Running head: REAL-TIME LOCATING SYSTEM 1 REAL-TIME LOCATING SYSTEM 2 Real-Time Locating System Student’s Name University of Affiliation Date Real-Time Locating System (RTLS) St. Michael is an acute care facility based in Alabama. The healthcare facility boasts of a 1,000 bed capacity that is run through a manual admission model. The local community hospitals refer their patients to the hospital after requesting for a consultation with a specialist doctor. Patients arrive at the facility in wheelchairs and ambulances which increases the population of sick patients along the hallways (California Healthcare Foundation, 2011). Some of the patients are assigned to the wrong floors which increases the level of hallway stays. Consequently, the most overcrowded hospital areas include:- · The emergency departments that deal with critical conditions such as accidents. · The inpatient section that deals with the admission of new patients. Change Project Plan The purpose of this project plan is to propose the implementation of a patient transfer center to handle all patient referrals from other hospitals. The center will be characterized by a call center for handling all incoming referrals. Therefore, all admission information will be managed from this central system including bed placements and emergency room requests. A Real-time locating systems (RTLS) tracking system will be implemented to keep track the locations of all inpatient admissions and shared medical equipment (“How to Prevent Corridor Clutter in Hospitals,” n.d). A 30 minute parking rule will be implemented within the facility to notify personnel whether equipment is close to violating the Line Safety Code. Assessment of environment Current practices During the swine flu pandemic the hospital faced increased pressure to its emergency and in-patient departments. The inefficiencies in the current system created unnecessary delays to the delivery of healthcare to patients(Pearl, 2018). The hospital corridors ended up being used as waiting rooms for patients who have been admitted to the hospital. The patients were forced to wait in trolleys placed along the hospital corridors or in ambulances for over 12 hours before finding a vacant bed (Triggle, 2018). The delays in the admission process have been blamed on the amount of paper work required to transfer patients form the emergency departments or operating rooms into the wards. Medical personnel are forced to create makeshift dividers along the corridors to provide privacy to the patients. The hospital structure The number of carts or equipment found along the corridors can reach a maximum of 240 at any particular time. This includes supply carts, rolling walkers, treatment carts, oxygen tanks, and patient beds (Mitchell, 2006). A higher rate of foot traffic is witnessed along the hallways during housekeeping, emergency situations, serving of meals and shift changes. The other category of non-wheeled clutter in ...

1. Running head: REAL-TIME LOCATING SYSTEM
1
REAL-TIME LOCATING SYSTEM
2
Real-Time Locating System
Student’s Name
University of Affiliation
Date
Real-Time Locating System (RTLS)
St. Michael is an acute care facility based in Alabama. The
healthcare facility boasts of a 1,000 bed capacity that is run
through a manual admission model. The local community
hospitals refer their patients to the hospital after requesting for
a consultation with a specialist doctor. Patients arrive at the
facility in wheelchairs and ambulances which increases the
population of sick patients along the hallways (California
Healthcare Foundation, 2011). Some of the patients are
assigned to the wrong floors which increases the level of

2. hallway stays. Consequently, the most overcrowded hospital
areas include:-
· The emergency departments that deal with critical conditions
such as accidents.
· The inpatient section that deals with the admission of new
patients.
Change Project Plan
The purpose of this project plan is to propose the
implementation of a patient transfer center to handle all patient
referrals from other hospitals. The center will be characterized
by a call center for handling all incoming referrals. Therefore,
all admission information will be managed from this central
system including bed placements and emergency room requests.
A Real-time locating systems (RTLS) tracking system will be
implemented to keep track the locations of all inpatient
admissions and shared medical equipment (“How to Prevent
Corridor Clutter in Hospitals,” n.d). A 30 minute parking rule
will be implemented within the facility to notify personnel
whether equipment is close to violating the Line Safety Code.
Assessment of environment
Current practices
During the swine flu pandemic the hospital faced increased
pressure to its emergency and in-patient departments. The
inefficiencies in the current system created unnecessary delays
to the delivery of healthcare to patients(Pearl, 2018). The
hospital corridors ended up being used as waiting rooms for
patients who have been admitted to the hospital. The patients
were forced to wait in trolleys placed along the hospital
corridors or in ambulances for over 12 hours before finding a
vacant bed (Triggle, 2018). The delays in the admission process
have been blamed on the amount of paper work required to
transfer patients form the emergency departments or operating
rooms into the wards. Medical personnel are forced to create
makeshift dividers along the corridors to provide privacy to the
patients.
The hospital structure

