Larry George is a retired Air Force clinical laboratory officer and currently serving as a contract project manager for the Center for Partnerships in Research and Technology (CPRT) in the Office of the Assistant Air Force Surgeon General for Medical Modernization. CPRT has projects and personnel assigned at Falls Church, Virginia, San Antonio, Texas and Biloxi, Mississippi.
In a previous blog post, I reported on a research project sponsored by the Office of the Air Force Surgeon General at the 81st Medical Group Hospital, Keesler Air Force Base in South Mississippi. The project, which uses Automated Identification and Data Collection (AIDC) applications, seeks to improve clinical and business processes. AIDC includes technologies such as Radiofrequency ID (RFID), ultrasound, bar codes and infrared that allows an item to be identified nearby, in the case of bar codes, or at a distance, using RFID.
An additional proof-of-concept project is underway in the hospital’s Central Sterile Supply (CSS) to validate the initial positive return on investment estimate. This application uses both bar codes and RFID to support surgical tray and instrument tracking. The two-dimensional bar codes (approximately 4 mm square) are electrochemically etched into the stainless steel surgical instruments, uniquely identify each instrument as well as its type, and are linked to information in the system data base. The accompanying picture shows a tech applying a 2D bar code as well as example instruments that have been marked.
As CSS technicians assemble a tray for surgery, each instrument is scanned and automatically compared by the system against a predefined count sheet for that particular type of surgery. An alert is given if the incorrect instrument has been chosen or if an instrument may have reached its expiration date. (Yes, some instruments have an expiration date and must be discarded after so many uses.) The system also alerts the tech if instruments have been inadvertently omitted. Once the tray is assembled, an RFID tag that can withstand steam/pressure sterilization (autoclave) is affixed to the tray and, following sterilization, the tray and contents may be quickly and accurately located in storage by the previously reported Asset Tracking system as the need arises.
This new application ensures that all trays are complete with the correct instruments and that no instruments have exceeded their expiration date. Since scanning also allows the computer to present the instrument’s picture and manufacturer’s specification, it is particularly useful when training student surgical techs. The 81st MDG Hospital is a Phase II technical training site for this and several other Air Force enlisted medical specialties.