Location, Utilization, and Movement

I had an interesting call with Will Lukens, Vice President of CENTRAK, a Real Time Locating System (RTLS) company. There are a number of debates swirling around RTLS such as what’s the best technology to use? (Wi-Fi, RF, Hybrid - Check out JHIM from Fall 2008 for further reading on the technology.) No matter what technology you use in the background, RTLS is a great mechanism to track the effectiveness of workflow for staff and “stuff”.

Step One is always to decide “what” you want to accomplish prior to deciding “how” or with which technology you want to use. The "what" or goal froma workflow perspective can be evaluated in three areas Location, Utilization, and Movement. Using these areas you can evaluate numerous abilities to track implemented technologies and initiatives.

LOCATION: It’s been reported that caregivers currently spend less than 30% of their time at the patient bedside, but that’s an average which is not applicable for every facility. Using RTLS a hospital could track the actual time frames that a caregiver spends with a patient and set a baseline for their specific facility.

Location is the portion of the puzzle that has the most value and the most apprehension. The ability to track caregiver’s locations with detailed reports of who, when is sometimes labeled “Big Brother” and “Micro-Management” and honestly, would you be pleased to wear a tag that tracked your movement the entire time you are at the office? “Bob, you spent way too much time at the coffee pot.” Using this as a coporate means of improvement as opposed to individual tool for punishment is really key.

UTILIZATION: “Work Around Artists” is a term that Karen Cox, Executive Vice President of Children’s Mercy Hospital in Kansas City coined in the last issue of Ingrams. That name captures the innovative spirit of the caregiver. They are the modern day MacGyvers using available resources to find more efficient paths.

Often hospitals will implement initiatives, or provide technologies with the desire to see an improvement in something that is lacking. For example, if there are high infection rates they may implement a hand washing initiative and provide a new sink in every patient room. What if the utilization of the sink could be documented automatically – even more so what if that information could be correlated back to the reduction of infection rate.

MOVEMENT: Frank Lloyd Wright would watch people’s movement habit’s to design walk ways. Once he didn’t put in a single side walk at a University until after the students had worn paths to show where he should be putting those walk-ways. RTLS is the modern day observation and automated documentation of movement habits. A caregiver walks 1 to 4 miles per day (depending on size of facility and quantity of patients) often a technology is provided to reduce that foot traffic. Hospitals can have humans track the movement with clipboards and pens or pedometers, but if they have an RTLS system that information is being collected.

Before you begin your journey - A great resource when planning RTLS purchase and implementation Robert Konishi’s RFID-RTLS Strategy and Planning Guide. Robert is the former CTO of UCLA Medical Center, and Current CEO of T2 Technology Group. According Konishi, there are four main areas that can be assessed to link to value when evaluating the RTLS system for equipment tracking:

• Cost savings associated with rental or duplicate purchases
• Lost Revenue and Opportunity Cost due to utilization
• Lost Time for Staff
• Quality of Patient Care, Throughput, and Regulatory

Konishi provides very helpful insights in the article from RFID News (http://www.rfidproductnews.com/pages/searchview.php?key=konishi&p=issues/2008.03/medical2.php) and a subsequent RFID-RTLS Strategy and Planning Guide.

The power of RTLS is the ability to track specific information. That information can become a metric which can be used to help the hospital better assess their workflow choices. A metric on it’s own is important – every business needs to track it’s ability to improve – however correlating those metrics with other data is the most powerful way to look at the data. That's why Sphere3 has developed our automated web based Sphere3 Scorecard™.

We look forward to sharing it with you.