3. The number of carts or equipment found along the corridors can
reach a maximum of 240 at any particular time. This includes
supply carts, rolling walkers, treatment carts, oxygen tanks, and
patient beds (Mitchell, 2006). A higher rate of foot traffic is
witnessed along the hallways during housekeeping, emergency
situations, serving of meals and shift changes. The other
category of non-wheeled clutter included linen bags, IV poles,
housekeeping, and food service carts. This category of
equipment contributed to more than 1% of the overall foot
traffic along the corridors.
Source:Patient waiting in hallways (Solomon, 2019).
The need for change
The Joint Commission (TJC) has identified corridor clutter as a
top safety standard for patients that can lead to hospital
incompliance (“The Joint Commission,” n.d). The commission
cites the Life Safety Code as a requirement for all exit paths
within a hospital. This includes emergency exits and fire
escape. This code requires hospitals to clear all obstructions,
clutter and unattended items along the corridors or egress
(“How to Prevent Corridor Clutter in Hospitals,” n.d). Clear
hallways enhance patient safety during emergency situations
such as terror attacks or fire among others. Clear hallways make
it easier for medical personnel to quickly evacuate and relocate
the patients as visibility is enhanced.
Advantages of change
Clearing all clutter along the hospital hallways will enhance the
hallway throughput rates and capacity. This will be achieved by
redesigning the patient admissions process, centralizing bed
placements and tracking the status of new referrals. The
benefits to the hospital will be to:-
· Reduce transfer time between facilities to one day.
· Increase patient flow along sensitive areas by 80%.
· Reduce the nursing time for finding patient information and
medical supplies by 50%.

4. · Reduce the number of registration personnel and admission
time by 90%.
· Reduce the average patient waiting time to less than 30
minutes.
· Reduce the rate of ambulance diversions and unseen patients
by 50%.
Cost and resources
Developing a central referral and call center will cost the
institution a minimum of $1 million. This cost will include the
underlying technological infrastructures, servers, tracking
systems and the supporting soft-wares. A bedside registration
and discharge system will be introduced to enhance the bed
allocation and patient discharge process. A discharge lounge
will set aside to fast track the release of patients from the
hospital. An outpatient area will be created to cater for patients
who do not need full registration or admission into the hospital
(“California Healthcare Foundation,” 2011). An emergency zone
will be created to manage placements of patients coming from
the emergency department or the operating rooms. These
patients will be provided with tags that will automatically
update their locations as they are transferred to new rooms. The
medical equipment such as wheel chairs and gurneys will be
stored in adjacent rooms facing sensitive areas such as the
laboratory, imaging rooms or operating rooms.
Source: (“Managing Corridor Clutter,” n.d)
Planning
Goal
The goal of this project is to enhancing the mobilization of
referral of patients between facilities by enhancing access to
medical equipment.
Objectives
· Minimize the number of equipment parked along the corridors.
· Set a 30 minute parking rule for non-essential medical
equipment.
Phases of change

5. Such a large scale organizational change will require a shift in
corporate culture and the relationships between the medical
personnel (Burnes, 2004). The hospital will utilize Kurt Lewin’s
3-step model to change to sustaining the required operational
changes.
Phase 1: The 10 most clutter prone areas will be identified and
prioritized for de-cluttering with the help of the medical staff.
Zoning areas will be used to prioritize regular inspections and
deployment of environmental service staff for clearing of
clutter.
Phase 2: Zoning areas will be clearly labeled using warning
signs to notify the personnel that they are within a compliance
checkpoint area. These signs will include additional information
regarding safety laws that does not entertain clutter along the
corridors.
Phase 3: All medical equipment coming into the hospital will be
attached with radio frequency tags. Network sensors and
transceivers will be installed along these sensitive zones to
track unattended and idle clutter along the corridors for more
than 20 minutes. This information will be communicated to the
hospitals information system for immediate action.
Phase 4: The bed management system will send automated
messages to the room managers for quick identification of
vacant beds (Boulos & Berry, 2012). A discharge alert system
will send information direct to the hospital dashboard to reduce
patient wait period. This will increase the patient flow along the
hallways thereby improving admission rates.
Phase 5: Patient information will be automatically captured
using hospital cards or electronic health records (EHR) for easy
management of referrals from other hospitals. This electronic
information management system will automatically notify
caregivers of any patient who has waited for too long by
sending alerts to the admission dashboard.
Timelines
The implementation of a patient transfer and call center will
take a minimum of 6 months. The supporting tracking

