It’s not exactly a secret in healthcare that clean hands are important.
From the minute any clinician steps into their professional environment, they know the importance of hand hygiene. Yet, for some reason, gaps in hygiene compliance remain a problem at many medical facilities across the country, with the Centers for Disease Control and Prevention (CDC) reporting that 90,000 die in the U.S. each year from hospital-acquired infections (HAIs). For this reason, Shannon Medical Center, a 400-bed hospital in San Angelo, Texas, implemented an automated radio-frequency identification (RFID)-based hand-hygiene monitoring system.
“The environment of a hospital is so busy that all of the staff have difficulty thinking about doing hand hygiene in and out of the room, simply because there are so many things they have to deal with on a second-to-second basis. So sometimes it’s forgotten. There’s no excuse, but that’s the way it is at nearly every hospital in the country,” explains Gerald Creel, director of the emergency department at Shannon.
The same CDC report found that HAIs add $5 billion per year in additional healthcare costs in the U.S. Add in the fact the Centers for Medicare & Medicaid Services (CMS) has created a healthcare reform-mandated program that will penalize patient care organizations for hospital-acquired infections, and the implementation of this RFID system made sense for Creel and company.
RFID-equipped hand dispenser tracks clean hands. Photo: Shannon Medical Center
Shannon teamed with Proventix Systems (Birmingham, Ala.), a vendor that deals specifically with RFID-related hand hygiene. The system uses the RFID network on both an alcohol foam rub and a soap dispensing units, while caregivers wear RFID tags. The system can determine whether or not the practitioner used the system upon entering and exiting the room.
When they do use it, the RFID tag, which communicates wirelessly with a network of what Creel calls “communication units,” records the dispensing. The system links each caregiver with the amount of times they have, or have not, used the system.
“[The RFID technology] provides a hands-free mechanism and makes it a little mindless for the individual as they enter and exit a room,” Creel says. “The dispensers we use are automatic, so you don’t have to push on a lever to dispense the soap or the alcohol.”
The fact that the system could help Shannon use data to assess and evaluate the caregivers’ workflow also appealed to leaders at Shannon. “If we have a patient that complains, ‘No one has seen me for eight hours.’ We can go into the system, and look, and it documents the second someone walks into the room and how long they were there. It helps us from a quality side.”
In addition, the system has LED screens that displays clinical, personal, and educational messages with each dispense. It also includes front-page news, and updates on the weather, sports, stock market, and healthcare education. This is for positive reinforcement purposes, says Creel.
Shannon underwent a six-month pilot project of the system on the medical floors. Before the system was installed, Creel says, Shannon was averaging 35 dispenses per room per day. On the first day the system was installed that number jumped to 90. It would only get better from there.
Over the six-month period of the pilot project, HAIs dropped by 62 percent. The hospital saw an 87.5 percent increase in soap dispensing, a 223.3 percent increase in sanitizer dispensing, and a 188.4-percent increase in total hand hygiene solution dispensing. Overall, Creel says this improvement equated to 96.8 days length of stay avoided, as well as significant cost savings.
In terms of challenges, Creel says the hospital had to overcome the stigma that the system was a kind of “Big Brother,” with the administration watching the practitioners’ every move. With the help from physician champion Ty Hughston, M.D., and Marilyn Pritchett, unit manager of the medical floor, Shannon was able to get past this and get practitioners to actively participate.
Going forward, Creel says Shannon's leaders are looking to expand the system to two surgical units and a skilled nursing unit. While the return on investment is “soft money,” meaning it’s money you are not being penalized rather than gaining, he feels the system is worth it as it’s “good for the patients and good for the hospital.”