Texas Health Resources’ early RTLS adoption is paying off

Texas Health Resources is one of the largest faith-based, nonprofit health systems in the United States with 29 hospital locations, 3,800 licensed beds and more than 23,000 employees across inpatient and outpatient facilities.

In 2008, Texas Health implemented Real-Time Location System (RTLS) technology in our Dallas hospital to manage assets after providers reported difficulties locating equipment. Based on that location's success, Texas Health built its new Alliance Hospital several years later with RTLS to deliver enterprise location services not only for assets, but for people as well to ensure the most efficient provider workflows and patient flows throughout the facility.

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Image of CenTrak asset tag

However, simply implementing RTLS is not enough. Texas Health Alliance optimized numerous workflows through data analysis and automated activities. This continuous improvement philosophy has led to cost reductions in assets, but also improved staff productivity.

The ability to reduce wasted time and effort while improving facility-wide staffing efficiency and patient throughput has been ideal preparation for value-based payment models where reimbursement will be partially based on our organization's ability manage costs.

Asset management challenge offers opportunity
The Dallas facility's original pain point that led to the RTLS implementation was rising equipment costs, especially among IV pumps and other in-demand clinical assets. Upon investigation, we determined that some providers were hoarding and hiding equipment because they were concerned it would not be available later. This led to increased rental costs and replacement purchases.

Once the RTLS was implemented, the data captured from the technology showed that in addition to the misplaced and hidden assets, rental equipment was occasionally not promptly returned or retrieved by the vendors, leading to extra fees. Correcting that oversight, combined with other process changes informed through RTLS data, helped Texas Health Dallas save $1 million the first year after implementation.

Taking enterprise location services to the next level
Officially opened in 2012, the 70-bed Texas Health Alliance Hospital included innovative features such as a wireless data networking infrastructure, mobile-device driven workflows and an open-architecture RTLS that allowed for facility-wide integration with hospital systems. The latter was also supported by a new Mission Control department dedicated to improving internal logistics and workflow. Based on the experience in Texas Health Dallas, enterprise location services available through RTLS were leveraged to track assets, providers and patients in conjunction with new equipment management policies and procedures. For example, par levels were instituted where a minimum number of each type of equipment is now always maintained in the appropriate location. Additionally, as soon equipment is no longer in use, it is located and retrieved for cleaning and preparation.

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Image of RTLS floor plan courtesy of CenTrak

Another example of how RTLS improved efficiency is patient discharge, which involves several phases and systems. The first step is clinician notification through the mission control system to transport the patient from the room to the lobby. Once the RTLS has detected that the patient and provider have exited the room, environmental services (EVS) is automatically notified through the facility's mobile communications platform to clean and prepare the room for the next patient. The RTLS tracks the patient transport to the lobby and documents the hand-off in the capacity management system. Meanwhile, when EVS exits the room, the RTLS automatically documents it is cleaned and the capacity management system changes the room status to Available.

Based on an algorithm that Texas Health created, this automated tracking and notification, eliminates manual data entry in disparate systems, while improving response time and increased patient satisfaction due to less time spent waiting.

Studying data essential for efficiency improvement
Developing automated processes through RTLS are essential to maximize the return on investment, but as we found, data analysis is required for continuous performance improvement.

For example, the Texas Health Dallas nursing staff claimed that IV poles were often unavailable. After tagging hundreds of poles through the RTLS, the utilization data was studied. It turns out that the perception did not match the reality, which was that IV poles were readily accessible when needed. RTLS asset tags were then reattached to equipment that were under higher utilization.

Texas Health continues to optimize our RTLS system to better manage assets, but, more importantly, maximize patient throughput and staffing efficiency for more significant long-term cost savings. Our goal is to nimbly deploy clinical staff where needed throughout the multi-location enterprise based on real-time patient volume and scheduling data analytics. Even further down the line, we hope to leverage our RTLS to automate accurate and complete charge capture by integrating the technology with our revenue cycle systems.

Whether it is efficient staffing, patient flow or asset management, increased automation reduces costs for Texas Health, and offers more time for providers to improve outcomes instead of entering data or waiting to deliver care. As risk-bearing value-based payment models ramp up across the industry, we are confident that RTLS will help us reach our efficiency goals to help us retain a larger share of that reimbursement.

About the author:
Kathi Cox is senior director of System Integration and Innovation at Texas Health Resources

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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