6. technologies and information systems will require a go-live
period of three months to acquaint the staff to the new system.
This will include a pre-implementation assessment period of one
month. Thesteps to clear the hospital hallways will take a period
of two months which will run from July –October 2019.
Mobilization the driving forces
The hospital staff will be increased to handle the high traffic
periods such as natural disasters, fire or terrorism attacks. The
disaster management plan will include an incident commander
that will control the flow of new patients. The incident
commander will use the hospital tracking system to assign
hospital beds and medical equipment required for each
emergency situation (California Healthcare Foundation, 2011).
A touch screen will be installed to manage all bedside requests
such as IV pumps, supply carts and oxygen tanks among others.
This information will be updated directly to the hospitals
information system.
Minimizing restraining forces
Lewin’s first-step to change states that employee behavior are
maintained through a status quo (Burnes, 2004). Therefore, in
order to create long term change such behaviors have to be
destabilized, unlearnt or unfrozen before new routines are
adopted. Thetracking system will require medical personnel to
issue physical tags to patients. These tags will have to be worn
around the wrist for easy identification of the patient at all
times.Therefore,the nurses will undergo an intensive training
program on the technical aspects of the new devices, their
installation process and how they work (“California Healthcare
Foundation,” 2011). All medical personnel will be responsible
for ensuring equipment are used and stored in their set
locations.
Plan of evaluation
Lewin’s second stage to change states that the motivation to
adopt new technologies does not necessarily translate to long
term change (Burnes, 2004). New forces can easily undo years
of hard work due to difficulty in technological adoption or

7. employee fear. Training programs will be used to assure the
medical personnel of the importance of the new system in
enhancing patient care rather than monitoring personnel
productivity. In addition to that an environmental excellence
initiative will be implemented within the institution to regularly
award positive improvements (“California Healthcare
Foundation,” 2011). Standards met will ensure the success of
the project.
Implementation
Training and education
During the roll out of the new tracking system, an in-house
vendor will manage the training programs for the system. A
training log will be provided to all employees as part of the
induction process that will be included in the professional
development records. The training logs will monitor the new
system for any inefficiency and provide remedies for deficit
skillsets (“Medicines & Healthcare Products Regulatory
Agency,” 2015). The training programs will be done regularly
to keep the medical personnel up to date with any new updates
to the system.
Evaluation
The evaluation of the tracking system will be based on
usability, ease of connectivity to hospital information systems
and coordination of hospital resources. Once the system reaches
a stable point of adoption, the third stage of Lewin’s theory will
become easier to adopt. This includes refreezing of new work
behaviors to prevent a relapse into the old routines (Burnes,
2004). As a result the hospital will implement quarterly audit
mechanism to reinforce any positive achievements made in the
past (“Duke-Margolis Center for Health Policy,” 2016). The
success of this project will enhance the hospitals certification
by The Joint Commission (TJC). The new system will also
reduce the regulatory burden on the hospital through active
surveillance and reporting of any healthcare safety gaps.
Conclusion
The purpose of this plan was to reduce the level of

8. overcrowding within St. Michael hospital emergency
department. The challenges of these overcrowded hallways
include the undocumented deaths due to long waiting lines
(Paiva, Brito2 & Leiva-Marcon, 2018). An inefficient admission
system creates cluttered hallways, long admission times,
prolonged hospital stay and delayed provision of critical
lifesaving healthcare. This leads to medical errors that could be
easily prevented by automating the critical hospital processes.
References
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