This document summarizes two presentations about how real-time location systems (RTLS) can enhance safety and quality initiatives in healthcare settings. The first presentation describes how Eastern Maine Medical Center's cancer care center uses RTLS to improve patient flow, ensure timely treatments, locate family members, and facilitate reporting. Benefits included improved patient satisfaction, treatment efficiency and safety, staff satisfaction, and cost savings. The second presentation explains how Western Maryland Health System's behavioral health unit utilizes RTLS for staff panic buttons, patient elopement alerts, and suicide precaution rounding to improve staff safety, response efficiency, and elopement prevention. Both case studies demonstrated enhanced safety, treatment quality, and operational benefits through RTLS automation and location-based

1. Beyond Patient Tracking
Enhancing Safety & Quality Initiatives with RTLS
February 24, 2014
Brenda Clements, RN, BSN, MBA, OCN
Manager of Nursing Services, Cancer Care
Eastern Maine Medical Center
Jeffery D. O’Neal, LCPC, NCC
System Director, Behavioral & Occupational Health
Western Maryland Health System
DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.
1

2. Conflict of Interest Disclosure
Brenda Clements, RN, BSN, MBA, OCN
Has no real or apparent conflicts of interest to report.
Jeffery D. O’Neal, LCPC, NCC
Has no real or apparent conflicts of interest to report.
© 2014 HIMSS
2

3. Learning Objectives
1
2
3
Identify points of safety and quality that can be
enhanced with RTLS
Explain how RTLS uses rules-based automation
to support safety and quality initiatives
Recognize how your facility can use similar RTLS
rules to improve safety and quality
3

4. An Introduction to the Benefits
Realized for the Value of Health IT
http://www.himss.org/ValueSuite
4

5. EMMC Cancer Care
►
New building in 2009
►
175,000 sq. feet, 3 floors
►
250+ patients per day
►
160 staff and physicians
►
Medical Oncology
►
Radiation Oncology
►
Pediatric Oncology
►
Breast Surgical Specialists
►
Research
Measures longer than a
football field
5

6. The Typical Day of a Cancer Patient
• May need lab tests and/or X-rays prior to provider visit and/or treatment
• May see more than one provider
• May have concurrent Medical and Radiation Oncology Therapies
• May interact with Research Staff, Patient Account Associates, or Schedulers
• May receive chemotherapy treatments dependent upon test results
• May see Social Worker, Behavioral Medicine Provider, or Dietician
• Navigates our 3-story facility measuring the length of a football field
6

7. It All Starts with RTLS Badges
Assigned to both Patients & Staff
7

8. Clinical-Grade RTLS Allows Us To…
Capture caregiver
interaction with patient
Monitor patient
alone time
Cue staff when it’s time to
check on patient or begin the
next treatment interval
Record accurate data for
historical reporting
The RTLS must be accurate, timely &
reliable for locating to bed- and chair-level
8

9. Rules-based Automation for Patient Flow
Complex “If/Then” statements based on
location information and button-presses
drive automated alerts.
For Example…
9

10. Provider Notification
IF CMA is in patient room with a patient AND presses
her badge button, THEN signal ready for provider
Satisfaction :
Patients & Providers
Treatment:
Efficiency
Savings: Reduced Wait
Times & Increased Volume
10

11. Alone Time Alerts
IF patient is seen in waiting room, exam room, treatment chair, etc. AND a
caregiver has not been seen in that location for 20 minutes THEN send alert
Improves Patient Satisfaction — Ensures no
patient is left alone for more than 20 min
Improves Treatment
Safety
11

12. Ensure Timely Medication Mixing
IF nurse is in treatment area with patient AND she presses her badge
button THEN signal to pharmacy that patient is ready for chemo
Satisfaction :
Patients & Staff
Treatment:
Efficiency & Safety
Savings: Reduced Wait
Times & Less Waste
12

13. Ensure Timely Medication Mixing
• Reduces phone calls or time spent walking to/from pharmacy
• Mixing meds at the correct time reduces potential for waste
Pharmacist simply clicks
the screen to acknowledge
Satisfaction :
Patients & Staff
Treatment:
Efficiency & Safety
Savings: Reduced Wait
Times & Less Waste
13

14. Ensure Timely Medication Mixing
• Nurse does not need to walk back-and-forth to pharmacy to check
• Reducing trips to pharmacy = efficiency for treatment nurses
Pharmacist clicks again
when pre-meds are ready
Satisfaction :
Patients & Staff
Treatment:
Efficiency & Safety
Savings: Reduced Wait
Times & Less Waste
14

