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RTLS reveals the current status of resources, including infection-control information. Other examples of how human error factors into the

spread of HAIs are wheelchairs, gurneys or other medical equipment. Equipment “gets sick” this way. An infected patient needs to go to radiology, but because most infection- control alerts are done manually and take a signifi cant amount of time, transporters and EVS personnel often don’t get word that they are entering an isolated room. T is exposure happens several times a week in some hospitals. Since the transporter was not aware the patient was in- fected, he doesn’t perform the special “clean” required to rid the wheelchair of germs. Now the chair becomes a rolling epidemic, since it will be handed off to the next transporter for another patient trip, and another, and another and so on. T is “inadvertent exposure” also applies to housekeepers.

For instance, when an infected patient is moved to another room, the isolation sign very often goes with that patient. When EVS personnel enter the fi rst room to clean it, they can be inadvertently exposed. Even if they don’t become infected, they can unknowingly become disease carriers throughout the hospital. Since these workers don’t know they have been exposed, they can spread disease to other workers, patients and family members when they go home. And, since they are the most travelled employees in any hospital, it’s reasonable to assume that they may be a cause for superbug infection moving from the ICU to the general hospital population at an alarming rate. According to the CDC, in 2009 over 60 percent of hospital-based MRSA cases reported in the U.S. were in the general medical wards, up from just 2 percent in 1970. How often does this happen? Hospitals don’t keep sta- tistics about “inadvertent” exposures, but the anecdotal evidence is startling. To combat this problem, the University of Virginia Medi- cal Center now has infection-control nurses in the patient fl ow loop, with exclusive control over isolation indicators in their automated patient-fl ow system. T is replaces the old system of having IF nurses hand-deliver isolation notifi ca- tions to every fl oor, a process that took hours to complete. Methodist Healthcare System of San Antonio, Texas, re-

quires infection status to be logged for all incoming patients before any bed is assigned. T is system then fl ags and auto-

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IMAGE COURTESY TELETRACKING

matically disseminates patient infection status to all levels of staff involved in the care cycle, from admissions and ED, through in-patient care, and on through to housekeeping and transport workers, all in real time. According to Susan Kilgore, R.N., vice president of pa- tient management, the eight-hospital system made infection control one of its top priorities. Methodist integrated TeleTracking’s Capacity Manage-

ment Suite with its ADT system to track every patient move, call up patient histories and monitor bed availability. Alerts were automated to all personnel with a need to know, includ- ing housekeeping and transportation, who receive electronic notifi cation when isolation is declared. Methodist went one step further by including a fi eld for isolation in its bed-request system. Placement personnel must indicate an infection attribute in the system or indicate “none” in order for the placement request to go through. T is assures that infection status is addressed by all admissions personnel throughout the hospital. To address possible equipment contamination, Method- ist implemented TeleTracking’s RTLS to track all moveable medical equipment and determine which wheelchair went where with whom, and which transporter took them there. “You need buy-in from the top down,” Kilgore says. “We

had reluctance when we decided to put a full-stop on patient placement before infection attributes were defi ned, but when we made the senior leaders and nursing directors aware of the impact, they supported our decision.” Beyond the obvious issue of patient well-being, another

reason for that buy-in is that HAIs cost U.S. hospitals $45 billion per year, according to the CDC, and that the average HAI patient is in the hospital 20.6 days versus the national length-of-stay (LOS) average of 4.5 days – stunning numbers in light of healthcare reform initiatives to lower LOS. Still, a recent survey by the Association for Profes- sionals in Infection Control and Epidemiology (APIC) said only 30 percent of its membership reported that top executives at their hospitals were willing to budget for preventive measures. HAIs already cost this nation 100,000 lives each year. T at’s too great a cost for this problem to be ignored. HMT

HEALTH MANAGEMENT TECHNOLOGY June 2013 19

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