RTLS and patient satisfaction

Improving HCAHPS Scores and Cultivating a Cultural Shift

When it comes to addressing grievances that affect Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores — such as "feeling unengaged in their care," "lack of clear communications," "noisy nurse workstations," and others cited in the 10 most common patient complaints — hospitals are often overwhelmed or uncertain of the right approach. Unfortunately, should these complaints go unaddressed, a hospital could see its Medicare reimbursement and reputation suffer.

Leveraging technology which addresses patient concerns is one way to reduce the uncertainty. Real-Time Location System (RTLS) is a technology uniquely positioned to confront satisfaction-related issues. By addressing these issues head on, RTLS also cultivates a culture focused on positive patient experiences.

Other than its impact on HCAHPS, patient experience is more important than some hospital leaders may appreciate. Nearly 35,000 online reviews of doctors reveal 96 percent of patient complaints are not due to clinical skill, but rather poor communication, disorganization and excessive delays in seeing a physician.1

By providing accurate, actionable data, RTLS gives clinicians and executives the tools needed to improve workflows and operations that translate to a more positive patient experience.

Driving value through location data
Advanced and open RTLS technology can integrate with clinical equipment management, patient nurse call, Electronic Health Records (EHR), and numerous other systems to help clinicians focus on patients, their care and their experience. With this ease of interoperability, the use cases for RTLS across an enterprise are seemingly endless, making it a cost-effective investment. In taking a look at three of the correlating factors linked with satisfaction — workflow, patient engagement and cleanliness — a clearer example of location data's usefulness is apparent:

1. Workflows that facilitate patient rest
"Noisy nurse stations" and "sleep deprivation" — two of the top 10 patient complaints — can be reduced by streamlining nursing care through RTLS.

For example, by integrating with wireless devices nurses carry, RTLS reduces the need for communicating on loud walkie-talkies, overhead paging or calling out in a hallway. RTLS can also automate call cancellation and rounding reminders, so the nurse can complete rounds before late night hours to minimize sleep and rest disruptions.

With an integrated RTLS, a clinical supervisor can also easily identify the locations of nurses, patients and mobile medical equipment. This information can help to improve the timeliness of care delivery, such as before the patient needs to rest or goes to sleep for the night.

Likewise, with RTLS automatic temperature monitoring capabilities reducing blood and specimen spoilages, hospitals can reduce the need for unnecessarily repeated blood draws or sample collections.

2. Patient engagement and family communication
The complaint, "feeling unengaged in their care," likely has several causes. One possible culprit is the EHR, or the repeated focus required of physicians to use the systems, which inadvertently decreases eye contact with patients. Another engagement-related complaint is the infrequency of whiteboard updates which contributes to patients feeling less connected to their caregivers.

An advanced and open RTLS technology infrastructure provides opportunities in this realm by integrating with the EHR, Computerized Maintenance Management System (CMMS) and other technologies, such as electronic whiteboards. Data captured from the RTLS can be synced with electronic whiteboard displays to alert loved ones regarding patient location and status. Additionally, in-room electronic whiteboards can be automatically updated through the integrated RTLS with staff information when a clinician enters the room. This means less manual data entry and clearer communications at the point of care.

As RTLS helps automate activities, physicians can make more eye contact, ask questions and actively listen. More time to engage with patients also translates to more time to communicate with a patient's family. This frequent clinician communication is supplemented with the availability of patient location data through the RTLS, which offers loved ones the peace of mind of knowing exactly where their family member is in the care process.

Meanwhile, RTLS can help address the complaint of "lack of orientation," which is common in major health systems. By providing location data to other applications and mobile devices, a real-time location system that is capable of leveraging Bluetooth Low Energy (BLE) technology, fuels wayfinding functions on electronic maps or smartphone applications. This enables patients and family members to navigate the hospital and its multiple facilities with ease.

3. Cleanliness
Patient complaints associated with the cleanliness of their rooms, and throughout the hospital, are also common. Even in this domain, RTLS may be leveraged for improvements.

Location data obtained from tagging equipment, patients and staff streamlines the cleaning process and allows personnel to be notified in real time about which equipment or rooms need to be cleaned without the need for manual data entry. Hospital staff can then verify through RTLS that equipment and rooms have been properly prepared for new patients and avoid mistakenly rooming a patient too early.

Although hand-washing was not listed as a patient complaint, it is certainly a cleanliness concern. Here again, RTLS can help. The technology can automatically remind clinicians to wash their hands and capture when hand washing is completed. Data for hand washing can then be analyzed for easy compliance reporting and to identify performance improvement opportunities.

By ensuring cleanliness, RTLS can help improve a hospital's infection control efforts by reducing the spread of life-threatening hospital-acquired conditions, which ultimately impact the overall patient experience.

A catalyst for culture change and patient satisfaction
Investing in RTLS helps hospitals address the most common culprits of low satisfaction scores, and in doing so, empower a much bigger hospital culture shift.

One example is Geisinger Hospital System, which recently implemented a "no-questions-asked" refund policy for customers who are dissatisfied with any aspect of their service. Geisinger's cultural shift, partly assisted by RTLS implementation and the ability to leverage location data to usher in improvements, has garnered national press coverage and boosted the hospital's reputation for putting patient needs first.

Understandably, for some organizations, an enterprise-wide RTLS deployment like Geisinger's might seem overwhelming, and an "overnight" shift in workflow and operations is not possible. Therefore, organizations looking to start with RTLS technology may benefit from implementing a phased rollout within one key department that impacts patient satisfaction scores, such as ED or outpatient surgery, then expand as needed.

Regardless of the implementation strategy, RTLS will emerge at the organization as one investment that yields multiple returns — the most important of which being healthier, engaged and satisfied patients.

About the author:
Ari Naim is chief executive officer at CenTrak

1 https://globenewswire.com/news-release/2016/04/26/832480/0/en/Study-96-Percent-of-Online-Complaints-About-Doctors-Fault-Customer-Service-Not-Quality-of-Care.html

The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.

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