15. Ensure Timely Medication Mixing
• Fewer interruptions for pharmacist reduces potential errors
• Pharmacist remains focused on order processing
Pharmacist clicks again to signal
chemotherapy meds are ready
Satisfaction :
Patients & Staff
Treatment:
Efficiency & Safety
Savings: Reduced Wait
Times & Less Waste
15

16. Locate parents of pediatric patients
IF assigned patient badge is located in Registration with an
unassigned badge AND both badge buttons are pushed sequentially,
THEN assign 2nd badge to be the parent of the patient.
Parents can be found
immediately if problem
arises with child
Satisfaction :
Patients & Parents
Treatment:
Efficiency & Safety
Savings:
Reduced Wait Times
16

17. List View Including Parent Badge
17

18. RTLS Reporting — Wait Times
Quickly and easily run reports on average wait time or other metrics.
Great to use when changing processes, to see the effect; for example,
when implementing new computer programs.
Treatment:
Efficiency & Safety
Electronic
Data
18

19. RTLS Reporting — Infection Control
RTLS reporting shows all staff or patients who came into contact with
an infectious patient.
Treatment:
Efficiency & Safety
Electronic
Data
Infection
Prevention
19

20. A Review of Benefits Realized for the
Value of Health IT
Improved Patient Satisfaction
• Consistently > 96.78%
Improved Treatment Efficiency & Safety
• Reduces patient alone time
Improved Staff Satisfaction
• Saves nurses 1 mile/day
• Saves CMAs 4.1 miles/day
• Efficiency for Providers
Reduced Potential Errors
• Related to interruptions (CMA / Provider
interaction and RN / Pharmacy
interactions)
Historical Data
• Infection Control Reports
• Process Improvement Reports
Infection Prevention
• Exposure Reporting
20

21. A Review of Benefits Realized for the
Value of Health IT
Improved Patient Satisfaction
• 1 Breast Cancer Chemo
Patient = $40,000
Efficiency Savings
• 3 FTEs saved =
$114,000 annually
• Saves nurses 1 mile/day =
$22,600 annually*
• Saves CMAs 4.1 miles/day =
$5,325 annually*
$181,925
annual savings
* 1 mile = 20 minutes x hourly rate of pay
21

22. Enhancing Safety in Behavioral Health
Western Maryland
Health System
• 275-bed regional medical
center with a full range of
services
WMHS Behavioral Health
• 17-bed, adult (ages 18+)
inpatient psychiatry unit
• 24/7 emergency services
• Hospital-based Outpatient
Mental Health Center
• Substance abuse clinic
22

23. Safety Challenges on Any Behavioral Health Unit
• Hidden areas that
allow patients to
surprise staff.
• Elopement potential
for violent/aggressive
patients.
• Violent or aggressive
outbursts placing the
patient, other patients
or staff in danger.
Mental health occupations have one of the highest rates
of workplace violence, second only to law enforcement.
~ National Crime Victimization Survey
U.S. Department of Justice, 2005-2009
23

24. RTLS for Staff Safety — Panic Button
If staff feel threatened
Press
Badge
Button
Pop-up
Message
Sent
Alert Button
Staff
Satisfaction
Savings: Efficiency
of Response
Code
Green
Initiated
Treatment/Clinical
Improved Safety
24

25. RTLS for Patient Safety — Elopement
If patient is sensed near egress area:
Alerts sent to handheld phones and
computers
Staff
Proactively
Respond
Savings:
Efficiency of Response
Treatment/Clinical
Improved Safety
Elopement
Prevention
25

26. RTLS for Patient Safety — Rounding
Patient & staff locations are displayed on the map
Blue Icons = Patients
Green Icons = Staff
Real-time patient location
improves suicide
precaution rounding
Staff Satisfaction
Other Icons = Assets
Treatment/Clinical
Improved Safety
Suicide
Prevention
26

27. A Review of Benefits Realized for the
Value of Health IT
Improved Staff Satisfaction
• Staff Feel Safer
• Easier to Round on Patients
• Improved Morale
Improved Efficiency/Safety
• Decreased Response Time to Code
Green from 12 to 4 min
• Timely suicide prevention rounding
Elopement Prevention
• Reduced elopements from
14 per year to 0*
• Ensures suicidal or
potentially violent patients
remain in secure setting
Efficiency Savings
• Reduced days off from
injury/workers comp
• Reduced cost for staffing
elopement response teams
*Defined as a patient successfully moving past the locked doors of the unit
27

28. Questions?
Thank You!
Brenda Clements, RN, BSN, MBA, OCN
EMMC Cancer Care
bclements@emh.org
Jeffery D. O’Neal, LCPC, NCC
Western Maryland Health System, Behavioral Health
jdoneal@wmhs.com
28