21ST-CENTURY TECHNOLOGY


monitor and control energy used across the NHS estate, is, Essentia maintains, ‘a low-cost way to improve energy efficiency and reduce energy demand’. Tas Hind explains: “For instance, electronic sensors installed in multiple locations can monitor lighting, heating, and humidity, turn such systems on and off, lower or increase settings, and – based on internal and outdoor temperatures – open and close windows and doors without manual intervention. Sensor varieties would typically include wall-mounted units, probe sensors deployed for air in ducting, and probes in metal packets for monitoring water.”


Monitoring and managing assets She continued: “IoT (The Internet of Things) devices fitted to heating, cooling, ventilating, lighting, cooking, water- heating, refrigerating, and electrical and mechanical surgical equipment can monitor the equipment’s performance, assess how often it is out of service, raise alerts on breakdown, issue messages for planned maintenance, and highlight when components need replacing. Experts estimate that, by 2020, the IoT will comprise some 30 billion ‘objects’, with its global market value reaching $7.1 trillion. These solutions provide a vast array of ‘dashboards’ that help monitor and manage the efficiency of buildings, both at a management and an operational level.


Tracking assets


“Unfortunately,” she continued, “poor patient pathways through existing buildings, and inefficient staff travel distances, are costing the NHS too much. Estates departments can use tracking technology to identify how to enhance or change existing pathways, or ensure that they are integral to the design of new


Hospital Coordination Centres A relatively recent concept for the NHS, says patient flow automation system specialist, TeleTracking Technologies, are Hospital Coordination Centres. Three English NHS Trusts – The Royal Wolverhampton NHS Trust, The Countess of Chester Hospitals NHS Foundation


buildings. With growing demand on limited resources, assessing which buildings and assets are being used most efficiently is key, and there are already many technology solutions available for doing this. For instance, sensors in outpatient waiting areas and clinic rooms can monitor how often they have been used, and by whom. One large London hospital is in the early stages of doing this. Although not yet using sensors, their use is on its agenda.”


Boosting productivity form available space


Tas Hind says ‘there is a clear opportunity to build on the work already undertaken by Casdyl Clinistate, and to understand the actual use patterns of space within a hospital estate to boost health space productivity’. She explained:


“Management consultancy, Casdyl (owner of Clinistate), has entered into an NHS exclusive joint venture with Beringar, which has developed a sensor that accurately counts the number of people in rooms and open areas, providing ‘a true picture of the use of clinical estate in real time’.” Coupled with environmental readings and the position of clinical assets within the space, the data can be used to help plan improvements to clinical asset utilisation, find clinical space for new and increased services, and improve the patient experience. The sensor technology has been field trialled, and is now in place in a number of locations.


Trust, and University College London Hospitals NHS Foundation Trust – have been identified as pioneers in implementing such Centres, underpinned by an Operations Platform. The model, ‘similar to that of an air traffic control centre’, has evolved as a result of patient flow solutions ‘that deliver real-time information on virtually every care support need within a hospital and/or region’. Managed by both clinical and non-clinical staff, the Centres are responsible for all ‘system throughput’ – including patient access, transfers, bed management, and patient transport etc. When paired with an Operations Platform as the ‘backbone’ for operational efficiencies, the Centres ‘bring together real-time reporting and analytics, workflow automation, and operational visibility, to enable staff to oversee daily functions across their organisation, and match supply to demand more efficiently’. The Hospital Coordination Centres ‘set the foundation for improvements in hospital operations, patient flow, real-time data, and access to efficient, quality care’.


Real-time locating systems As part of the Coordination Centre Model, the three Trusts use varying degrees of Real-Time Locating System (RTLS) technology to support their Centres in providing real-time visibility of all beds, patients, and equipment. TeleTracking said: “While RTLS is not necessary to get the benefits of the centralised centres, it certainly complements the Centres, and provides additional support to staff and patients. The RTLS component to the Coordination Centre model can provide more granularity and visibility by attaching sensors to beds, assets, and, in the case of The Royal Wolverhampton NHS Trust and The Countess of Chester, patients and staff. The hospitals can thus better allocate staff to patients, harness available resources, and obtain a more transparent view of patient flow bottlenecks and the real-time changes needed to improve processes. By tracking assets using RFID tags, Trusts can track and record devices, monitor their location and performance, manage planned maintenance and replacement, and raise, monitor, and escalate tasks.”


Hospitals’ and other healthcare facilities’ activities are increasingly – as elsewhere in society – ‘digital’.


TeleTracking Technologies says a key benefit of the RTLS technology is the impact on available assets. It explained: “Items in constant use are often closer to hand, but for something that might be shared across wards there are often procedural delays while staff hunt for a vital piece of equipment. Even finding wheelchairs can result in a constant search and rescue mission, with a knock- on effect that can leave patients in the wrong place, compounding the delay for the next, and wasting the time for those who need to perform clinical procedures.”


June 2018 Health Estate Journal 33


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