Applying RTLS Technology to Improve Nurse Efficiency and Patient Care 

Providing better patient care is a national imperative in the United States, and nurses play a critical role in this equation. This pressing issue has been impacted greatly by the ongoing nursing shortage, and the COVID-19 pandemic has only exacerbated this challenge in the United States.

The healthcare industry has been harder hit than most during the Great Resignation and exodus of over 5 million people from the workforce from 2020 to 2022. Reports estimate that healthcare lost 20% of its workforce, including 30% of its nurses.^1, Job burnout was identified as one of the top reasons that nurses are leaving patient care for other jobs. One approach to help decrease nursing burnout and turnover is to increase nursing job satisfaction. Being able to spend more time providing direct patient care and less time on administrative duties plays a key role in nursing job satisfaction.² Ensuring nurses are spending the maximum amount of time focused on patient care during each shift can help administrators mitigate this key challenge with the added benefit of reducing waste in the inpatient setting.

One way to increase patient care resources is by identifying and reducing key areas of waste. Since nurses represent roughly one-third of workers in hospitals, the issues they face can attribute to a large amount of waste in healthcare. While some waste is inevitable, reducing it can prove vital in reducing costs and improving patient care. One major area that can be improved is time management, specifically, time spent looking for equipment. The cost of lost productivity is clear, and the impact it causes can be life-threatening in some situations.³

In a 2015 international survey completed by 209 nurses and 30 doctors, it was concluded that preventable wasted time accounted for about one-third of each shift, nurses only spend about 30% of their time with patients, and about 12% of their shift is spent looking for equipment. ⁵ In its 2010 nurse survey, the Healthcare Management Council revealed that locating supplies and equipment ranked as the second largest time waster.⁴ Time spent looking for equipment certainly takes them away from patient care. In a study conducted by  General Electric HealthCare found nurses spend an average of 21 minutes per shift searching for lost equipment.⁵ One health system in Buffalo, New York, estimated nurses spend 57 minutes per shift looking for and cleaning equipment. While these studies span several healthcare settings, they all point to similar findings; 21 to 60 minutes per shift are wasted by nurses looking for equipment. 

Clearly, time spent looking for equipment can be a costly. There are 1.7 million registered nurses working in hospital or surgical settings.⁶ If these nurses spend at least an hour per shift looking for equipment,⁷ that equates to 200 hours annually of lost productivity not in direct patient care. With an estimated average salary of $40 per hour for a hospital RN,⁸ the time spent looking for equipment could save up to $14 billion dollars per year in reallocated nurse productivity.

While many technological applications are available to help improve hospital efficiency, a focus on nursing efficiency can have a direct impact on improved patient care. A real-time location system (RTLS) is one solution focused on reducing the amount of time nurses spend on activities such as searching for medical equipment. RTLSs are local tracking systems that identify the physical location of personnel and equipment in real-time.⁹ These systems utilize various software applications to relay tracking information from sensors. This information can be integrated into a healthcare organization's operational systems to provide access to equipment locations in real-time. While hospitals have long utilized inventory tracking systems to monitor medications, supplies and documents, the tracking of high-cost equipment hospitals have, usually in limited quantities, can prove to be one of the most effective methods of reducing the time nurses spend looking for this equipment.   

The benefits of using RTLSs to track and better understand hospital operational challenges have been highlighted in several studies.

• Improved workflow and staff resource assessments. One study using RTLS helped identify that physician residents only spent 12% of their time in patient rooms.¹⁰
• Improved asset management. A 2013 study done in Australia found that $60 million is wasted annually due to poor management of assets.³
• Scheduling and utilization management. In a 2018 study, researchers found that RTLS data could be effectively leveraged to identify the optimal provider scheduling to improve utilization in an outpatient clinical setting.¹¹
• Improved staff and patient safety. Utilizing a discrete panic alert from active RFID enabled badges to alert security of a security concern.¹² A Wake Forest Health system utilizes RTLS to trace and track the proximity of an infected person, which aids in improved safety.¹³

A systematic review of 42 peer-reviewed research projects on the application of RTLS to improve healthcare delivery concluded that while some limitations exist for hospital data integration and software implementation, RTLS is an effective method to assess workflow, productivity and asset management.¹⁴ Expanding on key research focused specifically on nursing productivity and the reduction of time wasted can have a direct correlation to nursing job satisfaction, increased patient care time, and overall improved quality of care. RTLS can help hospitals improve workflow analysis, quality and patient safety. There have been many advancements in inpatient healthcare delivery and therapeutics over the past decade, which are important in our current assessment of the application of RTLS technology in the hospital setting. An updated study of nursing efficiency would be the next steps in better understanding the quantifiable value and costs savings of real-time location systems. Future directions should focus on reassessing the impact of RTLS in an updated nursing survey and real-time nurse workflow analysis.   

References

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10. Use of a Real-Time Locating System to Assess Internal Medicine Resident Location and Movement in the Hospital | Medical Education and Training | JAMA Network Open | JAMA Network. Accessed January 22, 2023. https://jamanetwork.com/journals/jamanetworkopen/article-abstract/27931…
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12. Palter J. 8 Security Benefits of Using RFID Personnel Tracking Software. Accessed February 9, 2023. https://www.realtimenetworks.com/blog/security-benefits-of-using-rfid-p…
13. How Wake Forest Baptist Health uses RTLS to protect against communicable disease. Healthcare IT News. Published October 22, 2020. Accessed February 9, 2023. https://www.healthcareitnews.com/blog/how-wake-forest-baptist-health-us…
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