Introduction

Concerns about infant abductions, mother/baby mix-ups, and wandering patients have been a common fear among hospital administrators for some time.  These concerns fostered an interest in electronic tracking of infants and pediatric patients, and patients whose medical condition makes them prone to wander. Similar technology is used to keep track of high-value assets.  Litigation continues to be brought against hospitals and birthing centers when a Sentinal Event occurs. Invariably the charge is inadequate security protection.  As a result, the hospital infant abduction phenomenon sparked an array of manufacturers and vendors to develop a variety of systems designed to foil abduction attempts, match mothers to their babies, locate wandering patients as well as track high-value assets. 

With the continuing increase in litigation and stern guidance from the Joint Commission, it has become increasingly essential for hospitals to offer state-of-the-art security protection for their patients, mother/baby units, and visitors.  The proliferation of new security products makes it more difficult for administration, nursing, and security management to select a system that provides “ultimate protection” and ease of use at a reasonable cost.

For the past 15 plus years, SAI has been involved with many companies in the creation, development and evaluation of what have become "state-of-the-art" systems.  Yet, there are some infant protection systems on the market today that fall far short of their claims.

There are approximately 12 to 15 companies presently selling some type of infant security or wander prevention system to the healthcare industry.  They range from Fortune 500 companies to “Mom and Pop” type operations.   Several systems currently on the market are passive in design and can easily be defeated by simply shielding the tag.  Some of these passive systems simply converted technology used in the retail trade industry to deter “shoplifters” and are now using the same technology to protect newborns in the hospital setting.  On a good day this type of technology is only 70% effective for protecting merchandise.  How many times have you heard of someone you know taking clothes home from a department store with the security tag still attached to the garment?  It happens all the time.  What if the garment were a newborn baby?

Another inherent problem with electronic systems is the propensity they have for false alarms.  Although the marketing material will tell you a system is immune from false alarms, many of our client hospitals continue to complain of consistently having to deal with false alarms. 

Systems that incorporate “skin sensor” technology also present their own unique problems.  A baby’s constant movement as well as loosening of the band can cause the connection between the band and skin to separate creating a tag off body alarm while the tag is on the infant. Some manufacturers’ systems require the nursing unit to replace infant security tag batteries.  This places an extra burden on an already over worked nursing staff.    

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Additional issues of concern:

1. In order to save money, some vendors encourage the hospital to install the system themselves.  This is a bad idea, because the manufacture can always come back and say the product was not installed to the manufacturer’ specifications.  This can also cause liability to transfer from the manufacturer to the hospital.   

2. Quotations may not include total costs for installation, integration with existing IT system, testing or training. 

3. Additionally, the quotation may not include a battery back-up UPS System without which vital information can be lost.   Failure of the system alarm can also occur during a power outage. 

4. Electronic noise interference can cause passive systems to lose battery power in the infant tag by constantly activating the transponder/transmitter system.  A transponder should only become active when it enters an energy field created by an “Exciter Antenna”.   The system should be able to filter out extraneous noise.

5. Some systems battery power to their tag will prematurely deactivate the tag if the band is removed from the infant for an extended period of time.

Here is an excerpt of a letter from a Security Administrator at a major healthcare facility in Georgia.

Jeff,

We met at the recent Georgia Hospital Association seminar in Clayton College where you spoke on infant security.  I suggested to our Infant Security Task Force that we ask if you would consider scheduling a day to visit our facility and provide a review of our preparedness and ability.  Everyone agreed that this would be extremely helpful, especially when considering some of our unique problems.  The primary and most obvious problem to us is the excessive number of false alarms we are experiencing from our infant security system.  The alarm rate has been so excessive that the system is virtually ignored by everyone but our security staff who are (sic) responsible for documenting each alarm and the cause.  A significant percentage of the alarms are due to system failure or trouble.  Are you familiar with -------Infant protection system?  The company was bought out by --------.   I do not know when the company changed names, but the engineer who did the original installation still services our account.  Any opinions or experience you have had with this product will be treated with the strictest confidence.  We just need an unbiased opinion to help make a determination of continuing to work toward repairs and solutions or choose another system.  I can share a considerable amount of data on our current system and will do so if we can arrange for a consultative visit.   Thanks in advance for your help….

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I was very familiar with this company when it was in business.  The company’s primary business was to the retail industry for the protection of products in the department store setting.  There was a “Hold Harmless” clause in small print on the back of their sales invoice which read:

EXCEPT AS EXPRESSED IN THE DESCRIPTION OF THE MERCHANDISE HEREIN, BUYER ACKNOWLEDGES AND AGREES THAT NO WARRANTY OF ANY KIND, EXPRESS OR IMPLIED OR STATUTORY HAS BEEN MADE BY SELLER, IN FACT OR IN LAW, INCLUDING THE WARRANTY OF MERCHANTABILITY OR THAT THE MERCHANDISE WHICH IS THE SUBJECT OF THE CONTRACT IS SUITABLE FOR ANY PARITCULAR USE OR PURPOSE.  BUYER ASSUMES ALL RISKS AND LIABILITY WHATSOEVER RESULTING FROM THE USE OF SUCH MATERIAL WHETHER USED SINGLY OR IN COMBINATION WITH OUTHER EQUIPMENT SELLER SHALL NOT BE LIABLE.

