Improving Clinic Operational Efficiency and Utilization with RTLS

Berg, Bjorn P.; Longley, Grant; Dunitz, Jordan M.

doi:10.1007/s10916-019-1174-z

Cited by 22 publications

(8 citation statements)

References 16 publications

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“…For example, real-time locating systems (RTLS) have become a mature technology and can track the location and movement of staff, patients, and devices in a clinical setting. [83][84][85][86] Smart watches can track people's biometrics in a continuous manner, which can serve as a proxy to clinicians' burnout level, for example, positive association between burnout and heart rate. 87 Future studies should consider utilizing mobile and tracking technologies to collect real-time, individualized data which may be related to burnout and minimizes recollection bias.…”

Section: Utilize Mobile and Tracking Technology To Study Time Efficiencymentioning

confidence: 99%

A Scoping Review of Health Information Technology in Clinician Burnout

Kim

et al. 2021

Appl Clin Inform

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Background Clinician burnout is a prevalent issue in healthcare, with detrimental implications in healthcare quality and medical costs due to errors. The inefficient use of health information technologies (HIT) is attributed to having a role in burnout. Objective This paper seeks to review the literature with the following two goals: (1) characterize and extract HIT trends in burnout studies over time, and (2) examine the evidence and synthesize themes of HIT's roles in burnout studies. Methods A scoping literature review was performed by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines with two rounds of searches in PubMed, IEEE Xplore, ACM, and Google Scholar. The retrieved papers and their references were screened for eligibility by using developed inclusion and exclusion criteria. Data were extracted from included papers and summarized either statistically or qualitatively to demonstrate patterns. Results After narrowing down the initial 945 papers, 36 papers were included. All papers were published between 2013 and 2020; nearly half of them focused on primary care (n = 16; 44.4%). The most commonly studied variable was electronic health record (EHR) practices (e.g., number of clicks). The most common study population was physicians. HIT played multiple roles in burnout studies: it can contribute to burnout; it can be used to measure burnout; or it can intervene and mitigate burnout levels. Conclusion This scoping review presents trends in HIT-centered burnout studies and synthesizes three roles for HIT in contributing to, measuring, and mitigating burnout. Four recommendations were generated accordingly for future burnout studies: (1) validate and standardize HIT burnout measures; (2) focus on EHR-based solutions to mitigate clinician burnout; (3) expand burnout studies to other specialties and types of healthcare providers, and (4) utilize mobile and tracking technology to study time efficiency.

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Section: Utilize Mobile and Tracking Technology To Study Time Efficiencymentioning

confidence: 99%

A Scoping Review of Health Information Technology in Clinician Burnout

Kim

et al. 2021

Appl Clin Inform

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“…10 There are myriad applications of RTLS in healthcare, including operational, clinical, safety and quality improvement initiatives. [11][12][13][14] In anticipation of a large scale RTLS installation in a new critical care tower, our institution implemented an RTLS pilot program in the ED to troubleshoot installation, streamline implementation, and test its operational functionality. An RFID-based RTLS (Cen-Trak, Newtown, Pennsylvania, United States) was installed in the ED in October 2018 and all staff badging was operational by February 2019.…”

Section: Real-time Location Systemmentioning

confidence: 99%

Improving Documentation Using a Real-Time Location System in a Pediatric Emergency Department

2021

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Background Appropriate documentation of critical care services, including key time-based parameters, is critical to accurate severity of illness metrics and proper reimbursement. Documentation of time-based elements for critical care services performed in emergency departments (ED) remains inconsistent. We integrated electronic medical record and real-time location system (RTLS)-derived data to augment quality improvement methodology. Objective We aimed to increase the proportion of patient encounters with critical care services performed at a pediatric ED that had appropriate documentation from a baseline of 76 to 90% within 6 weeks. Methods The team formulated a framework of improvement and performed multiple plan-do-study-act cycles focused on key drivers. We integrated the capabilities of an RTLS for precise location tracking to identify patient encounters in which critical care services were performed and to minimize unnecessary audits and feedback. We developed an intervention using iterative revisions to address key drivers and improve documentation. The primary outcome was the proportion of patient encounters for which critical care services were performed for which a time-based attestation was documented in the medical record. Results We analyzed 92 encounters between March 2020 and April 2020. While the proportion of eligible patient encounters with critical care documentation improved from 76 to 85%, this change was unable to be directly attributed to improvement efforts. Patients with respiratory complaints encompassed the majority of eligible encounters without appropriate documentation. Conclusion Utilizing improvement methodology and a novel application of RTLS, we successfully identified the co-location of physicians with patients receiving critical care services and designed interventions to improve documentation of critical care services provided in a pediatric ED. While changes were not able to be attributed to improvement efforts in this project, this project demonstrates the utility of RTLS to augment and inform systematic improvement efforts.

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“…[42], RTLS are systems for identifying and tracking the location of assets and/or people in real-time or near real-time. Furthermore, RTLS provides an automated means of collecting operational data on clinic activity such as room utilization rates, or patient wait times [43]. We based the choice of an RTLS on its ability to allow automatic identification, avoiding the existence of a human error in identification processes.…”

Section: Elhealth Modelmentioning

confidence: 99%

Towards Evaluating Proactive and Reactive Approaches on Reorganizing Human Resources in IoT-Based Smart Hospitals

Fischer

Righi

Costa

et al. 2019

Sensors

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Hospitals play an important role on ensuring a proper treatment of human health. One of the problems to be faced is the increasingly overcrowded patients care queues, who end up waiting for longer times without proper treatment to their health problems. The allocation of health professionals in hospital environments is not able to adapt to the demands of patients. There are times when underused rooms have idle professionals, and overused rooms have fewer professionals than necessary. Previous works have not solved this problem since they focus on understanding the evolution of doctor supply and patient demand, as to better adjust one to the other. However, they have not proposed concrete solutions for that regarding techniques for better allocating available human resources. Moreover, elasticity is one of the most important features of cloud computing, referring to the ability to add or remove resources according to the needs of the application or service. Based on this background, we introduce Elastic allocation of human resources in Healthcare environments (ElHealth) an IoT-focused model able to monitor patient usage of hospital rooms and adapt these rooms for patients demand. Using reactive and proactive elasticity approaches, ElHealth identifies when a room will have a demand that exceeds the capacity of care, and proposes actions to move human resources to adapt to patient demand. Our main contribution is the definition of Human Resources IoT-based Elasticity (i.e., an extension of the concept of resource elasticity in Cloud Computing to manage the use of human resources in a healthcare environment, where health professionals are allocated and deallocated according to patient demand). Another contribution is a cost–benefit analysis for the use of reactive and predictive strategies on human resources reorganization. ElHealth was simulated on a hospital environment using data from a Brazilian polyclinic, and obtained promising results, decreasing the waiting time by up to 96.4% and 96.73% in reactive and proactive approaches, respectively.

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Improving Clinic Operational Efficiency and Utilization with RTLS

Cited by 22 publications

References 16 publications

A Scoping Review of Health Information Technology in Clinician Burnout

A Scoping Review of Health Information Technology in Clinician Burnout

Improving Documentation Using a Real-Time Location System in a Pediatric Emergency Department

Towards Evaluating Proactive and Reactive Approaches on Reorganizing Human Resources in IoT-Based Smart Hospitals

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