RF system keeps up with long-term patients

Nov 1, 1997 12:00 PM, GEORGE PARTINGTON

Sunnybrook Medical Center opened in 1948 to care for World War II veterans. Almost 40 years later, the hospital, renamed Sunnybrook Health Science Center, still provides care for some of those veterans. And that care has been enhanced with a sophisticated patient monitoring system.

Sunnybrook Health Science Center, which became a part of the University of Toronto in 1967, has major programs in cancer, trauma, heart and circulation, community services and mental health, but the hospital specializes in long-term care for aging and acute care patients. Of the hospital's 1,300 beds, 550 are occupied by those long-term-care patients.

Radio frequency (RF) security technology has added to the health and well-being of the center's aging patients. Sunnybrook employs an RF tag-and-antenna monitoring system that allows long-term care patients to move freely, getting the exercise they need without constant accompaniment. "The philosophy is to not have locked doors," notes Bill Gentles, director of biomedical engineering at the hospital.

Gentles helped procure the monitoring system, which was designed jointly by Cansec Systems Ltd., Mississauga, Ontario, Canada, and Cotag, Dallas. The system, controlled from a personal computer at the nurses' station, keeps record of each time a patient wearing a Cotag wrist band enters the RF field of antennas placed within walls around doorways and elevators. "If the patient is on the East unit and the nurse wants to find him, she can go to the computer and ask for a report on the movements of the patient," explains Gentles. "The computer will show the last place that the patient was picked up by any of the antennas, so she knows where to go and look for the patient. It saves them a lot of time."

Convenience is one feature; safety is another. If a patient goes near a fire exit, his or her location will be logged on the computer, but if the door happens to be open, an alarm condition will result. Sensors in the door tell the computer the door is not held fast by the magnetic lock. When the system connects this event with a wrist band in the door's RF field, a strobe alarm and a message flashed on the PC screen result.

On the floor that houses cognitively impaired patients, such as those with Alzheimer's, all doors leading from the unit are locked. "You can't get off that unit if you are wearing a wrist tag," says Gentles. And if a patient goes near an elevator or attempts to enter an elevator, the elevator doors will remain open, preventing the car from moving and the patient from leaving the care of doctors and nurses. An alarm, in the form of strobe lights and a message at the computer workstation, notifies the staff that a patient needs attention.

However, if hospital personnel or relatives of the patient wish to take the patient to another floor or out of the building, a code can be entered on a keypad by the elevator, disarming the alarm and lockout function. Since another, unintended, patient could enter the elevator after the correct code is entered, signs are posted to make people aware of this possibility.

Security conducts searches

If a patient does leave his or her designated area - and it can still happen, says Gentles, due to human error - they become the responsibility of Sunnybrook security director Bill Russell.

Russell, who commands a staff of 20 law-enforcement-trained individuals, is in the process of upgrading the security equipment at his department's disposal. He solves the problem of missing patients using both low- and high-tech methods, plus a healthy dose of common sense.

With the Blue Shirt Program, Russell has made the cognitively impaired patients easy to spot - the at-risk patients wear a royal blue shirt with the Sunnybrook Health Science Center logo emblazoned in yellow across the back. All hospital personnel and members of the immediate community are educated on the Blue Shirt Program and encouraged to report a wandering patient.

If a patient is reported missing, Russell's security department springs into action. Initially, security officers will search for the patient in all the general areas of the hospital, such as ground floor parking lots, washrooms, common waiting areas and cafeterias. The search can become extremely urgent if the patient is in need of medication or is out in inclement weather.

If the initial search fails to locate the patient, the staff faces the challenge of covering 7,000 rooms encompassing 2,300,000 square feet and 96 acres of park. "The search can escalate from a team of four security officers to a team of 120 searchers complete with maps of the facilities. Metro police can come in with horses and dogs," says Russell. "In very extreme situations, it would be a complete ground search using topographical maps."

Upgrading equipment Russell's philosophy is to stock his department with a highly trained security officers and provide them with the best possible equipment. Toward that end, the security director has added a 24-hour central monitoring station with Sony monitors, which receive images from Panasonic color cameras using Pelco housings. The CCTV system is controlled by Dedicated Micros multiplexers.

For door access, Sunnybrook uses a coded electronic key and electronic lock system. The access control system, from Hirsch Electronics Corp., Irvine, Calif., meets American military specs, says Russell. "It is probably higher than you would expect in a health care facility," he says. "It certainly meets the needs of our facility." The hospital plans to upgrade to either proximity or magnetic stripe card access, replacing the current scramble pads.

The upgrade should be completed in the next few years, thus furthering the mission of the security department at the Toronto hospital - to guard the health and safety of the 10,000-strong campus community.

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