Real-time locating systems drive design of patient-centered environments
Operational efficiency has been a mantra throughout the healthcare delivery environment for years. If you’re a hospital or clinic manager, you’ve been under significant pressure to cut costs and reduce errors while providing increasingly better care for patients in a demonstrable way. No small task, even in the smoothest of times.
And then came COVID-19.
Seemingly overnight, these pressures, while pulled from the forefront of institutional managers in the light of the crisis, nevertheless increased in urgency. Now, the elusive brass ring of “operational efficiency” includes financial recovery, the safety of both staff and patients and the public’s confidence at large.
What can construction and design professionals do in response to these industry demands? What can be done through design to enhance interactions between patients and their care providers?
Data helps prioritize design
Several technological advances in recent years have given rise to a robust body of data that has helped fuel changes in patient workflow design. Telemedicine, electronic medical records and real-time locating systems are just a few of the technologies contributing to this vast information set.
RTLS technology can contribute tremendously to this data set. Aggregated-RTLS information enables better planning for the future, as well as provide invaluable “live” data that makes for more informed moment-by-moment decision making at the point of care.
Broken down into simple components, RTLS technology uses sensors installed in the care environment, tags affixed to equipment, badges worn by patients and staff and intelligent software that translates locations and interactions into actionable information.
If all the system provided was real-time visibility to the movement of IV pumps, beds, staff and patients, that would be — and is — a tremendous boon to care delivery. But these systems do more. Much more.
Real-time locating systems have been providing this level of visibility for decades. But along with that visibility, it also captures workflow data, informing the design of healthcare spaces that maximize efficiency. Equipment and room utilization trends, moment-by-moment patient and staff locations over time, patient wait times, interactions between patient and care providers, and more can all be analyzed to provide a clearer picture of how care works in the spaces we make.
From this data set, there are four significant trends that medical construction and design professionals can learn from to help create more efficient and impactful environments.
Trend 1: on-stage/off-stage
Traditionally, care environments have a linear “wait, enter to treat and back out” model. This design features corridors used by both patients and staff and exposed staff workstations. Those corridors often become crowded with equipment, privacy issues are a concern and the overall patient experience is diminished. The growing patient population was already putting a strain on this model before the COVID-19 pandemic and will re-emerge with new energy as patients return.
The on-stage/off-stage model is most easily implemented in new construction or redesigns. This model makes a clear separation between caregiver work areas (considered off stage) and patient areas (on stage). Corridors are dedicated to either patients or caregivers. These roles enter exam rooms from different sides, meaning each exam room has two distinct entrances.
The benefits of this design are significant for both roles. Patients experience a calmer, more clutter-free environment. Caregivers have a centralized work area where information and collaboration are more accessible. Additionally, the off-stage professional area offers direct access to all exam rooms, improving flow management.
An installed RTLS solution provides clear visibility to which patients and staff are in which exam rooms; without such visibility, enjoying the most benefit from an on-stage/off-stage model would be challenging.
Trend 2: collaborative care
The concept of patient-centric care extends to much more than just patient-caregiver communication and attention. When taken to its logical conclusion, literally putting the patient in the physical center of the workflow offers a decreased length of stay for the patient and improved outcomes due to the increased interaction of caregiver teams.
In traditional facilities, patients must move from location to location during their visits, from an exam room to having X-rays taken to having blood drawn, for example.
However, by bringing various relevant services, such as referral scheduling, lab, financial counseling and even checkout to the patient in one room, the patient’s time is optimized, and their experience is less stressful.
Like the on-stage/off-stage model, RTLS enhances collaborative care. Beyond improved visibility, the use of intelligent rule sets combined with location data allows the automatic communication of which caregiver has seen the patient, and which one(s) may need to see the patient next. This improved coordination minimizes alone time for the patient and shortens their length of stay.
Trend 3: dynamic room assignments
One straightforward way to enhance workflows and achieve more efficiency is identifying and removing bottlenecks. In the traditional healthcare delivery environment, various exam rooms are “owned” by different physicians. This is a clear pinch point and a deterrent to fluid patient flows.
However, an environment where patients and providers are assigned to the first available room would offer several workflow enhancements. This fluid allocation reduces downtime in exam rooms for more utilization and less patient wait time, flexibility to allow for patient emergencies or walk-ins and even the ability for clinics to add more physicians or spaces for specialists.
Ultimately, clear visibility to room status enables this model to succeed and allows more providers to use fewer exam rooms. Again, an RTLS enables registration staff to see room status as soon as a patient arrives and empowers real-time assignment with little to no waiting.
Trend 4: self-rooming (or direct rooming)
Eliminating the waiting room not only improves the patient experience, it also allows exam space to be maximized. Additionally, complying with social-distancing requirements becomes easier when patients aren’t exposed to one another in a waiting area.
This model features a patient check-in process not unlike a hotel experience. Instead of a room key, the patient receives an RTLS badge and proceeds directly to their exam room or a diagnostic sub-waiting location. They can go on their own or be escorted by a staff member. With RTLS in place, the software alerts check-in staff about which rooms are disinfected and ready for new patients. Once the patient has entered the room, the technology notifies the care team of their arrival.
No waiting room means space for additional revenue-generating services, such as lab services or more exam rooms. As previously mentioned, it’s also a significant move toward improving infection control.
The proliferation of data, combined with an ever-increasing push to improve patient safety and experience, is allowing for a genuine design evolution in care spaces. And while the patient benefits from a more efficient and calmer experience, healthcare providers experience a safer and more flexible environment, smoother processes and enhanced communication.
Additionally, design and construction professionals can leverage this data in collaboration with health delivery clients to develop environments that provide more than convenience – they may actually enhance healthcare outcomes.
Author: Susan Martin Susan Martin is vice president, Midmark RTLS.