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 Hospital has been frequently recognized for providing a quality work environment, as well 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 RFIDMany hospitals are implementing one-off systems to achieve a specific goal, such as tracking assets and managing inventory. today as well as insights into how to move from one-off applications to an infrastructure approach to RFID. Application of RFID for counting surgical instruments which would improve safety, time and inventory control. Many hospitals are implementing one-off systems to achieve a specific aim, such as identifying patients or tracking one type of assets. While these system can achieve significant benefits, implementing RFID infrastructure that can be used to track patients, assets, surgical instruments that need to be decontaminated and other applications can profoundly improve a hospitals bottom line. I propose we take an infrastructure approach to RFID and implement for applications of patient identification, tracking surgical instruments and asset management. I PROPOSE THAT WE IMPLEMENT RFID as a trial base in our surgical department for 12 Months. I propose that to increase patient safety, reduce cost and enhance the overall patient care we implement RFID technology use in our surgical unit. I propose that we plan for implementation in our surgical department since it enhance the most benefits

1. Take your time, and formulate a strategy. "The challenge most organizations are facing is choosing a short-term or long-term plan," says Jeff Richards, of VeriSign

Radio Frequency Identification (RFID) is a subset of a group of technologies, often referred to as automatic identification, that are used to help machines identify objects, and which include bar codes and smart cards. RFID refers to the subset of automatic identification that uses radio waves to automatically identify bulk or individual itemsAn RFID system consists of three components: a tag (or multiple tags), a reader or interrogator and the necessary supporting infrastructure (both hardware and software). An RFID reader, or interrogator, is a device to communicate with the RFID tag. It broadcasts a radio signal, which is received by the tag. The tag then transmits its information back to the reader. Readers can either be portable handheld terminals or fixed devices that can be positioned in strategic places such as loading bays in shipping and receiving facilities, or the doors in transport trucks.RFID tags, also known as transponders, are usually small pieces of material, typically comprising three components: an antenna, a microchip unit containing memory storage and an encapsulating material. Tags can be either read-only or read-write tags. These terms refer to whether or not the information stored on the tag can be changed or erased. A Read-only Tag is a form of RFID tag that has an identification code (more specifically, an Electronic Product Code) recorded at the time of manufacture or when the tag is allocated to an object. Once programmed, the data on the tag cannot be modified or appended but it may be read multiple times. A Read-Write Tag is a tag that can have its memory changed, or written to, many times. which makes them effective for identifying and locating people or items that move frequently and over large distance indoors. Passive-RFID systems are effective for uniquely identifying things and people in controlled settings. The most important component is the RFID-specific software that translates the raw data from the tag into information about the goods and orders that are represented by the tags. This information can then be fed into other databases and applications (e.g., inventory management) for further processing.Middleware

Middleware is a generic term used to describe software that resides between the RFID reader and enterprise applications. It's a critical component of any RFID system, because the middleware takes the raw data from the reader—a reader might read the same tag 100 times per second—filters it and passes on the useful event data to back-end systems. Middleware plays a key role in getting the right information to the right application at the right time. Middleware is the interface needed between the interrogator and the existing company databases and information management software.

