As hospitals and health systems look for ways to transform quality of care, patient safety and efficiency, they are increasingly turning to powerful real-time location systems and workflow automation software technology platforms to achieve those goals and realize an immediate and compelling return on investment. The indoor positioning technology allows users to track and know the real-time location of clinicians, patients and medical equipment at all times and obtain accurate data to improve workflow and care delivery processes.
Today, 10 to 12 percent of U.S. facilities use RTLS. Based on their experiences, there are several key reasons to implement the technology:
1. Improving quality, safety and speed of care. The ability to locate patients, nurses, physicians and equipment quickly and accurately within a department or enterprise enables clinicians to deliver care on a timely basis and spend more time with patients. Nurses typically spend about an hour of every shift searching for missing equipment, personnel or the actual patient, delaying care and scheduled procedures. This contributes to delays in 30 percent of all scheduled surgeries. Being able to quickly identify any tagged equipment, staff or patients anywhere within a facility means on-time procedures and nurses can focus on patient care.
2. Enhancing ED efficiency, throughput and revenue. The pressure on hospitals to address overcrowded EDs and ambulance diversions will further intensify as 32 million uninsured Americans gain health insurance in coming years. RTLS offers a way for EDs to enhance performance on those two fronts while protecting a major revenue stream: ED patients represent over 50 percent of all inpatient admissions, 45 percent of a hospital's overall revenue, 71 percent of a facility's intensive care days, 66 percent of inpatient lab tests and 58 percent of inpatient days. By deploying RTLS to reduce the rate of patients who leave the ED without being seen and ambulance diversions, facilities can significantly boost their bottom line. For example, Philadelphia-based Albert Einstein Medical Center estimates RTLS contributed more than $14.8 million in 2010 alone through lower left-without-being-seen and diversion rates.
3. Workflow/process improvement. RTLS-based systems include a time-stamp capability that allow hospitals to collect data; track and monitor care intervals; and analyze response times more accurately, reliably and rapidly than they could using clinicians and others to capture information manually. The accuracy and reliability of manually-captured data is questionable because medical personnel often must deal with patient crises, making it difficult for them to record precisely when an event occurred or a task was performed. On the other hand, RTLS automatically records every interaction a patient has with a nurse, physcian or other caregiver exactly at the moment it occurs, providing facilities high-quality baseline information to identify and address problem areas.
4. Reducing hospital-acquired infections. Approximately 1.7 million patients annually contract an infection during their hospitalization, resulting in 99,000 deaths and an estimated $20 billion in additional healthcare costs, according to the Centers for Disease Control and Prevention. An effective strategy to reduce and prevent infections is for clinicians to wash their hands before touching patients, but hospitals have great difficulty achieving even a 50 percent compliance rate. A study in the May/June 2009 issue of the American Journal of Medical Quality found the hand-washing rate in intensive care units was 26 percent and non-ICUs was 36 percent. Institutions using RTLS to monitor hand-washing workflows and identify items a patient has or will come in contact with can drive those rates well past 90 percent.
5. Lowering liability risk. A malpractice judgment can potentially cost a hospital between $500,000 and $1 million per patient, which is about what it would cost a facility to buy and deploy RTLS across its enterprise. In other words, an institution could save itself hundreds of thousands to millions of dollars by investing in a RTLS solution. Through workflow analysis, monitoring and feedback improvement algorithms, RTLS performs as the sentinel to insure best practice is maintained and risk-potentiating deviations are reduced. These RTLS workflow algorithms, defined by clinical evidenced-based medical practice, support a synergy between workflow and medical care.
6. Assessing validity of patient complaints. Because RTLS-based solutions automatically records the time of interactions between patients, clinicians and staff, hospitals can easily determine if an individual's complaint about slow or poor service is valid. The information is unquestionably objective, making it easy for facilities to take appropriate steps including sharing irrefutable evidence to persuade patients their complaint is unfounded.
RTLS can be the key to optimize resource allocation and improve workflow efficiencies, improve patient safety and care as well as enhance a hospital's clinical and financial performance.
