Workflow solutions are about eliminating the many factors that reduce productivity. The vitally important meaning of workflow solutions in hospitals and clinics is to spend more time with patients. Thus, the endpoint of workflow solutions in healthcare settings is patient health and satisfaction.
Healthcare workflow solutions tend to focus on how staff spend their time: how effectively and efficiently they accomplish priority tasks. A related and inseparable focus is patient flow: how well-managed is the movement of patients from admission to discharge?
A third focus inseparable from workflow is how readily staff can locate the medical devices they need, including in emergencies.
We will focus on all three factors and how they interact to affect workflow.
Attention often focuses on the multiple tasks of the nursing staff. Nurses often are the ones who must locate other necessary staff, including physicians, but also equipment such as wheelchairs and medical devices like infusion pumps. An important question for moving toward healthcare workflow solutions is how much nursing staff time is spent with patients and how much on administrative tasks and coordinating (often just finding) personnel and equipment? With RTLS that locates patients, staff, and equipment with 99 percent accuracy down to room level; asset data sent to mobile devices such as cellphones; and with notifications sent to other staff members, the time spent on "go get" and "go see if you can find" is markedly reduced.
A comment published by the National Center for Biomedical Information puts it this way:
"On a slow Friday afternoon in the emergency room, as one nurse prepares to go off shift, the clerk looks up from the desk and asks, By the way, since you're passing by housekeeping on your way out, would you remind them that room 12 still needs to be cleaned?"
"No problem'" replies the nurse, and indeed, on a slow Friday afternoon, it is no problem.
These same methods that an organization uses to get work done, however, can begin to show stress under trying circumstances. When the ward is full, and it takes 12 hours for a room to be readied for the next patient, that impact is felt throughout the organization.
RTLS affects workflow and patient flow directly by empowering caregivers and givers with information, at any given moment, on the location of their colleagues and their patients. That is time that can be spent on direct patient care.
Making the rounds of patient rooms is built into the workflow of nursing staff and certainly constitutes direct patient care. But hourly rounds increase in efficiency when nurses have real-time data on which patients are in their rooms, which patients are with doctors or other staff, and which patients have visitors. RTLS enables nurses to send reports and notifications from patient rooms to staff anywhere in the facility.
Nursing staff clinical workflow solutions can be optimized only by integrating them with other successful workflow patterns. If there is a call from a patient, Kontakt.io Simon Solutions for Healthcare platform will inform the nursing staff that a caregiver has entered the room. RTLS can record automatically that there has been a response to the call, and when.
The time of physician staff, including emergency physicians, is key to effective healthcare workflow solutions. The time a physician spends in contact with a patient, delivering care, also has implications for chargeable time and its reimbursement. Of course, being able to locate and summon physicians when a patient has an emergency or is just waiting to be seen, improves the patient experience.
Workflow issues often begin in the emergency room, where inefficiencies can exacerbate over-crowding and backed-up services. Three issues in the ER are keeping track of patients and staff, triaging patients (especially when some are walk-ins for primary care), and locating available hospital beds for patients who should be admitted. RTLS addresses all three issues when patients are wearing bracelets that signal their location, wait time, and presenting problem.
ER staff complains that their time is consumed searching the ER for patients who could be located by access to an RTLS platform. The related issue of finding available hospital rooms is solved by room-level information. An article twelve years ago in Healthleaders, about ideas for unclogging ER bottlenecks, actually advocated sending doctors out into the hospital to find available beds that had been cleaned.
Staff workflow and patient flow come together in patient trips to surgery and radiology. Patient wait times in perioperative areas, sometimes in the surgery itself, and then in recovery and aftercare are measures of both patient flow and workflow. Real-time information about the numbers of patients at each of these locations—and potential bottlenecks—can refine last-minute scheduling. In the longer term, data kept automatically by RTLS can be organized and analyzed to identify days, times, and places bottlenecks tend to occur.
For example, when the scheduling of the surgical suite tends to overwhelm facilities and staff of aftercare, either scheduling of surgeries or resources of aftercare can be modified.
Managing patient flow can reduce wait times and increase safety and patient comfort in the hospital's most expensive and necessary areas such as surgical services, the emergency department, and specialty clinics. Developing bottlenecks can be spotted and avoided when staff has real-time ability to see all rooms and other treatment areas and the location of mobile equipment.
A patient's workflow in a hospital or clinic begins with admission to the facility. Some admissions can be automated with patient tracking, location of available rooms, and notification of nursing stations. All are features of RTLS with artificial intelligence.
When patients are moved to another department (handed off), both patient flow and workflow are affected. The first requirement is to notify all parties of the transfer, so the patient is not temporarily "lost" in transit—a problem not infrequently associated with negative consequences for the patient's health. An "alert" published by the Joint Commission warned: "Potential for patient harm—from the minor to the severe–is introduced when the receiver gets information that is inaccurate, incomplete, not timely, misinterpreted, or otherwise not what is needed." The ability to locate the patient in real time and use the RTLS system to send notifications are answered.
Efficient discharge of hospital patients ready to leave the hospital increases the availability of beds, especially if staff can be notified automatically of the need to clean the room. Both are issues of workflow. This is an added improvement of patient flows if discharge staff is notified far enough in advance to prepare the paperwork so patients and families do not face a long wait—a possibly negative final experience of the patient's stay.
A third "system wide" factor in workflow is availability and ease of access to the equipment, instruments, and medical devices needed for virtually all patient care, including patient comfort and safety. The need for a long search to find a device that is clean and ready to use is frequently a complaint of staff and concern of management. The lost time affects workflow but also forces waiting time that stalls patient flow.
RTLS using Bluetooth Low Energy (BLE) assets tags, available even for very small items that are often lost, transmit location and identity of assets at the room level. That includes areas for laundry and trash, where smaller devices may be lost. It also includes "hoards" of certain equipment that departments and divisions may maintain to solve their own search problems. RTLS maps asset location at the room level, floor level, and hospital level, making the scan useful, as well, for periodic inventories and scheduling maintenance by the BioMed engineering department.
The essence of workflow efficiency is having the right tools at hand when they are needed. Asset tracking represents a partial solution for many workflow challenges.
For any hospital or clinic, caregivers are the prime assets. Many things affect how caregivers spend their time, but to begin to understand the whole picture requires real-time data on the movements of caregivers. It also, of course, requires real-time data on the location of patients anywhere in the facility. That understanding and the improvement it makes possible is one goal of RTLS now increasingly used in hospitals and other health care facilities.
Software for RTLS, even as it manages the operation of the system, collects data that can be organized and analyzed from different perspectives to address system-wide wait times, contact times, duration of cycles, staff workflow, and utilization of rooms and other resources. Data organized to be transparent and relevant are leverage for moving toward consensus on the nature of challenges and how to address them. This both enables wide staff participation in problem-solving and management success in getting attention to problems.
Kontakt.io is a pioneer and innovator of BLE Internet of Things (IoT) technologies and AI-based cloud solutions. These are the core elements of the Kontakt.io RTLS: