Why Hospitals Must Solve Their Operational Invisibility Problem

Highlights

The current healthcare operating model is riddled with too much complexity and inefficiency that poses great risks to patient welfare and safety and threatens continued delivery of care services. This blog addresses: 

• Why healthcare facilities must urgently fix operational inefficiencies and improve visibility weaknesses 
• How and what technologies can accelerate operational transparency 
• What Real-Time Location System (RTLS) technology is and its benefits 
• What outcomes health systems can achieve with RTLS 

Advanced Operational Technology Platforms That Incorporate Capacity & Bed Management Software with Real-Time Location Capabilities Can Streamline Operational Complexity  

Hospital Operations: A Labyrinth of Complexity

If you were to peer into a looking glass of a hospital’s day-to-day operations, you would likely see hundreds of moving parts doing dozens of different things at a dizzying pace in constant motion across different units on different floors, even across different campuses. You would see some patients coming to an ED or admissions/registration area while others are being discharged and leaving. Some patients are interacting with nurses while others are being transported to operating rooms or back to their rooms post-surgery. EVS crews are cleaning beds, and all types of medical and surgical equipment are being moved to and from multiple floors as needed for different care needs.  

That’s the view from the outside looking in. Recently, hospitals have begun to get a better view of all this activity from “the inside looking in” with Command Centers driven by operational and capacity management technology, but how effectively are hospitals and health systems keeping track of it all as it is happening and why is that important?

Today, more than ever, any inability not to see every granular detail of activity happening inside a hospital leads to high risk delays in decision-making, which can lead to even higher risks  -- unaffordable risks – to everything from patient safety –to- overall quality of patient care –to- the flow and movement of patients from admission to discharge –to- increasing costs of medical equipment misusage or non-usage –to- ill-preparedness for a disaster or emergency.

Given the ever-expanding range of revenue-impacting healthcare changes outside of the control of care facilities --combined with rising internal operational pressures largely focused on staffing, hospitals and health systems must be able to get their arms around two areas they can control – costs and efficiencies. In fact, given the instability and uncertainty in the healthcare operating environment, facilities must explore any methods available to accelerate tightening up internal inefficiencies in the race to stave off financial crises. 

Capacity Overload + Infrequent Operational Process Updates = Visibility Shutdown 

Healthcare inefficiency has continued to increase with rising numbers of patients needing acute care. Operational process planning has never kept up with swelling hospital patient populations and was conducted with very low-level visibility into bed capacity and patient movement, flow, and care team engagement, even when patient censuses were lower. Unfortunately, facilities were slow to embrace even modest upgrades in their IT systems to improve their view into operational workflows, largely relying on manual or low-tech methods to communicate patient, staff, and other resource whereabouts. With the advent of Electronic Medical Record (EMR) technology, systems and facilities were able to get their arms around some aspects of clinical procedures and patient care data happening across their operations but were still unable to accurately project and manage patient access capacity, movement, and necessary care interactions, nor track data pointing to inefficiencies in these areas to make improvements. 

The technology that can drive a new operational framework enabling hospitals and health systems to streamline process and workflow complexities to give them that true “eyes and ears” visibility into when, why, where, how, and to and with whom everything is happening at any time has existed and continued to evolve.

However, many facilities have not been aware of it or have tried to stitch together internally created solutions with off the shelf applications and limited capabilities that still left them with numerous blind spots into day-to-day patient movement and care workflows. 

Slaying the Labyrinth: The Advent of Real-Time Location System (RTLS)Technology - A Health Facility’s “Eyes & Ears” 

Numerous health systems and hospitals have already recognized the urgent need for visibility into patient care and treatment processes to better identify and correct capacity and operational workflow inefficiencies. 

The foundational technology that facilities have increasingly adopted has been capacity management software systems that integrate a range of capabilities including intelligent bed management and patient placement, projected patient census volumes, and patient flow ED -to- admission -to- throughput -to- discharge management from anywhere in their facility, and analytics tools that enable views into areas of operational inefficiency so healthcare institutions can make necessary process and procedure changes.  Hospital IT teams have built centralized Command Centers leveraging these capacity management software systems that provide multi-screen real-time views within facilities, as well as to remote staff, that further optimize operational visibility.  

Today, that core capacity management technology’s benefits are available with an advanced automation capability called Real-Time Location System (RTLS). RTLS takes a giant step toward tearing apart and simplifying today’s labyrinth of operational complexity, enabling hospitals and health systems to finally have true “eyes & ears” into everything happening at their facilities. With RTLS, facilities can:  

• track in real time exactly where their patients, staff, and equipment are and what they are doing  
• create faster patient “auto-discharge” processes  
• monitor patient-staff interactions, emergencies such as infection outbreaks, and any internal care environment changes such as temperature and humidity, as well as compliance with hand hygiene rules 

The key capabilities of a comprehensive capacity management system integrating RTLS technology, such as TeleTracking’s RTLS-Enabled Capacity Management Suite^®, include: 

PatientTracking™

One of the major high-risk blind spots in health care facility operations is not being able to track all patient movements while they are being treated, e.g., if they are moved from their rooms to radiology or go to the bathroom. PatientTracking™:  

• provides real-time visibility into a patient’s location within the facility anytime, anywhere by giving patients an RFID-activated bracelet tag upon admission that tracks their movements on the RTLS system screens  
• triggers patient “walkout” and “isolated area” alarms  
• monitors every patient-care team interaction throughout the facility to indicate if any additional staff support needs to be deployed or redeployed  
• visualizes and enhances patient movements and flows to enhance care delivery safety, outcomes, and patient experiences  
• records patient care progress and movement histories to plan next steps for treatment and recovery before discharge  

