Successful Deployment of RTLS in Health Care:

A Cooperative Vendor Partnership to Assure Success

presented bySam Itani, Vice President, San Joaquin Community Hospital

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About San Joaquin Community Hospital

• Part of the Adventist Health System

• Premier provider of healthcare services in Bakersfield and the surrounding cities of Kern County 255 patient beds

80% ratio of private rooms

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Our Values• Compassion:  The compassionate healing ministry of Jesus • Respect: Human dignity and individuality • Integrity: Absolute integrity in all relationships and dealings • Quality: Excellence in clinical and service quality • Stewardship: Responsible resource management in

serving our communities • Wholeness: The health care heritage of the Seventh-day

Adventist church • Family: Each other as members of a caring family

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Our RTLS Value Drivers• Positive Impact to Patient Care

– Staff efficiency– Staff satisfaction– Allow clinicians to focus on clinical care

• Solution to Budget Pressures– Unknown utilization– Equipment shrinkage (lost, misplaced)

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RTLS Deployment Facts330,000 Sq. Ft. | 1475 total tags | 36 Asset Categories

Bair Huggers Gaymars ScalesBeds / Gurneys Glucometers Speech AmplifierBladder Scanners HEPA Filters StimulatorMonitors Housekeeping Carts Syringe PumpComputers on Wheels Isolation Cards Transport MonitorsDefibs IV Pumps VacuumsDopplers Pacemakers VentilatorsFloor Care Equipment PCA Pumps WarmersFreezers / Refrigerators

Phototherapy Units Wheelchairs

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Our RTLS Solution: How it Works

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Vendor Selection Criteria

• Easy to install• Non invasive• No capital purchase• Fully managed service • Easy to use and extensive reporting suite

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Installation Success Criteria• Each step is critical to success• Verify asset coverage areas

– Know your true enterprise footprint – For us, immunization building, Biomed remote location

and storage areas were outliers• Vendor/IT walkthrough

– Upfront planning to insure details are known

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Mutual ResponsibilitiesVendor Responsibilities:• Prep and install network, tag initial assets, training

Hospital Responsibilities:• Provide approved list of assets• Guarantee appropriate vendor access (security, etc.)• Leadership-guided training mandate (user adoption)

Mutual Goals• Define success criteria for acceptance

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Inventory Asset Details• Asset selection based on value goals

– Leadership, biomed, clinical• Asset reconciliation• Asset naming convention

– Category, display name, type, description, make/model, owner (literal owner vs. maintenance owner)

• Workflow process– Alert parameters

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Installation Acceptance Criteria• Verify software application• Validate search accuracy• Verify feature deployment

– Par levels, exits, zones, alerting• Confirm satisfactory staff training

– Sign-in sheets, all appropriate departments, leaders, accommodate shifts

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Ongoing Action Plan and Phasing• Vendor responsibilities

– See to it that we continue to maximize the value of RTLS

– Work closely to determine our needs– Liaison to be sure promises are kept– Hold our hand as we walk through the project

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Ongoing Action Plan and Phasing• Hospital responsibilities

– Commit to maximizing the value of RTLS• Executive sponsor, departmental leaders/steering committee,

day-to-day users

– Be direct about our needs • Staff efficiency, positive impact to our patients

– Clearly state hospital value drivers • What constitutes success? • How will we monitor, measure, improve?

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Turning Data into Information• How do we use RTLS to impact change?

– Steering committee to drive change– Areas of focus

• Equipment flow and movement• Par levels• In use / out of use (custom rules)• Stationary asset visibility• Temperature asset management

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Top Search Trendsas of April 2010

Housekeeping Carts PCA PumpsWheelchairs GurneysTransport Monitors Floor Care EquipmentPacemakers IV PumpsMonitors, Vital Signs RefrigeratorsDopplers VentilatorsVacuums Blood WarmersWarmer, Blood/Solution TelemonitorsComputers on Wheels Other (Advanced Search)

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Increased Staff ProductivitySearches for Period

Time/Search Before SAM

Time/SearchAfter SAM

08.09 - 03.10 7,738 23 minutes 5 minutesTime Savings in Hours (8 months) 2,321Annualized Value of Productivity Increase(FTE Equivalents)

1.81*

* Provides positive impact to patient care with no additions to payroll: staff efficiency, staff satisfaction, allows clinicians to focus on clinical care

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Utilization Increase by Asset Type

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Equipment Utilization• Capital purchase decision validation

– Managing from stationary asset report– Latest report revealed 40 assets that had not moved

for more than 90 days

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Par Levels

• Eliminate needless “sneaker patrol”• Proactive alerting on equipment levels (dirty

closets)• Expanding department based par levels

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• Alert if temperature is outside preset thresholds

• View temperature trends and history

• Proactively avoid out-of-compliant events

• Assure compliance and maintain standards

• Dashboard at-a-glance

Temperature Asset Management

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Alerting RecapExit Alerts:First floor, Main lobby, ED

Temperature Compliance: Home Health Freezer-Plant Ops, Home Health Freezer-Immunization, Pharmacy Refrigerators

Par-Level Alerts: Soiled Utility, Wheelchair

Entry Alerts: Laundry Area

Zone Alert: OR Equipment leaving the OR

Additional Impact Opportunities• Rentals

– Full implementation for increased benefit of rental savings

• Shrinkage– Exit and zone alert expansion and escalations– Missing asset alerts and workflow integration

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Key Lessons Learned• Leadership must drive adoption and process change • Must be an administration-driven project with cross

functional involvement• Be clear about our needs and clearly state ROI

expectations• Meaningful asset naming convention is critical• Vendor must be held accountable for success

criteria and remain involved