21 Sep 2010
On an LCD panel mounted to the wall, columns of numbers and codes in different coloured boxes look like a maze to the untrained eye. For the bed management staff at Singapore General Hospital (SGH), it is a snapshot of the status of every bed in this 1,500-bed hospital.
The codes indicate whether a bed is occupied, awaiting a transfer, pending a discharge or admission, or is being cleaned by housekeeping. A few minutes later, the screen is updated and a bed's status may have changed, prompting a staff to click on her mouse and type information into her computer for an automatic admission.
The LCD screen is part of the Bed Management System (BMS) recently implemented at SGH that helps the hospital improve waiting time for admissions, capacity and caregiver effectiveness.
This system uses a "visual utility" platform and Radio Frequency Identification (RFID) technology to provide real-time information on patient location, room status and hospital bed occupancy. Authorised staff can immediately access patient information or location simply by glancing at the electronic patient care communication dashboards, placed at various points in the hospital.
Implemented mid-last year, the BMS is the world’s first fully integrated Bed Management System with RFID enabled workflow automation. It is also the world’s largest bed management implementation and RFID deployment for patient location tracking.
“Like most hospitals, SGH is continuously faced with the challenge of managing our bed resources. This includes searching for available bed resources in the hospital, assigning patients to the beds of their specialty to facilitate right care, ensuring fast cleaning for vacated beds to increase bed availability, and projecting/forecasting bed availability. Without an integrated system, hospital staff had to rely on manual processes such as paper, whiteboards and extensive phone calls. This resulted in longer waiting times for our patients, cancellation of electives and frequent emergency executive meetings to resolve tight bed situations”, said Professor Ang Chong Lye, Chief Executive Officer, SGH.
“At certain times, we have pressure on bed capacity and we want to make sure we are making absolutely the best use of our resources. Optimising patient flow is essential to deliver efficient and timely treatment to our patients. We are working hard to improve our bed management processes and this new system gives us up to the minute information at our fingertips, making bed capacity management much more effective”, Professor Ang added.
BMS is a web-based system that allows patient flow information to be accessed from anywhere in the hospital. The BMS screen has been configured to display the location of patients in the ward and the primary physician. Ward staff can also view any actions outstanding for the patient, notes on the patient’s specific needs and any planned movements to other wards. This gives nurses and bed management staff a complete overview of the hospital status and patient needs which allows them to take action without constantly touring the hospital.
“On behalf of everyone at Eclipsys, we’re proud to have worked so closely with SGH and their multidisciplinary teams to optimise and automate patient flow from the point of admission to the point of discharge. SGH’s use of Sunrise Patient Flow™ — along with other integrated clinical solutions from Eclipsys — serves as an international model for effectively using information technology to improve patient care and outcomes,” said Eric Rosow, Eclipsys’ Vice President and General Manager of Sunrise Patient Flow solutions.
All the wards are equipped with LCD panels to display the ward dashboard with real-time patient RFID location. With the dashboards, staff no longer need to rely on manual updating of books and whiteboards in the wards as patients' information and bed statuses will be updated automatically.
“The constant to and fro on the phone checking on the bed status took up a lot of the nurses’ time. They can now refer to the latest information on the dashboard without having to constantly walk through the floors to check whether the rooms were patient-ready. This allows us to manage beds in real time down to the individual beds, hence freeing up nursing time to focus on patient care,” said A/Prof Lim Swee Hia, Director for Nursing, SGH.
How does the BMS work?
Upon admission, each patient receives a radio frequency identification (RFID) tag which has a unique identifier that will identify the patient throughout his/her stay in the hospital. The system searches for and assigns a bed that best fit the patient's clinical condition. A real-time location system identifies the patient’s location via the tag and automates workflow related to the patient’s movements. As a result, the system enables staff – whether clinical, administrative or support – to eliminate manual tasks related to the movement of patients.
Once a patient arrives at the ward, the RFID will automatically update the patient's location information in the system. This provides real-time patient location information and frees up the ward staff from the manual task of updating the system. Patient's whereabouts within the hospital can also be tracked with the help of RFID readers.
Upon discharge, the ward staff will remove the RFID tag from the patient and place it on the RFID console and press the discharge button. This process will update the patient's information in the integrated system and triggers a message to the housekeeping unit to clean the vacated bed. The housekeepers deployed at the various wards are informed via their PDA for any cleaning jobs. Once they have cleaned the bed, the housekeeper will update the bed status via their PDA.
Instead of making multiple phone calls to one another in an attempt to coordinate patient flow, the system automates current activities and ‘next step’ requests. The integrated system is designed to reduce the amount of time that clinical and support staff spends behind the computer, enabling them to focus more time on patient care.
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