Patient idPatient Care and Management (providing a means to rapidly and accurately verify information concerning patient allergies, prescription history, etc. to prevent surgical errors). Clinicians achieve greater efficiencies, patients realize a better overall surgical experience, and waiting loved ones are engaged with relevant surgical status information. Paperwork is time consuming, patient transfers are often poorly coordinated, and busy providers juggling multiple responsibilities do not always communicate well with each other or with the patient and their family. These system inefficiencies create opportunities for medical errors and safety gaps, potentially harming a patient. The system reduces the time nurses spend entering data about the patient, leaving them more time to provide care. The system also reduces misidentification of patients and allows for more accurate.Among the fears are a mistake such as the doctor operating on the wrong leg or performing the wrong procedure. Although such mistakes are rare in the thousands of operations that take place in the United States each day, they do happen. Government estimates indicate that five to eight wrong-site surgeries occur each month. New RFID technology approved by the Food and Drug Administration last November is starting to help some patients relax 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. The new RFID verification system, called Surgichip, is being sold by AMTSystems as part of its suite of PatientSafe patient-safety systems, which also include medication-verification products. Surgichip is an RFID tag that gets encoded by medical staff with the patient's name and other identification such as date of birth and medical-record number, as well as information about the type and site of procedure and other surgical instructions. The tags also are HIPAA-compliant and meet national patient safety standards of the Joint Commission on Accreditation of Healthcare Organizations, says Todd Stewart, AMTSystems' VP of business development. The 2-inch-by-1-inch nonallergenic label gets stuck to a patient's skin near the surgical site, such as a left knee, before the operation. Before surgery begins, the tags are read by operating-room staff with handheld readers to confirm the patient and procedure. "This is one more way for us to be super-sure" that the correct patient is about to undergo the right surgery, says Dr. Frank Cook, an orthopedic surgeon at The Palm Beach Orthopedic Institution. During the first year use of Surgichip, the cost of the system comes to about $6 to $9 per surgery, including the costs of software installation, says Stewart. However, by the second year, the cost drops to about $3 per procedure. Huntsville Hospital decided on an RFID-enabled system mainly because it wanted to improve efficiencies and communications that would directly improve surgical start times, Cathcart says. "The surgery department had identified several components to the patient throughput and staff workflow that often creates a bottleneck throughout the continuum of care," she says. The hospital specifically wanted to improve communication among staff via real-time updates of patients' status, provide caregivers with visual cues via an LCD monitor of scheduled procedures and their status, as well as provide a mechanism that would correctly identify patients being prepped for surgery. "JCAHO [the Joint Committee on Accreditation of Healthcare Organizations] is reporting five to six wrong site surgeries per month," said Debbie Murphy. The product could provide a useful means for health care organizations to avoid surgical errors and assuage patient concerns, she said. According to Stanchfield, end-to-end setup of the standalone SurgiChip system will cost health care organizations anywhere from $25,000 to about $75,000, including software, hardware, installation, labels and staff training.

identify and manage the inventoryUsing RFID technology, WaveMark CIMS collects, reports, and manages usage and inventory data in real time. This information allows hospital staff to accurately manage supply levels, easily monitor expired products, and efficiently track product usage. With WaveMark CIMS, clinical environments can improve operating efficiency and reduce costs. Having the right products, for the right doctors, at the right time, is increasingly complicated and challenging, potentially trade-off patient safety, staff job satisfaction and overall productivity. By monitoring the status and whereabouts of critical medical equipment used in the operating rooms, doctors and nurses can ensure that equipment and rooms are ready for surgical procedures. Many hospitals are using RFID to track high-value assets within their facility so that care givers spend less time looking for assets, utilization is improved and routine maintenance can be scheduled and managed automatically. By automating the storage, tracking, utilization, and billing of clinical resources through RFID, healthcare providers realize enhanced care quality, increased productivity, accurate billing, and significant inventory cost savings.

Surgical equipmentThey can help prevent sponges and other materials from being left inside a patient during surgery. According to a recent study at the Stanford University in California, involving eight patients who underwent abdominal and pelvic surgery, RFID-tagged or untagged sponges were placed by a surgeon. Another surgeon, who did not know which of the sponges contained the tags, ran a wand over the patients' abdomen to look for the sponges. The wand could identify all the tagged sponges and never reported the presence of a tagged sponge when there was none. It took just three second for the tagged sponge to be identified. This manual process is time consuming and subject to human error. When there is a discrepancy in the counts, at most hospitals, an X-ray is required before leaving the operating room. Additionally, many hospitals call for X-rays for high risk cases such as emergencies, transplants and surgeries greater than five hours in order to assure no retained objects. Application of RFID for counting surgical instruments which would improve safety, time and inventory control. Why not put rfid tags into all the instruments and sponges. Then after surgery, run a scanner over the patients body - anything left inside should show up quickly. According to ClearCount, recent studies have estimated that cases of retained foreign bodies occur between 1 out of every 100 to 1 out of every 5,000 surgical procedures, and studies have shown that two-thirds of all retained foreign bodies are surgical sponges.

