NFC-based Smart Notification System for Hospital Discharge Process and Bed Management
An efficient discharge workflow with objective to minimize the turnaround time upon discharge of a patient in a typical hospital environment is proposed. The implemented workflow, which relies on a near-field-communication (NFC)-based patient discharge event, triggers a sequence of notifications and actions both by the nurses and housekeepers till the bed is cleared for occupancy by the next patient. The notifications are automated through Telegram Bot API. Android-based mobile applications are developed for both nurses and housekeepers. The mobile apps allow for follow-up actions and the status of the bed to be captured and sent to the cloud. Key functionalities of the system include immediate notification send to the housekeepers when a patient leaves the hospital, simple sending of cleaning requests and viewing of bed status. The system has been deployed in a hospital and evaluation is carried out in terms of improvement in the turnaround time of hospital beds.
With rising aging population throughout the world, shortage of beds in hospitals is a common problem. This leads to long waiting time for patients, queuing to be assigned a bed, which in some cases can be as long as two days. This problem is made worse during flu seasons where patients have to wait more than eight hours for a bed and were housed in tents or put in covered carpark areas [1, 2]. To free up more beds for patient admission, one of the area hospitals try to improve on is the patient discharge process. Previous study in [3] had found that the efficiency of the discharge process can have significant impact on the average length of stay (ALOS) for a patient. Some of the factors concerned with the patient discharge process that leads to unnecessary delays in making beds available immediately upon discharge are a) family members being unable to accompany patients home promptly upon discharge; b) patients waiting for family members to collect their medications and documents; c) delays introduced in the communication to the housekeepers on the status of beds. Many hospitals devise solutions to minimize this problem. These include setting up a patient discharge lounge which includes bed crunches to allow patients to rest while waiting for their medication, documents, and family members [4]. Radio Frequency Identification (RFID) technology has found applications in not just inventory managements systems [5] but across process control in many industries [6]. RFID have found extensive application in health care sector in the context of process and workflow managements [7, 8]. Bed management systems provide the capability to keep track of the patients and beds status by relying on RFID technology to provide real-time information on patient location, room status, and hospital bed occupancy. Typically, active RFID tags are used and the discharge process would require patients to visit the nurse to remove the RFID tag. Upon removal of the tag, electronic notification (e.g. SMS or WhatsApp message) is sent to the housekeepers while concurrently updates are carried out to the patient’s information system on the discharge. Once cleaning is done, the housekeepers will update the bed status by messaging the administrator at the bed management unit (BMU) instead of making multiple phone calls [9]. The BMU administrator will update bed status and this will automatically refresh the bed status dashboard, displaying the available beds [9]. In this paper, we describe a hospital discharge notification system that has been implemented in a local hospital. In the proposed implementation, the bed management system is decoupled and independent from the patient information system. Instead of adopting RFID-based solutions, a simple and cost-effective NFC-based solution is proposed and implemented.
The paper described a NFC-based patient discharge process that automatically informs housekeepers which bed to clean and also inform the Admissions Office which beds have been cleaned. This leads to a reduction of the turnaround time of hospital beds, and hence the shortening of the waiting time for patients to be admitted. The system is low cost and easy to deploy. It simplifies the patient discharge process through automated notifications and messages, which leads to improvement in the productivity of both the nurses and the housekeepers.