Case Study: Implementing RTLS at Texoma Medical Center
1. Pinpoint the problem. Mr. Stepp says Texoma Medical Center has had an on-going issue with missing or hard-to-find movable medical equipment, such as sequential compression devices, PCA pumps, feeding pumps and wound VACs. Members of the materials services department would spend anywhere between 20 to 30 minutes trying to track down and retrieve medical equipment, which impacted the department's ability to spend time tending to their other responsibilities.
"When a request is made for a piece of equipment, our department is responsible for getting it to the floor, picking it up once it was used and cleaning and reprocessing it for the next patient," Mr. Stepp says. "We could find it in our storage spaces and take it to the floor, but we weren't able to find those pieces of equipment once we sent them out. We'd spend time going from room to room trying to track them down."
In addition to losing track of a piece of equipment, the hospital was finding many pieces of equipment were also being accidentally thrown away. After being placed into bags after use, the equipment would sometimes be improperly placed in trash bags or laundry bags, which leads to permanent loss of that asset and creates additional costs for equipment or rentals, Mr. Stepp says.
2. Educate staff members on the problem and the solution. Education has been the key component in the successful implementation of RTLS at Texoma Medical Center. Mr. Stepp says the easiest part was educating others on the problem of missing and hard-to-find equipment. The more difficult part was getting the staff members on board in adopting RTLS as the solution to the problem. Mr. Stepp says there was some resistance from staff members, particularly nurses, who weren't comfortable with the drastic change. Eventually, staff members started coming around to the idea of adopting RTLS after Mr. Stepp revealed the benefits of using such a solution, particularly with temperature monitoring in refrigerators, which is required by Joint Commission.
"With RTLS, each tagged refrigerator reports back temperatures, and we're alerted if for some reason the temperature falls outside of an accepted range, which can lead to something spoiling or freezing," Mr. Stepp says. "What I did was package the information about asset tracking with temperature monitoring and presented that to our staff members, and that was what led us to the joint buy-in."
3. Find a system that works well within your organization. Mr. Stepp says healthcare organizations need to take time to analyze all the possible options for implementing an IT solution for asset tracking. Texoma Medical Center, which uses an RTLS system powered by Awarepoint, incorporated a system that consisted of low-power sensors and ZigBee protocol, which is a specification for wireless connection. The system includes 250 sensors throughout the building, 50 bridges and a server that is separate from the hospital's own wireless network. Every piece of equipment that is tagged sends a signal to a sensor, which relays that signal through the bridges and then to the server. From the server, staff members can pinpoint where exactly a piece of equipment is stationed or whether it's moving through a hallway.
"Along with that capability, we have the ability to set up a firewall or alert, so if a piece of equipment with a tag goes outside of a set of sensors, it alerts us to know that the equipment is about to leave the building or is headed toward a trashbag," Mr. Stepp says.
Mr. Stepp adds that this particular system was chosen because of its quick installation period of a little over one month and its ability to operate separately from the hospital's wireless connection. "ZigBee protocol is something that I'm not sure very many people are aware of. I think most people are using their traditional wireless connection, which can be a drag on your network."
4. Assess your returns on investment. A thorough assessment of ROI first begins with a healthcare organization deciding which success indicators to measure. Mr. Stepp says his hospital's ROI was focused on soft costs, meaning part of the measured ROI included time saved looking for missing equipment. After determining time spent searching for missing equipment was cut down from 20-30 minutes down to five minutes, that finding was stratified to calculate savings in hourly wages.
"You have to decide ahead of time how you're going to measure ROI, and everyone measures it differently," he says. "We're seeing a lot of the return coming back to employee productivity, which is hard to put a pencil to. I have been short-staffed in the last eight months, and I don't know if we could have ever done our jobs well if we still had all those same responsibilities while spending all that time looking for equipment."
In addition to measuring how much productivity has increased, Texoma Medical Center discovered that huge savings were being reaped from not spending money on rentals or new equipment to replace lost items. "One of our big ROI savings was about $88,000 because of not buying new PCA pumps. We started analyzing how many PCA pumps we had, and we found we had 75 percent of the pumps available when staff members thought 99 percent of the pumps were unavailable. So instead of spending $88,000 to buy new pumps, we saved that money because we are able to track our equipment's location and availability much better," he says.
Texoma Medical Center was also able to save approximately $3,000 each month in rental expenditures. Mr. Stepp says sequential compression devices were one of the bigger ticket items that was going missing frequently, and so the hospital often turned to rentals to compensate for lack of equipment availability. "I have not had to rent a piece of equipment in about seven months because everything we were renting was things we lost or could not find. There is an enormous amount of money being saved just through our rental savings," he says.
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