7 Best Practices for Installing Real-Time Location Systems in Your Hospital

Real-time location systems are an IT solution that has been adopted in many different industries, including the military and healthcare industry, as a way to improve asset management. Specifically in the healthcare setting, RTLS may be installed to better track mobile medical equipment, expensive surgical equipment and other supplies to reduce supply chain expenditures. In other instances, RTLS has also been employed to track patients as a means of improving operational processes that can affect a healthcare organization's efficiency, such as patient throughput, wait times and length of stay. Here are seven best practices for hospitals before fully employing RTLS.

1. Get organization-wide buy-in. Valerie Fritz, vice president of marketing for Awarepoint, a real-time solutions company, says it is critical hospitals get all potential end-users on board with the installation of RTLS. This starts by engaging all major stakeholders, departments, physicians, administrative leaders and staff members about why RTLS is the solution for the organization's weaknesses, whether it be poor management of assets or poor patient throughput. "If you go in and just get buy-in and feedback on opportunities for improvement from the biomedical department's perspective, you're going to lose opportunities in other areas, like the OR. What's important from the very beginning is getting key leaders from each department to understand the issues that need to be resolved within the organization and how RTLS fits into the picture," Ms. Fritz says.

Scott Sullivan, business officer for perioperative and imaging services at UC San Diego Health System, says his healthcare organization established a steering committee made up of constituents from multiple departments. The committee meets once a month to collectively decide as a group which assets will be tagged. "There are representatives from all departments, including nursing, our pharmacy, IT department, security, nutrition and clinical educations," Mr. Sullivan says.

2. Start with a specific objective with the end-goal of expanding. Ms. Fritz says healthcare organizations should zero in on a specific goal to accomplish, such as seamless asset tracking, with the intent to expand RTLS use over time. This gives healthcare organizations the opportunity to test RTLS on a smaller scale. However, it is absolutely critical that organizations implement the RTLS network coverage across the entire organization, even if only specific departmental assets are being tracked initially, Ms. Fritz says.

Jim Barnes, manager of the OR support staff at UC San Francisco Medical Center, says his organization first implemented RTLS for his OR suites, which were located on the fourth floor. In the initial stages, RTLS slightly expanded to include six "high use" floors that are most likely to have OR equipment, including the radiology department and delivery unit. A year later, Mr. Barnes says it was clear how necessary it was to install RTLS across the entire system.

"We are the flagship of the health system, so we lend a good amount of equipment to various other areas across the system. RTLS is imperative when you're looking for a piece of equipment and you find someone from the Orthopedic Institute has it," Mr. Barnes says.

3. Consider what location accuracy your organization needs. Accuracy can vary, depending on the technology solution you select. The long-term success and full return on investment of many hospital applications hinges on location or positional accuracy, Ms. Fritz says. RTLS zones can range from room-level to floor-level. Ms. Fritz states healthcare organizations must carefully measure the pros and cons and really understand the long-term benefits of RTLS for all stakeholders in the organization.

"Many organizations argue that a general zone level accuracy is better than what they have now, which is no system and staff members running around with no way of knowing a general idea of where hospital equipment is," Ms. Fritz says. "While that may be true, our argument is that there is a lot of value in having room-level accuracy. Search efficiency, equipment utilization and optimization, rental management and work flow initiatives can only be maximally improved with room-level accuracy."  

4. Know what installation and maintenance entails before deploying. Just like any other technology acquisition, healthcare organizations should diligently research what exactly it will take to install RTLS in their facilities. Beyond the initial question of how much it will cost to purchase RTLS, healthcare organizations should also research the time it will take to install the solution, the implications of installation of RTLS on patient care and staff members' productivity, ongoing maintenance requirements and so on. Ms. Fritz says one of the most important aspects of RTLS installation that healthcare organizations must closely measure is invasiveness. Will the RTLS solution require a change in the organization's physical infrastructure? Will patient rooms or other care areas need to be shut down during installation? Will physicians and staff members' work be impeded by the solution?

"For some RTLS systems, installation can take months and month of time. When you're talking about patient care areas or operating room suites, hospitals can't afford exposing sensitive patient areas to an installation process that can cause infection control concerns, or take a long time, especially if installation requires drilling walls or anything just as invasive," Ms. Fritz says.

In the same vein as invasiveness to work flow productivity, hospitals should consider how the RTLS technology they choose coexists with the facility's already existing wireless network. Technology has become so sophisticated that there are now technologies that are able to coexist on different planes of wireless connectivity, such as Zigbee protocol, which is a wireless mesh network that operates separately from a building's wireless network. This way, the wireless network is not slowed down or jammed because of the asset tracking system.

5. Research what other benefits RTLS can provide. Hospitals should look to see how various RTLS systems are able to provide tracking abilities beyond the day-to-day asset or patient tracking. Mr. Sullivan says UCSD has applied RTLS to emergency preparedness.

"In 2007, we had two major wild fires that were both headed toward our hospitals, and we were put on possible evacuation alert," Mr. Sullivan says. "Since we have RTLS, we are able to find the exact location of all our hospital's gurneys and wheelchairs."

Both UCSF and UCSD have also applied RTLS as a means for temperature monitoring of refrigerators in their hospitals. For quality purposes, The Joint Commission requires hospitals to regularly log temperatures of all refrigerators. RTLS has given the two health systems a way to continuously monitor and log refrigerator temperatures without the need of a manually logging by a hospital staff member.

6. Understand the RTLS solution's interoperability. As mentioned before, although healthcare organizations may consider RTLS with the starting goal of asset management, hospitals will yield greater successes with the end-goal of leveraging RTLS throughout the entire healthcare system. Given the nature of this end-goal, hospitals should look for RTLS solutions that can integrate with already existing systems at the hospital to capture greater returns on the investment. Ms. Fritz says this can be done with a standards-based solution and an open application programming interface, so that the system can provide the location and status of assets or patients to other third party applications in the hospital.

"Let's say a hospital already has a software application to manage equipment and preventive maintenance schedules. RTLS could simply augment that existing system so that when a staff member runs the PM schedule, the specific location of each item on the list is displayed. This can save countless hours of search time and improve preventive maintenance completion rates overall," Ms. Fritz says.

7. Choose a vendor whose business model is the best fit for your hospital. Some companies allow hospitals to rent their RTLS solutions on a month-to-month basis with no upfront costs, which is the simplest and lowest risk business model available. This gives hospitals a chance to test-run RTLS in their facilities without the pressure of a long-term commitment and huge upfront investment.  Another factor of the business model is understanding what the vendor provides once the system is installed. To ensure success, a solution provider with experience in RTLS for hospitals can help you summarize projected savings and outline the steps needed to achieve desired outcomes.

"I think one of the biggest challenges is debunking the concept that there's something magical about technology. It's not a silver bullet but a tool, and unless you really focus on the people and process changes to fully take advantage of the power of RTLS, at some level, you're going to fail," Ms. Fritz says.

Learn more about Awarepoint.

Learn more about UC San Diego Health System.

Learn more about UC San Francisco Medical Center.

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