Laguna Honda Hospital & Rehabilitation Center – RTLS | STANLEY Healthcare

Laguna Honda hospital is a very old
facility in San Francisco California, it was actually started in the 1850s or so,
in response to needs that were rising in the gold rush days. When I came there in
1996 the newest part of the building had been built in the 1950s and it was quite
old and out of compliance with current hospital code. Staff were very concerned
and wanting to make sure that we could give really good care and this
provided us a real opportunity to really begin to explore new approaches to care.
We were very interested in being able to help manage wandering and elopement in a
way that was humane, comfortable and not disruptive. We were looking at the
possibility of using RTLS systems. So, in the new facility, we have used both
Resident locator capabilities so that we can track the location of residents who
are at risk for wandering due to dementia and we’ve also implemented
staff duress. One of the concerns that we had was individuals who have cognitive
impairments walking out of doors and getting into dangerous situations.
What we wanted to do was have a multi stage system of graduated alerts and
interventions for that, we have four different levels there. The state 1 alert
was particularly interesting to me, it was really the notion that, can we
intervene in a way that does not put a burden on the staff, that actually helps
that individual learn about the environment in a way that’s graceful, not
disruptive and doesn’t cause panic for that individual. So, the intention here
was to have a voice redirection in that individuals primary language, we
worked with the AeroScout, which paired with single wire to put their IP
speakers above the door there, so that if a resident is approaching that door
it triggers an alert that says ‘stop, go back’ or ‘please step away from the door’
in the language of that particular individual. Some benefits that we
think have occurred from this, first of all, the whole environment including the resident locator system has helped in improving
the comfort of the individuals there. This has resulted in a lower number of
transfers to acute psychiatric care. We also think that this has been very
helpful in reducing the number of tailgating elopements, lastly we think
that it’s also helped in the staff oversight of the units. We’ve got private
spaces which are highly beneficial for the individuals but it
makes oversight more difficult and so being able to use the locator system is
very helpful to our nursing staff. We’re looking to expand the AeroScout
RTLS system. First of all by including coverage in our garden spaces, we really do want our residents to get out and enjoy
fresh air and get exercise outside and yet still be able to trigger alerts if
somebody goes out beyond the garden spaces into unsafe territories. We also
would like to make use of analytics to examine how an individual status
is changing over time. So for example an individual with a traumatic brain injury
who is gradually improving in their cognition, if this individual is
approaching the door less and less and beginning to respond more and more to
the voice intervention then we know that this person is getting better and that
they may be able to return to their home environment for care.

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