Technology Provides Aid in Fight Against Workplace Violence

Medscape

5 days ago

In American hospitals, the corporate buzzword 'employee engagement' likely means something different than it does at the local widget company. No, in healthcare it first and foremost means keeping clinicians and all the caregivers in the hospital environment safe.
The most recent data released from the US Bureau of Labor Statistics showed that healthcare workers accounted for 73% of all nonfatal workplace injuries and illnesses due to violence in 2018. This was a rate of 10.4 incidents per 10,000 workers, and the number of incidents showed steady increases since 2011. These figures do not account for the fraught period around the pandemic, during which time one study conducted in Egypt reported that more than half the healthcare workers who responded had been subjected to some sort of abuse on the job, whereas another conducted in Pakistan found that nearly 40% of emergency department doctors and nurses reported at least one episode of violence.
With figures like these, not to mention the profession-wide burnout crisis, healthcare facilities all over the world are seeking out new approaches to keep providers safe. Northeast Georgia Health System, headquartered in Gainesville, Georgia, and Holyoke Medical Center, based in Holyoke, Massachusetts, are using a Bluetooth Low Energy ( BLE) system to do just that — and more.
Tool Protects 10,000 Staff Members in Northeast Georgia
With 950 beds and 10,000 medical staff members to protect at five locations, Northeast Georgia Health System Chief Information Officer Chris Paravate had a security challenge on his hands.
'When patients come to us, particularly in the emergency room and inpatient, they were not only bringing their medical condition, they're bringing everything with them. Their problems, their issues, their anxiety, their fear, their families, their socioeconomic problems come in our front door, and people are the most vulnerable when they are in that setting,' Paravate said. 'Sometimes their actions are not so favorable, and we want our patients and our employees and our staff to feel safe.'
In 2021, Paravate turned to Poland-founded, New York-based Kontakt.io and their BLE badging system to enhance security at their locations. The device contains a portable duress button that provides real-time location services, can be integrated within existing security and nursing workflows, and is able to be pressed discreetly — much more so than the old system of pulling a cord or rope to trigger an alert system, or even reaching for and pressing the emergency button on a cell phone, either of which may serve to only exacerbate a dangerous situation.
Paravate said he left his first meeting with Kontakt.io's CEO and put some sample devices in the hands of one of the charge nurses on duty in the emergency department of their Gainesville facility, and the reaction was immediate.
'I said, 'Would you wear this?' And she took the badge and put it on and said, 'I'll try it. What does it do?'' Paravate said. 'I said, 'Well, it's got a button on the back, and you can press it if you need help.' She said, 'Oh, that'd be cool.''
Nurses are understandably picky about their gear and notorious for immediately sensing anything that will slow them down or get in the way of providing care. This reception was what Paravate had been looking for in a technology-based approach to workplace violence reduction.
'(You usually can't take) that type of innovation and…talk with someone who has journeyed through that, who literally was 50 steps from four trauma rooms, who's sitting in the core of the third largest emergency room in the state, and…get that reaction,' Paravate said.
The charge nurse wanted to know when the rest of the staff would get the same tool and how it works and wanted to know that if she pushed the button, someone would actually come help, he said.
'It was never about, well, you're gonna tag me or you're gonna track me,' he said. 'It was, 'Wow, you'd invest in technology for me to ensure that I was safe.''
Paravate had also been looking for a system that could be used for multiple purposes. At Northeast Georgia Health System, they are using the badging system to track patients to accurately deploy physician resources as well. For example, it can ensure that physicians only round on patients who are in their rooms so as not to waste providers' time when they could be caring for others. Paravate said these data are being used over time to forecast and anticipate staffing needs. Overall, Northeast Georgia Health System reported an estimated $10.2 million return on investment in the first year of deployment of the badging system's initial use case, which is a factor of 20x on their initial spend.
What Is BLE?
