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f stability is a measure of success, Providence Healthcare (Toronto, Canada) deserves a blue ribbon. This year is a milestone for Providence Healthcare, marking the 150th anniversary of the opening of the original House of Providence in downtown Toronto, by the Sisters of St. Joseph. Providence began life as a house of charity to alleviate the poverty throughout the diocese, and, at its peak, it provided accommodation for 700 elderly residents and orphans—the persons who were among the most vulnerable in society. It is a legacy of spirituality, compassion, and quality care that staff members, such as Tom Clancey, Providence’s Director of Environmental Services, are proud of. “There are really good values here,” he says, “and, as a result, excellent care.”
       As a fixture in Canada’s largest city, Providence Healthcare specializes in rehabilitation for patients who have experienced strokes, orthopedic surgery, or lower- limb amputations or who require specialized geriatric rehabilitation, assessment, and treatment. It also provides complex continuing care, long-term care, and community outreach, with a particular focus on addressing the medical, physical, spiritual, and emotional needs of individuals with geriatric conditions.
       Programs and services are provided through three integrated care divisions. The first is Providence Hospital, one of Ontario’s largest rehabilitation and complex continuing care facilities. Providence Community Centre also specializes in community clinics, caregiver support, education, and neighborhood outreach programs (eg, the nationally acclaimed Alzheimer’s Day Program and the innovative Tamil Caregiver Project). Its third division is the Cardinal Ambrozic Houses of Providence, a long-term care facility comprising eight 36-bed houses for 288 residents.
       About 25% of the long-term care residents are prone to wandering, a result of being affected by some kind of early dementia. “They might be forgetful, but it’s OK for them to wander around the facility—we just need to know where they are,” says Clancey. But among this group, only eight or so are considered high-risk persons. However, that small number of individuals was dictating policy for the majority; it was necessary to restrict everyone’s movement in order to keep tabs on those who were most likely to leave the building without authorization. Providence staff realized this was a situation that needed to be fixed and set out to find a technology that would keep all residents safe.

A New Approach

       In February, Clancey and his staff flicked the switch of a new monitoring system that uses a combination of RoamAlert technology and Axiom 5 software. “It’s the backbone for all our security systems, now and in the future,” says Clancey. “It integrates all of our resident anti-wandering devices.”
       To follow is a description of how Providence’s new system works. As a resident wearing a RoamAlert pendant or bracelet approaches one of the eight houses’ 60 alarmed doors, an infrared signal is picked up and sent through the Axiom 5 software to a central processing unit. Then, depending on who the resident is, the unit maintains the status quo on the door or locks it.
       “Low-risk residents can roam around, get on the elevator, and go to places, such as the gift shop, the great room, or the gardens,” says Clancey.
       If, however, the system locks the door because the resident was previously identified as unsafe to wander, it also sends a message to a nurse’s pager, drawing attention to the resident’s coordinates. At this point, a staff member will go get the resident. If the resident still somehow manages to wander through a door and down an elevator, thanks perhaps to well-intentioned visitors trying to help him or her gain access to restricted areas, an audible alarm sounds. If the resident still has not been intercepted by a staff member and is able to exit the building, the system notifies both the residence supervisor and security personnel.
       These are specific alarms for specific situations. In Providence’s old system, alarms were indiscreet and went to all staff. Clancey says that was unnecessary and estimates that, 90% of the time, alarms were related to events that were outside of most staff members’ jurisdiction or area of responsibility (eg, on another floor or another part of the building in which they did not work). It did not mean the alarm was not important. But it was not usually pertinent to them.
       “With the old system, there were too many alarms. When an alarm went off, it was difficult for staff to assess if the alarm was for someone in their area,” says Clancey. “With the new system, staff members only get alarms that are pertinent to them.”
       Understandably, staff members are much happier with the new set up, a sentiment that has repeated elsewhere when new, more tailored systems are brought in, says Diane Hosson, Vice President of Marketing for VeriChip Corporation, makers of the RoamAlert system.
       “Senior-care facilities are looking for systems that can make staff more productive and able to concentrate on resident care. And for that, you need a high degree of configurability so that the system can be adapted to the particular situation and needs of each facility."
       Families are happy, too, says Clancey. Initially, issuing residents anti-wandering pendants or bracelets was unnerving, because everyone was subjected to the same level of monitoring. But now, Providence is able to institute two levels of monitoring, and the main level involves very few restrictions and a great deal of movement.
       “In the old system, anyone with any type of early-stage dementia was restricted,” says Clancey. “Too many people were restricted. Now, that’s changed.”

Looking Ahead

       The next step, says Clancey, is to add closed-circuit television surveillance to further ensure resident safety. Again, this system will be connected to the rest through the Axiom 5 backbone; when an alarm is triggered at a door, a camera focused on that door will display the image on a television screen at a main reception area so staff can observe what has happened and which resident is involved. It is an integrated platform that is working well with the RoamAlert system, and Clancey is confident it can handle Providence’s needs for the next 5–10 years. “This technology works,” says Clancey. “We help people maintain their dignity and keep them safe at the same time.”