Losing track of your keys, wallet or smartphone is inconvenient. But in health care, not being able to immediately locate medical equipment is a serious problem that can lead to delayed procedures, lower productivity, and the loss of specimens and supplies.
A health care organization must have a single and complete picture of its materials, facilities, personnel and patients at all times in order to provide the highest level of care. Real-time location systems (RTLS) can be a powerful tool to streamline hospital operations and increase visibility.
In this Q&A, we talk to Timothy Shiuh, MD, chief medical information officer at ChristianaCare in Wilmington, Delaware. He shares how ChristianaCare is boosting efficiency and enhancing patient care by using RTLS in its three emergency departments.
Q: What is RTLS? What are some of the key problems it can help health care organizations solve?
A: RTLS provides GPS-like tracking of staff, patients, equipment and assets within the four walls of any health care setting. Tags and badges, that are attached to people and objects, interact with a series of receivers and readers that serve as location sensors to pinpoint to room and bed-level specificity. RTLS operates with various technologies, like infrared, ultrasound, Wi-Fi and Bluetooth Low Energy, in order to provide instant location awareness.
Hospitals are complex environments, which makes RTLS a great tool for removing the barriers and delays associated with locating people and equipment. RTLS data can be integrated into electronic health records, bed management and nurse call systems, as well as asset management software, to improve operational efficiency, automate manual processes, promote patient and provider safety and prevent infections.
Q: What was ChristianaCare’s journey to implementing RTLS?
A: We started using RTLS in 2004. At that time, the volume of patients in our emergency department was growing rapidly to approximately 110,000 patients a year. We needed a way to improve patient throughput, automate milestones and provide location transparency of patients and staff. There were safety issues we were trying to solve, too. For example, when tracking potential exposures to communicable diseases, RTLS let us quickly see all staff, room and patient interactions. Fast forward to 2020 with COVID-19, and the critical importance of this capability becomes crystal clear.
Q: How is ChristianaCare currently using RTLS?
A: Today, we primarily use RTLS to automate manual processes. With this technology, we’ve been able to eliminate delays and get patients seen by physicians faster.
Here’s an example of how it works: When a patient comes to the emergency department, they receive a sensor tag at registration. This immediately begins driving RTLS awareness and process automation. As the patient progresses through their visit, bed and clinical assignments are automatically assigned, triggering and satisfying major tracking milestones – patient assigned to room, ready for evaluation, seen by provider. When a patient leaves the department, their badge triggers a move to “checkout” status and updates the room as open for the next patient. In addition, tags are placed on critical pieces of equipment, so clinicians can quickly find what they need on the capacity management map.
RTLS is also used to help improve the patient experience. We can use RTLS data to support the interactions between caregivers and patients, including their time and duration.
Q: What are ChristianaCare’s future plans for using RTLS in the clinical setting? Industrywide, what’s next for this technology?
A: ChristianaCare has the infrastructure for end-to-end tracking across the organization and to know the movement of every patient, caregiver and piece of equipment (and their interactions) from beginning to end. The potential to use this RTLS data is exciting, yet daunting. Eventually, we hope this data can help us predict and address patient flow issues and bottlenecks, identify staffing and resource constraints, improve processes and efficiency, and eliminate waste.
Additionally, we see RTLS improving patient satisfaction by providing continuous updates to family members on milestones during their loved one’s stay. It could also help us better understand the potential connection between the frequency and duration of patient and caregiver interactions and satisfaction, quality of care and outcomes.
Another significant effort ChristianaCare is undertaking now, along with the industry, is addressing the safety of our caregivers. Ideally, any staff member who feels they’re in danger could press a button on their tag to summon help and have their exact location pinpointed through RTLS. We’re also looking at RTLS technologies to help us monitor hand hygiene.
Q: What are some best practices you can share with other organizations that might be interested in integrating RTLS into their operations and care delivery?
A: Health systems should consider what their business needs are for RTLS and their objectives. There are many uses for RTLS, integration considerations and different technology options. A technology suited for one use case may not be scalable for future needs. It’s important to understand the scope of what a health system wants to achieve before picking a solution, as RTLS is a strategic investment.
Change management is another important consideration with RTLS. Questions arise when you put tags and sensors on patients and caregivers. People want to know why you’re tracking their movements. At ChristianaCare, we secured buy-in from our caregivers when they understood our focus was to improve efficiency and safety, not to be punitive or track how long someone spent in the bathroom or breakroom. A good approach is to launch a pilot to test specific scenarios and promote adoption. That’s the model we followed by starting in the emergency department, choosing a scalable platform and then developing a broader strategy for the entire health system ─ building on our initial learnings and successes.
Cerner is committed to optimizing the patient journey through the health system. Learn more here.
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