Bluetooth is the wireless technology familiar to most people for its use in earbuds, car stereos, and the like. This 'digital handshake' enables a variety of wireless devices to connect and interact using radio waves to transmit information. When two Bluetooth-enabled devices are in proximity, they can detect each other and initiate a connection. That's called pairing, where devices exchange unique security codes to establish a secure link; once paired, they remember each other for future connections.
Instead of maintaining a continuous connection, BLE devices send small packets of data intermittently, sleeping when not transmitting or receiving data to conserve power. These devices manage their transmissions through a system of what are called advertising channels — not advertising like on television but advertising in the 'Hey, it's me, I'm here,' sense: A peripheral device, like a sensor in a badge in this case, will 'advertise' its presence by periodically sending out small data packets. A central device, such as a smartphone, can then listen for these advertisements and initiate a connection if it needs more information.
Once a connection is established, BLE maintains its energy efficiency by using a pared-down client-server architecture known as the Generic Attribute Profile. The peripheral device acts as the server, holding data in a standardized format of services and characteristics. The central device, or client, can then read or write these data as needed. Using asynchronous communication, the client only requests data when necessary, and the server only sends updates when new information is available. With BLE's very fast connection setup times and short data packets, this ensures that the radio is active for the minimum possible duration, extending the battery life of devices so that they often last months or even years on a single coin cell battery.
The Competitive Landscape in BLE
Several of Kontakt.io's competitors in the staff duress badging sector include BLE in their badging makeup. These competitors include the following companies:
AiRISTA Flow, which specializes in RTLS solutions across many industries. Their products include BLE-based tags and infrastructure for healthcare. They focus on improving operational efficiency, patient safety, and asset utilization.
BeaconTrax, a Canadian company that specializes in beacon-based technologies powered by BLE that offers staff distress systems for the healthcare industry. Its systems include panic buttons and wristbands.
BlueUp, an Italian company that designs and produces Local Positioning Systems based on BLE technology, as well as a wide range of other systems. They offer solutions for localization, tracking, and asset management in healthcare facilities, as well as for manufacturing and logistics operations, and their products include badges and wearable devices.
CenTrak, which has a wide range of tags for both patients and staff, some of which include BLE in their technology package, often combined with Wi-Fi and their proprietary Gen2IR for accuracy. They offer solutions for staff duress and patient management among other functions.
Lansitec, which offers a range of Bluetooth beacons, including badge-style transmitters, that are suitable for hospital asset tracking, staff location, and more, as well as a wide variety of other products. They emphasize features like adjustable transmit power and Angle of Arrival support for precise location.
MeshTrac, which offers BLE beacon-based tracking systems for patients and assets in healthcare, emphasizing real-time visibility, enhanced patient safety, and workflow optimization.
Minew, a significant manufacturer of BLE beacons and tags, including badge-style wearables designed for people management, staff tracking, and safety applications in various industries, including healthcare. Like Lansitec, they offer both standard and Angle of Arrival versions for improved accuracy.
Stanley Healthcare (AeroScout), a multinational company that is increasingly implementing BLE in its solutions, including for staff safety and for patient management.
Real-Time Location Services
'Real-time location services' is the name of the technology that makes locating a staff member in trouble, or determining that a patient is not in their room, possible. Real-time location services can be handled in a variety of ways in the healthcare: infrared, active and passive radio frequency identification (RFID), Wi-Fi, and ultra-wideband are all alternatives to BLE.
They each have pros and cons: While ultra-wideband is highly accurate, it's also generally much more expensive to deploy than BLE because it requires dedicated infrastructure and doesn't mesh as well with other systems; Wi-Fi, meanwhile, is cost-effective and easy to integrate but less precise and consumes more power; infrared systems can only achieve room-level accuracy because they generally can't penetrate walls; passive RFID tags are generally only useful for choke points like entries and exits, and active RFID tags require a battery but maintain a persistent signal so are less energy efficient than BLE.