The Leaflet Article
Largest Health System in Illinois an Advocate for Infant and Child Safety
Four newborn abductions occur in the United States each year, on average, from hospitals of varying sizes and types and in both urban and rural communities, according to the National Center for Missing and Exploited Children (NCMEC). All hospitals that offer maternal and child health care services face this threat, and the senior risk managers at Advocate Health Care list it as a serious concern, the prospect of which has at times caused them to lose sleep.
As the largest fully integrated health care delivery system in Illinois, Advocate Health Care has been at the forefront of preventing these incidents at its facilities and was among the first in the nation to employ an infant security system using electronic ‘anti-theft’ tags originally developed for the retail industry.
Combined with a comprehensive culture of safety and security that includes policies and procedures to help protect our young patients, Advocate recognized in 2011 that it was time to update the existing infant security system, expand it to include pediatrics and standardize it across eleven of our Chicago-area and downstate Illinois hospitals.
It was a complex undertaking bringing together experts from several disciplines to identify the best new technologies and most reliable partners and to implement the right approach enterprise-wide. Crucial to our entire process was participation by Advocate’s Public Safety and Security and Information Systems leaders as well as leaders from Women’s and Infant Services, Patient Safety and Pediatric Services.
From my point of view as a manager of planning, design and construction, their involvement was critical. Having these leaders serve as project champions allowed every voice to be heard as we worked toward consensus, ultimately contributing to a successful outcome.
“Patient safety was and is our number one priority,” said Donna Currie, Advocate’s Director of Clinical Support Services and one of the project champions. “We used to operate as distinctly different hospitals, so some sites had systems that were at end of life or no system in place at all. Over the last few years, there has been a true commitment to creating a standard of care that improves the patient experience and outcomes. That’s what’s always top of mind.”
In keeping with Advocate’s safety journey and the goal of having zero safety events by 2020, our team determined the infant protection system needed to be expanded to pediatrics as well.
“For pediatrics, our concern centered more around elopement. Children in our pediatrics areas are sick kids who have been in the hospital a long time and it is our responsibility to help protect them while they are here,” noted Minni Marwaha, Advocate’s Director of Pediatric Services for the Children’s Hospital and project champion.
The four-year long process to transition to the new infant and child security system began with engineering firm Jensen Hughes collecting interview and survey data from each of the hospitals, all of which vary widely in size, age and type of construction. We brought in competing security providers to demonstrate their products and followed that up with a detailed questionnaire asking stakeholders to score the various systems.
Advocate selected the STANLEY Healthcare Hugs® Wi-Fi Infant Protection solution because of the system’s ability to track the infant or child tags on the hospital premises using Wi-Fi technology. The new system is an evolution of its very popular, highly reputable and reliable Hugs system.
The Hugs solution uses standard Wi-Fi access points and is compatible with multiple wireless local area network (WLAN) architectures. To accommodate this potentially lifesaving system, Advocate validated its wireless network prior to installation to make it more robust and ramped up signal strength to help reduce gaps in the Wi-Fi network.
The teams from Jensen Hughes and STANLEY Healthcare helped us map out how best to bring the new, standard system on-line at each of our hospitals, considering the different facility designs and layouts, patient traffic flow patterns and infrastructures.
From a real-time location perspective for infant and child security, and asset management as well, the ideal layout for access points is a grid pattern. However, our hospitals were not deployed in this fashion; instead, access points were located in areas where a need had been identified, such as in office spaces. We had to figure out how to create a grid system without incurring undue cost.
“The way we got around it was to walk-test each unit to determine if the existing access points provided adequate coverage to provide triangulation of infant tag locations and then selectively add access points to create the necessary grid coverage patterns to make the system effective,” said Bill Sako of Jensen Hughes. Another accomplishment was preserving the scope of the project while maintaining life safety requirements.