SmartSponge, surgical teams will be able to scan the patient with an RFID interrogator in the form of a wand during postoperative safety checks to find any sponges mistakenly left behind. The technology could supplant time-consuming manual counts done by at least two nurses several times during the course of a surgery, or costly and time-consuming X-rays that can detect threads sewn into the sponges.

This seems like a really clever use of RFID. The idea is to embed chips in surgical equipment, and then wave a detector over surgical patients to make sure the doctors didn't accidentally leave something inside the body.Another 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. Thisrequired an additional operation, causing unnecessary worry to both doctors as well as patients.

PrivacyMany RFID tags include a built-in 'kill' function. When provided with the correct pass-code, a tag can be either reprogrammed or told to 'self destruct', rendering it useless

CostDevices and enterprise systems need to integrate with your RFID software. Most companies will need to hire a systems integrator to install the readers, determine the right placement of tags for products and make

sure that they are feeding data to the middleware in the right format. Companies will also need to invest in training for their employees, particularly engineering staff who will manage readers in manufacturing and warehouse facilities, and IT staff who will work on the systems that manage RFID data. The cost of middleware varies from vendor to vendor and is usually based on the number of locations where it will be installed, the complexity of the application and many other factors. Forrester Research put the cost of middleware at $183,000 for a $12 billion manufacturer looking to meet the RFID tagging requirements of a major retailer.

Companies will also need to purchase servers to run middleware within a warehouse, distribution center or production facility. That means that companies will need to invest in enterprise applications that can make use of RFID data. Warehouse management software providers, such as Manhattan Associates and RedPrairie, have upgraded their applications to manage the unique serial numbers in RFID tags. Enterprise resource planning software providers, such as SAP and Oracle, are also working to upgrade their applications. It's likely that software will evolve as RFID adoption spreads and companies learn how to use RFID data to improve their operations. The cost of these applications vary depending on the number of "seats"—how many users will access the application—the number of locations ??? and other factorsActive tags have a read range of up to 300 feet (100 meters) and can be read reliably because they broadcast a signal to the reader (some systems can be affected by rain). They generally cost from $10 to $50, depending on the amount of memory. OrderING a radio frequency identification system involves a lot more than purchasing the right tags and installing the right readers (see Basics of RFID Technology). To get business value from the all of the information collected, companies will need middleware to filter the data. They may need to upgrade enterprise applications and integrate it with RFID middleware. Each component will have up-front costs and some unexpected costs.

It's not possible to provide a list of every element that every company will need and the cost of those systems, but we'll explain each of the major components, provide some guidelines on costs and point out where there might be some hidden costs. Keep in mind that every company's needs—and every application—are different, so costs will vary widely from implementation to implementation.

UHF readers range in price from $500 to $3,000, depending on their functionality.The cost of middleware varies from vendor to vendor and is usually based on the number of locations where it will be installed, the complexity of the application and many other factors. Forrester Research put the cost of middleware at $183,000 for a $12 billion manufacturer looking to meet the RFID tagging requirements of a major retailer. . RFID tag prices have fallen in recent years, but they're still pricey. Consider buying tags in volume to negotiate a better price. If your RFID infrastructure is evolving, consider teaming up with other companies in your supply chain to buy together in volume. 6. Keep it simple. An RFID system will require you to collect more information about your enterprise, but don't get carried away. Don't feel like you have to read a tag 10 times per second, just because you canThere needs to be bridge software, or middleware, incorporated into the overall architecture to prevent the amount of data that hits the system at the same time from overwhelming it. So RFID requires data filtering and data-flow management, to turn parallel, two-way data into the serialized data that a legacy system can handle. These functions can be also partially handled by the printer/encoders and readers.

Another consideration—the need for more bandwidth in the network—depends on how much RFID increases the overall amount of data flow within the network. If existing networks can handle the additional traffic with the speed required by the applications, they should not necessarily need to be upgraded or be any more complex

At this time, no significant barriers have emerged that would prevent implementing and using RFID technology in a variety of applications.