Nine-hospital health system HCA North Texas, based in Irving, is like most health care organizations in the United States: faced with a challenging financial environment, it needs to find innovative ways to do more with less. Explains Michael Hayes, director of asset management for the health system, "We have to streamline processes that historically have been resource-intensive. Reimbursement is not getting any better. Any way we can find to add value is critical."
For that reason, the health system recently launched a new method for managing mobile assets across its nine disparate facilities. Leveraging the AgileTrac RFID system from GE Healthcare and the expertise of GE's Asset Management team, HCA North Texas began to cull unnecessary equipment from its hospitals. "Traditionally, lots of equipment would be kept in each individual patient room," Hayes says. "But even if you keep an infusion pump, for instance, in every room, at some point a patient will need a second line, and eventually you'll be cannibalizing from other patient rooms. That became counterproductive."
Aided by the AgileTrac real-time location system, Hayes and staff began by establishing centralized equipment depots at each hospital. "In critical care where 99% of the population probably needs an infusion pump, it may still make sense to keep that equipment in the room, but for the other rooms, nurses were finding that equipment had been removed," Hayes says. "We guarantee them now that if you go to that central location, the device you need will be there waiting for you."
Smarter Asset Management
According to facility case studies performed by GE Healthcare, the average hospital's utilization rate for mobile equipment is only 42%, and the typical nurse spends up to 21 minutes per shift searching for lost equipment. The AgileTrac platform uses RFID-enabled applications to track and manage mobile assets throughout a facility, reducing the need for unnecessary equipment and decreasing the time staff spends searching for needed assets.
"Among our nine hospitals, we have the opportunity to reduce our total inventory of mobile assets by 20%, while improving availability," Hayes says, adding that these assets come with significant cost burdens: "You have additional costs associated with repairs, with the ongoing support from a biomed perspective. If the devices are wireless, you pay a license fee per device." Maintenance and cleaning were key factors that led HCA North Texas to consider RFID tracking for its equipment: "When you're trying to meet a target rate on preventive maintenance, being unable to locate the equipment has always been a big issue," says Dwight Peper, division director of contracting for the organization. "Now that we are able to find equipment and make sure all the maintenance is done on time, our rate has increased from 93% to 98%."
The AgileTrac system takes asset location a step further by allowing organizations to trend their mobile equipment needs. "You can assess and see where the demand is," Hayes says. "We can establish a minimum and maximum level of equipment, and can remotely inventory that from a centralized area—we know what needs to be replenished without even walking into that nursing unit."
Having realized the benefits of implementing centralized inventories for each of its nine hospitals, HCA North Texas is now in the process of taking its AgileTrac implementation a step further. "Previously, we were reducing our quantities of equipment," Hayes says. "Now we're culling those assets at the division level. Ultimately, what we want to be able to do is become our own rental company, and fluctuate those devices based on census and acuity throughout our nine facilities."
Nine Hospitals, One Repository
Hayes explains, "Historically, we really worked as nine independent facilities where mobile assets were concerned. Most recently, with the new AgileTrac platform, we've been able to see things from an enterprise view—previously, we could only see devices in a specific facility, but now we can see that device's presence in all nine."
HCA North Texas has already been in the process of centralizing select operations across the nine hospitals, including laundry, supply chain, and courier systems, which makes centralizing equipment distribution a logical next step. "We already have the infrastructure in place," Hayes says. "Because our centralized laundry facility is located between all nine facilities, we can also utilize that location as the distribution point for mobile assets."
Cleaning will be handled on-site at the hospitals, each of which has its own asset management supervisor; devices will be transferred to the centralized repository bagged and ready for their next use. Routine maintenance may one day be handled at the repository, Hayes says. "There may be a benefit of being able to come to that location and have all those devices located in the same place," he notes. "It's an opportunity for the vendor to lower their support costs."
Cultural Change
This shift, which Hayes anticipates could begin as early as January 2012, will represent a significant cultural change for the nine hospitals in the health system—particularly for nurses, who are most often responsible for locating mobile assets. "You're changing the culture within the facility," Hayes says. "But if you can meet the expectations of what nursing needs, the system will perpetuate itself—it's a combination of technology and collaboration from all sides."
The first step in managing the change is demonstrating to nursing leadership that the change will make their jobs easier. "You have to start at the top and get them to believe in the process—that you will have what you need to meet their needs, every time," Hayes says. "GE has helped us utilize the software and facilitate the processes for our staff. It's been a joint collaboration in reaching these milestones, and at the end of the day it's about demonstrating that the deliverable will be there."
Soon, Hayes anticipates seeing the benefits of the AgileTrac system taken to the next level thanks to the central equipment repository. "With the new infrastructure, we'll be able to move devices daily, and through the constant monitoring, we can identify when those devices are available, forecast future demand, and meet the need," he says. "There's a finite amount of capital available for these devices, and this solution further increases our utilization percentage. We're saving money on equipment we don't need so we have it to spend on equipment we do."
Cat Vasko is editor of HealthCXO.