PatientTracking: AutoDischarge™

Locating and identifying discharged vs. waiting-to-be discharged patients is a major piece of the labyrinth. The RTLS system’s PatientTracking capability removes much of the opaqueness of patient discharge by: 

• featuring an AutoDischarge capability in which the RFID-tagged armband a patient receives at admission recognizes when a patient passes through a designated discharge exit and communicates to the capacity management system (TeleTracking’s Capacity Management Suite^®)  
• triggering a “bed clean” request as soon as the patient exits the room, avoiding “dead bed time” even if the nurse hasn’t completed final discharge paperwork  

StaffTracking™

Another significant part of the healthcare facility operational labyrinth, in addition to lack of visibility into patient location, is the location of nurse and care teams at any given time and whether they are being optimally deployed as patients continually move throughout the stages of their care journey. StaffTracking™: 

• keeps an eye on where all facility employees are and how they interact with patients, including interaction frequency and duration, so managers can make needed adjustments to patient-to-caregiver load balances virtually on the fly  
• enables fast location of additional staff required for patient assistance via RFID tags  
• provides continuous monitoring of patient-staff interactions, which is particularly critical in detecting high risk, high-cost infection outbreaks or other in-facility health and emergencies, as well as tracking and reporting of staff compliance with hand hygiene regulations (healthcare worker compliance is currently below 50%)

AssetTracking^® 

The third major piece of the healthcare facility invisibility puzzle is ensuring the equipment that is instrumental to sustaining a patient’s care, recovery, and safety is optimally located where it should be and is being utilized with maximum efficiency to control equipment maintenance costs. AssetTracking™: 

• keeps close watch of where all equipment is located throughout a facility at all times and their status (functioning, under repair etc.) 
• catalogs a history of medical equipment utilization over time (e.g., when an infusion pump is being used vs. sitting idle) to increase usage and guide existing equipment cost maintenance and purchasing/leasing/renting strategies  
• improves response times to low inventory levels and maintains Joint Commission compliance  

TempTracking™

In addition to losing visibility of patients and equipment in a hospital with complex operating processes, sudden or unobserved changes in care environment conditions, such as temperature or humidity, can pose very high risks to patients. It can also cause the loss of critical resources across the hospital, such as medicines stored by the pharmacy, blood bank supplies of blood, and stored foods. TempTracking eliminates manual tracking of environmental condition changes and enables 24/7 continuous monitoring of temperature-sensitive environments by placing sensors in temperature-controlled equipment in these areas that trigger an alert in the RTLS system when a temperature or humidity fluctuation or change occurs, so hospital staff can quickly take corrective actions.  

RTLS Health System Outcomes: A Snapshot    

Hospitals and health systems across the country utilizing TeleTracking’s Real-Time Location System technology have experienced tangible efficiency improvements:  

• Video: Torrance Memorial Medical Center Improves Patient Discharge Rates with VIDA 
• Case Study: Three affiliated hospitals achieved $6.25 million in Length of Stay (LOS)-related cost savings and a nearly 25% increase in Early Bird (before 11AM) patient discharges with PatientTracking: AutoDischarge
• Case Study: A Florida-based acute care community hospital added $22,000 in revenue with 31 bed turnover days and 350 hours, 35-45 minutes, and $1,000 per bed turnover time saved, and 24 hours LOS reduced
• A Southwest-based health system saved $1.7 million in equipment rental expenses, and reduced equipment locating time by 75% and redirected $812,000 in capital costs through improved assets/equipment management 
• A Pennsylvania-based health system improved mobile medical equipment loss rate by 30% 
• A U.K.-based hospital located a “lost” equipment asset in 25 seconds 

RTLS Benefits:  

1. Decreases lost bedtime by instantly discharging patients 
2. Improves patient and staff satisfaction by mitigating wait times for equipment  
3. Avoids unnecessary costs with right-size equipment & rental needs  
4. Automatically monitors frequency and duration of care 
5. Increases caregiver efficiency with real-time visibility to patient location & patient/caregiver interactions 
6. Provides automatic reporting and auditing of patient, staff, and asset interactions  
7. Improves infection control by monitoring hand hygiene compliance 
8. Avoids loss of critical resources with automatic temperature and humidity monitoring 

The New Looking Glass: Demystified Hospital Operations 

Hospitals and health systems can no longer afford guesswork and blindness in their daily operations that can result in patient safety and financial risks, which could ultimately bring their organizations to the brink of collapse. Healthcare institutions must recognize that the complexity of their workflow and patient care processes must be changed so patient care can continue to be sustained and even optimized into a new streamlined model that produces new and better, trackable health and operational efficiency outcomes. Newly evolved technologies that are available now, like capacity management and real-time location systems, can cost-effectively leapfrog the eradication of complexity in healthcare delivery and its associated astronomical financial and liability costs. The promise of these technologies is the regeneration of the new hospital that can both be seen and sees itself as a transparent, uncomplicated deliverer of patient healing and care, no longer shackled by its own blindness of how it operates and serves its communities. 

Takeaways

• Lost patients, staff, equipment, discharge, and care environment data due to operational complexity and lack of visibility pose high risks to hospitals and health systems 
• Hospitals and health systems can break operational complexity and remove operational invisibility with advanced technologies combining capacity management with RTLS capabilities 
• Breakthrough cost management and efficiency outcomes can be achieved with RTLS technology, transforming hospitals into truly transparent healthcare delivery services enterprises