over!helming it. (o RFID requires data filtering and data-flo! management, to turn parallel, t!o-!ay data into the serialized data that a legacy system can handle. *hese functions can be also partially handled by the printerIencoders and readers. $nother consideration9the need for more band!idth in the net!or"9depends on ho! much RFID increases the overall amount of data flo! !ithin the net!or". If e6isting net!or"s can handle the additional traffic !ith the speed required by the applications, they should not necessarily need to be upgraded or be any more comple6 $t this time, no significant barriers have emerged that !ould prevent implementing and using RFID technology in a variety of applications.