Two hospitals (a 40-year-old flagship facility and a new 58-bed facility) that are part of the Texas Health Resources health system use a real-time location system enabled by radio frequency and infrared identification technology to monitor the location of major pieces of equipment; one hospital also uses it to monitor the whereabouts of patients and staff, and the second hospital is in the process of adding this capability. Integrated into other information systems within the hospitals and overseen by a centralized “mission control” unit, the system is used to improve various clinical and nonclinical processes, including asset management, infection control, room turnover, and transportation. It is not used in a punitive manner with staff. The system has significantly reduced annual equipment costs, room turnaround time, and staffing costs, and contributed to high levels of patient, physician, and staff satisfaction.
Evidence Rating (What is this?)
Moderate: The evidence consists of pre- and post-implementation comparisons of equipment rental costs at one hospital using the real-time location system, along with post-implementation comparisons of room turnaround times and budget allocations for equipment shrinkage (lost equipment) at hospitals that do and do not use the system. Additional evidence includes post-implementation feedback from patients, physicians, and staff on their satisfaction with various processes influenced by the system.
Texas Health Resources
Use By Other Organizations
The University of Maryland Medical Center uses radio frequency and infrared identification tags to track emergency medications found in crash carts.1 Oregon-based Sacred Heart Medical Center at River Bend uses them to track the location of infusion pumps and ensure that each unit remains above its periodic automatic replenishment level.2
Date First Implemented
Texas Health Presbyterian Hospital Dallas (a 650-bed, 40-year-old facility) began using the real-time location system to track high-value equipment in 2008. Texas Health Harris Methodist Hospital Alliance (a 58-bed facility) has used a real-time location system to track patients, staff, and high-value equipment since opening in September 2012.
Most hospitals experience bottlenecks and inefficiencies because of their inability to track the location and recent movements of patients, staff, and equipment in a timely manner.
Lack of timely information: The typical hospital has no easy or timely way to accurately track the location and movement of patients, staff, and high-value pieces of equipment, such as wheelchairs, beds, and infusion pumps. For example, no mechanisms exist to quickly find out which individuals and pieces of equipment have come into contact with a patient discovered to have an infectious disease, when a patient has been discharged (meaning his or her room is ready for cleaning), or where a missing piece of equipment is located.
Resulting bottlenecks and inefficiencies: This lack of timely and accurate information can lead to bottlenecks and inefficiencies. Among many others, examples include delayed and inaccurate information to guide infection control processes, significant amounts of staff time spent searching for missing supplies and equipment, costly delays in returning rented equipment, and delays in initiating room cleaning after discharge, which in turn can create bottlenecks in admissions, the postanesthesia care unit, and the emergency department (ED).