Albert Villarin, MD, FACEP, is a consultant at Awarepoint, the leading provider of real-time location systems for hospitals and health systems and the former chief medical informatics officer of Albert Einstein Healthcare Network, an integrated delivery system in Philadelphia.
Today, 10 to 12 percent of U.S. facilities use RTLS. Based on their experiences, there are several key reasons to implement the technology:
1. Improving quality, safety and speed of care. The ability to locate patients, nurses, physicians and equipment quickly and accurately within a department or enterprise enables clinicians to deliver care on a timely basis and spend more time with patients. Nurses typically spend about an hour of every shift searching for missing equipment, personnel or the actual patient, delaying care and scheduled procedures. This contributes to delays in 30 percent of all scheduled surgeries. Being able to quickly identify any tagged equipment, staff or patients anywhere within a facility means on-time procedures and nurses can focus on patient care.
2. Enhancing ED efficiency, throughput and revenue. The pressure on hospitals to address overcrowded EDs and ambulance diversions will further intensify as 32 million uninsured Americans gain health insurance in coming years. RTLS offers a way for EDs to enhance performance on those two fronts while protecting a major revenue stream: ED patients represent over 50 percent of all inpatient admissions, 45 percent of a hospital's overall revenue, 71 percent of a facility's intensive care days, 66 percent of inpatient lab tests and 58 percent of inpatient days. By deploying RTLS to reduce the rate of patients who leave the ED without being seen and ambulance diversions, facilities can significantly boost their bottom line. For example, Philadelphia-based Albert Einstein Medical Center estimates RTLS contributed more than $14.8 million in 2010 alone through lower left-without-being-seen and diversion rates.
3. Workflow/process improvement. RTLS-based systems include a time-stamp capability that allow hospitals to collect data; track and monitor care intervals; and analyze response times more accurately, reliably and rapidly than they could using clinicians and others to capture information manually. The accuracy and reliability of manually-captured data is questionable because medical personnel often must deal with patient crises, making it difficult for them to record precisely when an event occurred or a task was performed. On the other hand, RTLS automatically records every interaction a patient has with a nurse, physcian or other caregiver exactly at the moment it occurs, providing facilities high-quality baseline information to identify and address problem areas.
4. Reducing hospital-acquired infections. Approximately 1.7 million patients annually contract an infection during their hospitalization, resulting in 99,000 deaths and an estimated $20 billion in additional healthcare costs, according to the Centers for Disease Control and Prevention. An effective strategy to reduce and prevent infections is for clinicians to wash their hands before touching patients, but hospitals have great difficulty achieving even a 50 percent compliance rate. A study in the May/June 2009 issue of the American Journal of Medical Quality found the hand-washing rate in intensive care units was 26 percent and non-ICUs was 36 percent. Institutions using RTLS to monitor hand-washing workflows and identify items a patient has or will come in contact with can drive those rates well past 90 percent.
5. Lowering liability risk. A malpractice judgment can potentially cost a hospital between $500,000 and $1 million per patient, which is about what it would cost a facility to buy and deploy RTLS across its enterprise. In other words, an institution could save itself hundreds of thousands to millions of dollars by investing in a RTLS solution. Through workflow analysis, monitoring and feedback improvement algorithms, RTLS performs as the sentinel to insure best practice is maintained and risk-potentiating deviations are reduced. These RTLS workflow algorithms, defined by clinical evidenced-based medical practice, support a synergy between workflow and medical care.
6. Assessing validity of patient complaints. Because RTLS-based solutions automatically records the time of interactions between patients, clinicians and staff, hospitals can easily determine if an individual's complaint about slow or poor service is valid. The information is unquestionably objective, making it easy for facilities to take appropriate steps including sharing irrefutable evidence to persuade patients their complaint is unfounded.
RTLS can be the key to optimize resource allocation and improve workflow efficiencies, improve patient safety and care as well as enhance a hospital's clinical and financial performance.
Albert Villarin, MD, FACEP, is a consultant at Awarepoint, the leading provider of real-time location systems for hospitals and health systems and the former chief medical informatics officer of Albert Einstein Healthcare Network, an integrated delivery system in Philadelphia.