For the demolition and construction phases, Advocate needed a turnkey solution with local response within a certain timeframe. Based on a proven record of successful experience with Advocate and other large hospitals, STANLEY Healthcare and Jensen Hughes recommended Red Hawk Fire & Security to provide project management for removal of the old system wiring and panels, installation and integration of the new system as well as maintenance and coordination with the building contractors at each of the hospitals.
An important part of the project required implementing and monitoring rigorous best practices to ensure no dust or debris from the demolition or renovation would enter working areas of the hospital. Abiding by stringent infection control procedures to ensure patient safety meant sealing off construction work zones with physical barriers and isolating them from the rest of the hospital with keypad controlled, locked doors. We also installed and monitored a negative air system to draw air contaminants into the work zone and away from patient areas using HEPA filters to capture any tiny particles; conducted planned and surprise inspections to make sure all construction crews adhered to procedures that included taking multiple steps to remove dust and debris from their hands, gloves, tools and clothing before leaving the work zone.
The construction safety measures had to be a continuous and stable part of the transition to the new system as workers removed ceiling tiles and aging wires and replaced them with the new wireless system.
The first new systems were brought on line in 2015 with the Hugs Wi-Fi solution helping guard against infant abduction and mother/infant mismatch. Here’s how it works: each infant wears a Hugs Wi-Fi tag on the ankle or wrist attached by a tamper-detecting band. The Hugs tag is waterproof, hypoallergenic and rechargeable. The tag activates the moment it is attached and is automatically enrolled in the system. If an infant is brought near an open exit, an alarm sounds. If that door is closed, an exit controller can activate a magnetic door lock preventing egress. Using Wi-Fi technology, the system can monitor the infant tags helping protect the babies if they need to be transported beyond the Obstetrics Unit to different areas of the hospital for tests or other valid reasons.
“In designing the Hugs Wi-Fi solution, we wanted to build on the excellent track record of the previous generation of Hugs, which has helped prevent a potential abduction on more than one occasion,” says Diane Hosson, Senior Director of Security Solutions for STANLEY Healthcare. “The obvious step was to expand that protection beyond the OB unit to cover other areas of the hospital, taking advantage of enterprise infrastructure not only to locate infants but also to give system access to staff members from any network PC. Infant security is a priority for the whole hospital and the infant protection solution should match that scope.”
Nursing staff is able to monitor system activity and perform day-to-day tasks through the MobileView and Hugs Instant Notifier software on the nursing station computers. The MobileView web version is used by management on their office computer and is located on the documentation computers in the patient rooms. Detailed alarm information is displayed with a map showing the infant’s location. Advocate Health Care receives Hugs system notifications via email to keep staff fully informed.
While the nursing staff is at the front lines of defense in preventing abductions and documenting incidents, electronic security measures using the latest technologies can make their jobs easier and serve as a force multiplier if the unthinkable occurs.
Safeguarding newborn infants and children requires health care facilities to create a culture of security with an integrated approach.
“We’ve looked at this product, not as the be-all and end-all of our security plan, but as another layer of protection,” said Advocate’s Andrea Miller, Director of Women and Infants at Christ Medical Center.
Miller notes that Advocate has a security policy stating that we will protect the children in our care and take clinical and IT-related measures to accomplish that goal. There are also site plans and training in place that give specific instructions on what to do if a child goes missing.
“The customer or patient view of all this is that the new mom and dad or the parents of sick children tell us they feel so much better knowing they have an extra level of security and protection,” Marwaha said.
Though infant abductions do not take place with great frequency, and thankfully have not occurred at an Advocate facility, they do occur.
For Advocate Health Care, one of the nation’s largest health care providers, addressing the topic of infant safety has been a complex and ambitious process made more manageable by its collaborative internal team approach as well as professional expertise by partners like security integrators Red Hawk Fire & Security, engineering firm Jensen Hughes and sophisticated new technologies such as the STANLEY Healthcare Hugs Wi-Fi solution. ,p>Today’s hospital administrators, risk managers and security directors have the duty and responsibility for guiding the public trust in their facilities as well as patient safety and staff awareness.