Everything needs to run smoothly at an accident and emergency department. Life-or-death decisions and prioritisations are made all day, every day. There is no time to waste going from room to room in search of equipment or patients. In the project TagOn, RISE has worked with hospital staff and the private-sector to develop a positioning system to reduce wasted time.
“We attempted to identify the problems facing staff and then understand and analyse the flow,” explains Fredrik Nilsask, project manager at RISE.
Using small tags attached to equipment and armbands on patients and staff, it is possible to obtain an accurate picture of flows within the A&E. Positioning, data processing and a user-friendly interface allow staff to track things such as how long a patient spends in the waiting room, when a trolley needs cleaning or how many kilometres a piece of equipment has been transported during a shift, all in real time.
“In terms of the time spent looking for the correct equipment, our study has indicated that this can be reduced by two thirds,” says Fredrik Nilsask.
The pilot study was carried out at the A&E Department of Skåne University Hospital (SUS) in Lund. The time saved thanks to the positioning system could well be as much as 5,000 working hours; however, it is not only equipment that can be mislaid – patients and colleagues also need to be localised. The pilot study reduced time spent looking for individuals from 30 to 20 minutes per shift.
“When the A&E Department is under pressure, patients are often moved between rooms to facilitate the prioritisation of treatment. For this to run smoothly, it is important to know where patients are; room changes may also be an indication that the department’s workload is high and act as an objective measurement of this,” says Fredrik Nilsask.
The TagOn project saw a great deal of close collaboration with staff from the regional health authority, Region Skåne, and SUS, with regular meetings and workshops held to ensure that the solutions were of real benefit to staff. Other project partners have also contributed their own unique expertise. Sony provided technical infrastructure in the form of tags, armbands and cloud services, while KnowIT provided integration and apps. RISE has taken on the role of project management, as well as providing its own expertise in measurement technology, data processing and user friendliness.
During the pilot study, a maximum of 80 patients and various pieces of equipment could be simultaneously tracked.
Interesting side discoveries
A number of interesting side discoveries were made over the course of the study,” says Fredrik Nilsask.” “Among other things, we were able to demonstrate that – once the location of instruments was always known and their use could be better planned – they could advantageously be shared between departments. It was also possible to discover when relatively healthy patients had gone off to the smoking area while waiting, or that a colleague one was searching for was actually in the operating theatre and quickly decide to look for someone else instead of disturbing them and so on.”
The ethical aspects have been under discussion throughout the project. All patients participating in the pilot study did so voluntarily.
“In fact. I haven’t heard of anyone feeling troubled. When we have explained that our aim is to make the work of the A&E Department easier, we have been met with great understanding,” says Fredrik Nilsask.
The Lund A&E has continued to use the system for its equipment even after the end of the project and Sony also has installations in other hospitals and industries.
Possible continuations of TagOn are now being considered.
“Based on the developments already made, there are many interesting issues to be addressed; for example, in terms of tracking infections. Having followed a patient, one can naturally see which rooms they have been in and who else was there at the same time.”
Project partners: RISE, Sony, KnowIT, Region Skåne, Lund University, Malmö University.
Project period: 2015-2017