Seth Hostetler, Lead Process Engineer, Care Support Services at Geisinger Danville and Robert Teachout, Project Manager, RTLS Workflow, at TeleTracking discuss how Real-Time Location Systems [RTLS] or Enabling Technologies is helping improve both efficiency and patient care.
On this second part of our conversation, we dig deeper into the implementation of a Real-Time Locating System (RTLS) at Geisinger to improve asset tracking.
On this episode you'll learn:
• The implementation of RTLS (1:01)
• Training for the change a RTLS brings (4:07)
• Projecting forward to further process improvements (9:24)
About the Experts:
Seth Hostetler is the Lead Process Engineer, Care Support Services at Geisinger Danville. Hostetler has an M.S. in Industrial Systems Engineering and specializes in facility logistics, healthcare systems engineering, and lean methodologies.
Robert Teachout is the Project Manager, RTLS Workflow, at TeleTracking.
Rob, could you share some information about what the implementation process was like and how you helped Geisinger realized benefits quickly?
We like to joke with them that we're trying to help them address the four pages, which are hoarding, hiding, hunting, and hoping for equipment. One of the things we do with my group is an initial utilization assessment of equipment. When we do this, we go room to room, and we actually assess where the devices in the room are and how they’re being used. And it is common for us to come away with the information from a hospital that they’re only using about 35 to 40% of their infusion fleet at any given time, which means the rest of that fleet is in some other state of transition.
Whether it's somewhere “just in case,” whether it's somewhere for cleaning, whether it's in an inventory, it's not necessarily able to distribute and use. Just as Seth mentioned, the perception is always from a caregiver that I went to get one a couple days ago and there wasn't one where I needed one. We help illustrate that it’s not the case.
It's okay to rent if your use case if your fleet utilization supports it, because you can imagine seasonal peaks and valleys in the distribution of these. One thing that our system does is helps you keep your finger on the pulse of those rental devices as they flow through your facilities so that you can retrieve them and get them out of there and stop billing on them as soon as they're no longer necessary to satisfy demand. And then the other thing that comes to mind is item types that are not necessarily as high volume, maybe they can be shared between units.
It’s understandable that clinicians get frustrated when they need to put their hands on a piece of equipment type when they need it, and they’re not able to do that. They either need to purchase or rent more, or they need a better technology around where these devices are located.
Implementing something like this is a significant change for the people that are on the front lines. If you're used to hiding, hoarding, and hoping it's a big change now to shift to something like this. Can you share what you did as far as training and things you did to help with change management and staff engagement?
So, it is a big change, I think, here at Geisinger. And I have to imagine this may occur at other institutions too, but I'll say we had a very phased rollout not necessarily intentionally, but more budget driven. So, it's not as though we came out and deployed at a, I'll say a bed level granularity in every hospital for all 14,000 assets on day one. We really focused on some of our heavy use areas and the heavy use asset classes. And so, it allowed us, I think maybe in some ways slowly and gain the use of the RTLS.
We really wanted to focus on those assets that people are frequently asking about. And then it was a lot of just hands-on education. Obviously, we can't meet with every frontline user, but we worked with the staff that are looking for those assets the most, unit desk clerks or nursing assistants, and really showing them the time saving benefits. For us it was consistent and repetitive education, circling back every couple months to see if people had questions and reminding them the benefits. And I think once they realized the benefits, it was a fairly quick adaption at the frontline.
Our supply chain distribution team and our clinical engineering biomed team both quickly adopted the use of it because it was greatly beneficial to them and the distribution folks. It saved them a lot of time, being able to narrow in on the location of assets.
One of the things that Geisinger does well is the maintenance of the system to keep people's confidence high in it, because it is not just a set it and forget it system. It’s an active system which maintenance to be sure the system is updated accordingly.
One of the biggest lessons learned, and probably one of our initial missteps, was not completely planning out the maintenance of the actual RTLS devices. We started having some battery failures and realized, well, changing these, when we get the little battery notice, it's going to take a lot more time to do one at a time, rather than looking to integrate those battery changes.
And so that's been very beneficial to the system and that's, as we've expanded use cases and gotten other users of our system, we've made sure to be very clear and define ownership and what the maintenance is. It's not a lot, right? It doesn't take long to change a battery. But if you don't do it and it goes dead, you start to lose confidence from your end users.
And you want to make sure you have the trust and the engagement of the people that are on the front lines in using that equipment every day. You've had such a great experience. I mean, you've made so much progress with the technology. What are the next steps? What's in the future?
Our future, and really a little bit of our past, has been continuing to use the asset tracking the best we can bringing on new asset classes kind of branching out from the traditional biomed. For example, our IT group in the last few years deployed iPads for all inpatients. We actually have RTOs tags on those iPads so that we can find them—as a side note, just having an RTLS tag on the iPad is a little bit of a theft deterrent.
We've also used the asset tracking a little bit beyond the original scope, using some staff locating and looking at workflows. We branched more into some of the patient and staff locating technologies that Tele Tracking also has through their XT platform. So, we use at one of our hospitals, we're using our RTOs for hygiene monitoring of staff. Through the COVID process, we're able to do contact tracing when we had a couple of small staff outbreaks, we're able to really hone in on where those co-interactions were.
If we have a patient admitted who then later test positive for say TV, we can then actually look and alert our employee health of which staff members were in contact with that patient and ensure they get the proper testing to help with our employee safety.
We’ve also used it to track patients who may wander off. So, we've been able to look quickly into the system, search on that patient's RTLS badge, and very quickly find them before any adverse events occurred.
EVS is one of the departments we've had some discussions with about can we look at some of their workflows by looking at the movement of their trash hoppers or the cleaning cards to see the different flows and try to maybe improve the pathways they take to get the same amount of work done but do it more efficiently. I think that's really where we're going next as much more in the workflows for clinicians and other ancillary groups.