Wake Forest Baptist Medical Center took a look at the healthcare landscape and knew it had to make some organizational changes. With the industry increasingly focused on operational efficiencies, quality service and patient satisfaction, the hospital saw opportunities for cost savings that had eluded them -- and looked to a combination of technological innovation and culture change to make that a reality.
The journey started by implementing RTLS technology. RTLS -- or real-time locating systems -- are used to automatically identify and track the location of objects or people in real time, usually within a contained area, in this case a hospital building.
The way the technology works is that wireless tags are affixed to either objects or people, and fixed reference points receive wireless signals from the tags to determine their location. Some hospitals use the technology to locate medical equipment; examples of its use in other industries include tracking cars through an assembly line or locating merchandise in a warehouse.
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Wake Forest's focus was on the functionality and utilization of its medical equipment. Sensing that it could trim operational costs by making the use and storage of said equipment more streamlined, the hospital set up communication boards so that staff would be able to monitor these devices in real time, and ensure that storage and usage guidelines were being held to strictly.
"From a regulatory perspective, we cannot have equipment sitting in hallways or corridors," said Conrad Emmerich, senior vice president of health system operations and integration at Wake Forest Baptist Health. "There are certain alcoves. Like many hospital organizations in the country, we have a lot of equipment, and we focus on building good patient care space, but didn't always focus on where we store equipment when it's not in use.
"We needed to keep it out of our corridors," he said. "If it sits idle, it sends an alert to a nurse's station or distribution team. It says, 'You need to move me because I am not in a compliant space.'"
The RTLS system runs on CenTrak hardware and Infinite Leap software, but the partnership with those companies didn't just result in a more advanced way to track and monitor equipment. Experts from each organization were tapped to help Wake Forest establish what it calls the Office of Enterprise Visibility, the main function of which is to drive organizational goals.
Like many business plans, this one was summarized in an acronym: SPOT. It stands for Service excellence, Patient safety and satisfaction, Operational efficiency and the Transformation of healthcare delivery.
That ethos has guided Wake Forest's use of real-time technology. And the financial results have spoken for themselves.
There are a lot of devices the hospital tracks -- about 35,000 all told. Roughly 6,000 sensors throughout the facility help track these items, but they can also track patient flow. With more than 2,000 patients in the hospital at any given time, the ability to track and monitor them has led to significant reductions in wait times.
"The average wait time reduction is 50%, so from a patient satisfaction standpoint that's great," said Emmerich. "The rooms are better optimized. There are cost reductions and increased capacity."
Patients receive more personalized attention, as well.
'When we check patients into our cancer center, we provide them with a VIP badge, a care pass, and we essentially can know where they are in their current day while on campus," said Emmerich. "If a patient is sitting in a waiting room for too long, and the care pass is idle, it can alert someone from the registration desk to check up on them, or allow them to take action to see why (the) patient has been sitting in the phlebotomy sub-waiting room for 16, 17 minutes, or whatever we feel is an appropriate time to wait too long."
Being able to track patients is a prime example of the "S"in SPOT -- Service excellence. Emmerich said it has improved staff interactions with patients, and while their care experience has improved, the hospital is still pursuing its original goal of streamlining equipment storage and usage.
Using real-time tracking technology on both of those fronts has helped to bring about the "T" in SPOT: Transformation of healthcare delivery.
Emmerich said that transformation has occurred "across the board, from really enhancing and completing the entire patient experience in terms of wayfinding, and knowing how long our caregivers interact with our patients, to howlong our patients walk from the front door to et to the cancer center, or even to digestive health. That information opens our eyes to the complete patient experience when they walk through our door."
The savings to date have convinced Wake Forest that it's on the right track. After the initial investment, RTLS technologies have resulted in savings of about $3.5 million annually -- and that's figuring conservatively. Emmerich said there have been significant savings on top of that which haven't yet been quantified.
Workflow efficiencies provide one such example. Wake forest centrally monitors more than 1,000 refrigerators and freezers, and the temperature of each has to be checked twice daily to comply with regulatory guidelines. Before the Office of Enterprise Visibility spread its gospel of real-time tracking technologies, nurses and other caregivers were tapped to check those temperatures, which can take a couple of minutes each time.
A couple of minutes here and there add up over time, but remote monitoring makes that unnecessary. Caregivers can now focus more of their time on actual care.
"That's thousands of hours that can get redeployed to actual caregiving," said Emmerich. "That's been quantified in hundreds of thousands of dollars in savings year over year."
Wake Forest sees these efficiencies as necessary to continued viability, not only for their business but for the healthcare industry generally.
"Where RTLS is going to impact us in the future is continuing to improve access and throughput for consumers and patients," said Emmerich, "and it will allow us to create capacity within the confines of our current infrastructure."