Badges of Honour

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To combat hospital-acquired infections, TRI added a wearable tech weapon to their arsenal.
Posted On: November 29, 2016
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In front of a bank of docked badges, Holliday and Pong (left and right, respectively) review a TRI ward’s hand-hygiene performance. Photo courtesy of Michael Freeman. (
By Michael Freeman, ORT Science Writer & UHN Trainee
It’s official. It’s flu season.
Though most people recover in less than two weeks, some populations are especially vulnerable to serious flu-related complications, including older adults (over 65 years of age), children (less than 5 years of age), pregnant women and residents of long-term care (LTC) facilities. Last year, more than 5,000 Canadians were hospitalized as a result of contracting the virus and nearly 300 people died. But people who live in LTC homes are at risk of contracting more than just the flu while receiving care: hospital-acquired infections caused by ominous microbes like Clostridium difficile and methicillin-resistant Staphylococcus aureus account for more than 8,000 annual deaths in this country.
The primary culprit: poor hand hygiene (HH).
Experts at the Toronto Rehabilitation Institute (TRI) have decided to focus their generous intellect on the problem. And, in keeping with the institute’s reputation as one of the most advanced rehabilitation research centres worldwide, you can expect that their solution is elegant and awesome.
"When this thing vibrates, it is saying, ‘think about where your hands are going to be.’ That's it," explains TRI research associate, Pam Holliday. She is talking about the pager-sized module (‘badge’) clipped to her lanyard that delivers a pulse to remind her to wash her hands.
The system is engineered to give these reminders whenever a user with unclean hands crosses the threshold of a patient’s room, which is guarded by ceiling-mounted, infrared light-beaming sentinels. To be cleared for entry, your badge must be assigned ‘clean mode’ status, which is done by visiting a hand sanitizing station. Once the alcohol or soap is dispensed and your hands are washed, another sentinel beams a signal from above the station, turning the green LED on your badge from ‘off’ to ‘on’—dirty to clean. For 60 seconds, you are in ‘clean mode’ and can enter a patient’s room to provide care without protest from the badge. With each move across this threshold—going in or out—the same procedure applies, providing powerful real-time feedback on your HH practice.
A 30-person TRI care team demonstrating adequate HH practice—defined by the Ministry of Health’s ‘Four Moments for Hand Hygiene’—will encounter more than 1,400 opportunities for hand washing over the course of a single shift. This represents of a lot of dispenser pumps, and plenty of opportunity to forget a couple.
“Of course, the staff already understand the rules and already have the patient’s best interests at heart…all they seem to [occasionally] need is that little reminder,” says Steven Pong, a TRI staff industrial designer and PhD student instrumental in developing the HH badge technology.
After one year of multi-site pilot testing, the results of these wearable reminders have been tremendous. Pong explains, "What we are seeing is a sustained doubling of performance."
Reflecting on the impact of this in-house technology, Holliday says, “It can save lives. And don’t forget, it’s the patient that counts.”
Check out more of TRI’s incredible innovations and space-age laboratories for rehabilitation research.