This particular company was bought out by a Fortune 500 Company - one of the largest retail security companies in the world – and had been marketing infant protections systems across the U.S. and over seas for years.  SAI was retained by a Major University Medical Center after one of their babies was abducted wearing the tag from one of their systems. 

Many of SAI's clients have had, and continue to have, problems with this passive system.  The Fortune 500 Company that promoted their systems worldwide went out of the infant electronic protection business several years ago.  In addition to having a high propensity for false alarms the passive tag was affected by antenna orientation.  While many hospitals are still using this unreliable infant protection system, many others have replaced it with another, more reliable system. 

What are some of the features and specification to look for in a hospital infant protection system capable of providing a high level of protection?

♦   The receiving antenna should not be affected by antenna orientation.

♦   The system should have the capability to identify an infant by name, room and tag I.D. number, log events, archive activities, and create reports.

♦   The system should have the capability of self supervision and the ability to visually identify any problems with the system through trouble alarms.

♦   The infant band should be flexible and made of a soft material to provide maximum comfort for the infant.

♦   The transmitter frequency should be high enough to prevent it from being affected by electronic noise generated throughout the hospital by other patient care equipment.

♦   Should have battery backup in the event of a power outage.

♦   Should be a company that offers a PM program with the product.

♦   Company should have a track history of strong customer support. (References Required)

♦   1 Year Active Transmitter (transponders and passive tags are unacceptable)

♦    Transmitter must be watertight if submerged for cleaning

♦    Transmitter must have expiration date permanently engraved

♦    Transmitter pulse rate must be at least 10 times per second

♦    System must interface with electromagnetic locks, elevators and paging systems, various nurses’ stations, CCTV, RS-232 Port, and other devices that may be activated by dry contact.

♦    Cut band technology.

♦    A computer interface with programmable entry codes.

♦    Anti-tailgate feature with auto re-arm capability when door closes.

♦    System should have self-supervision capability.

♦    Identify infants by name, room number, and tag identification number.

♦    Delayed egress capability

♦    Should provide continuous door status

♦    Perimeter alarm and elevator lockout capability

♦    Should have the ability to support mother/baby matching

♦    System should contain a 12 hour full battery backup

♦    Control panel must know the time of day and be programmable to lock and unlock doors at programmable times.

♦    Manufacture should carry products liability insurance protection in the millions of dollars.

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Some complaints from SAI client hospitals:

●   “We have been forced to place additional infant tags on our infant bassinets because the plastic sides of the crib prevent the infant’s tag from being detected.

●   “Although the marketing material claims an immunity to false alarms, we are constantly having to deal with false alarms.  The baby’s constant movement causes the connection point to separate creating a false alarm.”

●    The vendor’s sales approach was to “put down” the competition and they talked very little about their own technology.

●   The vendor’s presentation is based on an emotional sell to the hospital and it used questionable facts.

●    The vendor incorrectly compared the exposure of an infant RF transmitter to a  cellular telephone.  RF transmitters produce power that is so weak it can be measured in millionths of a watt.

When deciding on an infant security system it is best to form a committee from various disciplines and departments within the hospital.  Listed here are some of the evaluation criteria recommended for committee use.

VENDOR CONSIDERATIONS

1. Customer service (local and national support)
2. Financial stability
3. Proven track record
4. Bench marking ability
5. Implementation strategies and proven abilities
6. Quality management
7. Legal  considerations
8. Maintenance of systems
9. Growth potential and adaptability
10. On-going development and improvement

TECHNICAL CONSIDERATIONS

1. Scope of services
2. Data collection and processing capabilities 
  
3. Speed and performance   
                                
4. System reliability 
                                             
5. Security Assessments                                         
6. Support system 
                                                 
7. Receiving functions
8. Information management
9. Proven applications
10. Distributor relations
11. Ease of use
12. Report capabilities
13. Historical archive ability
14. Warranty

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      I’m sure you have heard the old adage about ”The proof is in the pudding …”  SAI strongly recommends that you ask the vendor to furnish yor committee with the names of at least three hospitals where they have a system installed, and then call on those hospitals to get their opinions on the reliability of the system.  Ask the facility closest to you if you can bring some of your staff to observe the system operation on site.  You can learn a lot by talking with the end users of the product (Nurses) and there is no one better way to learn the pros and cons of a system you may be considering for your hospital.

      Upon request, SAI will be glad to assist with identifying and selecting the appropriate system for your facility.  Jeff Aldridge, SAI president has worked directly with and/or evaluated infant security products from the following companies*, and has assisted in the development of many infant security products currently in use in the healthcare industry.

*NOTE: Some of these companies are no longer in business, have merged or changed ownership.

• Hollister • Security Tag Systems • Sensormatic • RF Technologies / Safe Place© / Code Alert© •
• SecureCare / Kinderguard© • Executone / Stork© • Dynaflow • Instantel •
• Accutech / Band Removal System / Co-Tag • VeriChip© / Hugs© / EXI / Halo© / Prosec© / Roam Alert© •

Sincerely,

Jeff Aldridge
Security Assessments International

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