mounted on the ceiling of all patient care areas. The sensors then transmit the patient’s location to the tracking solution, which is easily accessible to nurses, physicians, registrars and other authorized personnel.
Linda Laskowski-Jones, M.S., R.N., ACNS-BC, CEN, is vice president of emergency and trauma services at Christiana Care Health System, which has deployed real-time location systems enterprise-wide. For more on Awarepoint solutions: www.rsleads.com/203ht-211
Not wash and wear Since deploying the sys- tem, Christiana Hospital has found that badges sometimes become buried in the linen when patients are discharged. Although housekeeping has
been trained to look for the badges, when things get busy they can be overlooked and don’t survive the wash cycle. The hospital is considering installing sensors that will sound an alarm whenever badges are detected in laundry chutes. In a handful of cases, patients refused to return badges because they mistakenly thought their personal health infor- mation was stored in them, which surprised the facility. The hospital never insisted on return and refi ned its education process to address these issues. They tell patients upfront what the badge does and does not do, and they instruct staff to be aware of the location of the badges, particularly at discharge. Another challenge Christiana faced is that the technology used in the ED requires a clear line of sight for the badges and sensors to communicate. If the badge is covered by a blanket or fl ipped around, the hospital momentarily loses
How does workfl ow management impact the bottom line and the quality of patient care?
Jay Deady, president and CEO, Awarepoint Corporation A hospital’s biggest revenue- generating departments – emergency, surgery, cardiovascular and oncology – can all be adversely impacted by a lack of real-time visibility of critical assets. As just one example, a facility can put a patient’s health at risk and lose revenue when it must delay surgeries because the patient, surgeon or a vital piece of equipment is not present at the scheduled procedure time. Fortunately, the growing prevalence of advanced
real-time location systems (RTLS) has proven to improve asset visibility for healthcare providers across the enterprise. In addition, as more and more of today’s RTLS provide the functionality to scale by the entity to be tracked, its purpose and scope of hospital workfl ow, facilities will be better able to adhere to regulatory compliance requirements, identify process ineffi ciencies and support the higher occupancy and acuity needs of today’s hospitals.
the patient. However, the loss is brief because the facility has installed 400 sensors across the ED, meaning that the system will pick up people as soon as they start moving again and line of sight is reestablished. A technology upgrade is currently underway that will eliminate this issue by enabling sensors to detect the badges even when they are obscured or turned the wrong way.
Actionable intelligence drives improvements The RTLS-enabled workfl ow effi ciencies were so impres- sive that Christiana deployed the Awarepoint RTLS solution at its second ED at Wilmington Hospital and eventually expanded its use enterprise-wide for asset tracking. In just the fi rst year, RTLS was a key factor in reducing ED length of stay (LOS) by an average of 36 minutes and cutting the LWBS rate by 24 percent. As Christiana Hospital’s ED volume soared between 2004 and 2008, the health system realized it needed to expand its use of RTLS from a tracking to a continuous process-improvement tool. A major advantage of Awarepoint’s RTLS is that it can precisely record, measure and track numerous performance metrics at pre-determined time intervals, including wait time, arrival to discharge, door to triage and door to doctor. This actionable intelligence enables users to identify and prioritize processes. It also enables users to refi ne or redesign processes and procedures and determine whether changes are successful. To maximize the value of the RTLS data, in 2008 Christi- ana dispatched a group of employees to a six-day immersion course at the University of Tennessee on lean production system principles pioneered by Toyota Motor Corp. Since then, Christiana’s lean group has focused its attention on improving ED throughput of low-, medium- and high-acuity patients. The lean group has been able to use the RTLS data to achieve numerous benefi ts, including:
• Cutting overall wait times for low-acuity patients by 46 percent, even as ED volume jumped to 116,000 in 2011 from 85,000 in 2003; • Reducing the ED LOS for low-acuity patients to ap- proximately an hour from an average of two-and-a-half hours;
• Decreasing the overall LWBS rate by 25 percent; • Dropping the admitted patient ED LOS by over 30 percent despite the census increase; and • Enhancing staff safety with an automatic log of all direct and indirect patient interactions.
Like other health systems, Christiana Care is challenged by mounting costs, growing ED visits, wait times and pres- sure to provide high-quality, timely and effi cient care, while simultaneously striving to attract patients and be recognized for the excellent care it provides. RTLS has been instrumental in helping the organization successfully address major chal- lenges while improving workfl ow and staying ahead of the curve and market trends.
HMT HEALTH MANAGEMENT TECHNOLOGY March 2012 25