As patient acuity and staff workloads continue to increase, healthcare executives must enable effective staff communication and workflows. Without these, the resulting staff stress and patient care delays can negatively impact both patient and staff satisfaction.

One way to coordinate patient flow and streamline caregiver workflows is to use patient and staff tracking technology, which eliminates many manual processes, simplifies hand-off communication and reduces care delays — thereby achieving positive return on investment. There is a common misconception, however, that the sole purpose of real time location system (RTLS) technology is to track equipment. In reality, there are a number of ways in which it can improve both provider workflows and patient flow.

Here are the facts behind some frequent RTLS questions and concerns:

What is RTLS?
RTLS is a hardware/software tool that uses active radio frequency communication to automatically identify and track the location of patients, staff and mobile medical equipment as they move throughout a hospital. RTLS tags, which are attached to equipment or worn by people, emit radio signals. These signals are detected by sensors, enabling location data to be used to interpret activities such as movement and the frequency of staff or patient interactions.

Improving documentation and data collection
RTLS can strengthen patient flow in a variety of ways, but the most basic is by automating the documentation of activities and the collection of metrics — simply as a byproduct of monitoring tags as they move across a facility.

For example, when a patient wearing a tag is moved from the emergency department (ED) to radiology, an RTLS system can send an HL7 message to the electronic health record (EHR) that reflects the date and time the patient physically left the ED. Likewise, the duration of the radiology visit is recorded, and the time the patient returned is documented. In addition, information is captured about the staff members who accompanied the patient during transport and interacted with the patient throughout the procedure. Forward-thinking organizations can use time stamp data such as these to conduct performance improvement analysis.

Other care milestones also may be documented through tag button-press events or by knowing a patient and caregiver are in the same location. Take the pre-operative setting, for instance. The entry of the anesthesiologist of record into the space around the patient’s bay, combined with the dwell-time of that anesthesiologist for a prescribed duration, implies the completion of the pre-operative anesthesia assessment. This data could be used to mark the completion of this milestone in advance of the anesthesiologist’s ability to document the assessment in the EHR, keeping downstream staff apprised of patient progress. Moreover, the pre-operative nurse could use a tag button-press to indicate the completion of a group of activities related to surgical preparation (e.g., the assessment, IV initiation and administration of pre-operative medications).

Expediting patient care through tracking
Questions sometimes arise about how tracking helps patient care. The answer lies in a tracking system’s ability to provide a critical link between staff movement and care delivery.

A robust RTLS not only detects interactions among providers, patients and equipment, it also relates them to the medical orders and care plans documented in the EHR. It can draw conclusions about what is occurring, what should happen next and who is responsible for making it happen. That information then is directed in real time to the appropriate staff members via dashboards, so they can act on it quickly. For example, if a laboratory technician hasn’t entered a patient’s room within 15 minutes of a stat order, an RTLS can automatically send a reminder message to the appropriate technician and/or manager.

Furthermore, because a dynamic RTLS recognizes the completion of milestones in a patient’s care progression and proactively communicates anticipated roadblocks, providers gain a clear view of a patient’s status in accordance with the ordered plan of care. For instance, clinical staff might receive reminders: if someone hasn’t been in the room for hourly rounds; physical therapy staff haven’t ambulated the patient according to schedule; a nurse hasn’t entered the room for re-assessment more than 30 minutes after patient medication; or when a patient has been in a bathroom for an excessive amount of time.

Enhancing infection control practices
With recent concerns over Ebola and other infectious diseases, the need for rapid identification and isolation of exposed people and equipment is top-of-mind for many hospitals. RTLS enhances exposure detection through its ability to monitor all providers or patients who come into contact with people or equipment contaminated by an infectious disease. Upon the confirmation of a communicable disease, a history of all exposed patient and staff populations can be pinpointed immediately and treatment instituted expeditiously.

Compliance with other infection control protocols also can be detected through RTLS such as hand hygiene, by monitoring the use of gel or soap-and-water stations before and after patient interactions. Compliance with equipment cleaning protocols and processes may also be monitored using RTLS; alerts can be issued when equipment flows from one patient room directly to another, bypassing the hospital’s decontamination protocols, for example.

Gaining staff buy-in
The advantages of RTLS depend on staff and patient willingness to wear tags, and there is understandably some concern about how tracking data will be used. Success with an RTLS endeavor is contingent on how well a hospital achieves staff buy-in.

Facilities that include staff in the evaluation process and give them a voice regarding how the equipment and data will be used typically experience the greatest staff acceptance. Transparency about where tracking information will or will not be used is of utmost importance; staff then can discover how tracking increases efficiency.

Greater efficiency, better care
In today’s healthcare environment, achieving efficient staff workflows and patient flow are business imperatives. Healthcare organizations need to know that RTLS supports the intelligent orchestration of care delivery, which improves the patient experience while simultaneously giving clinicians the time and information they need to solve complex patient problems.

Merrie Wallace, RN, MN is the CNO and EVP of Product Solutions at Awarepoint.