Stop, Evaluate, Restart – My Journey with RTLS

This week, our featured RTLS in Healthcare Community member is Judy Travis, RD, LD, MHA, MBA, LSS BB. Judy is the Senior Director of Operations for Ambulatory, Retail, Food and Nutrition Services, Rehab Services, RTLS, and Mission Control at Texas Health Resources in Dallas, TX.

Infinite Leap: Judy, can you share with us how your journey with Real-Time Location Systems (RTLS) started?

Judy Travis: Our organization started using an RTLS system back in 2008 for asset management and staff location purposes. Over the years, we lost focus on the system. We were not “feeding and watering it.” Employees were no longer using the RTLS system, yet we were still paying for it. In 2016, the President of our hospital asked me to take over the management of the RTLS system and to provide him with recommendations regarding expanding the use of the system to other use cases, such as patient flow.

Infinite Leap: So what was your recommendation?

Judy Travis: Before I could recommend anything, I asked for a “time-out.” We needed the time to evaluate our current state: how the system is being used, what benefits we are seeing, how we are measuring value, and last but definitely not least – how much the system is really costing us.

Infinite Leap: What were the outcomes of this evaluation?

Judy Travis: What we found came as a surprise to many. For example, the use of the system for locating mobile medical equipment was minimal. The information in the system was no longer up to date. With each year, our maps also became outdated and when the system was not validated – people stopped using it. Also, staff were putting their badges in their drawers instead of wearing them, which meant that staff location functionality was not functioning as well. In summary, our RTLS system wasn’t really offering much value in the shape that it was in because we hadn’t invested the time, effort, and resources to keep it functional.

Infinite Leap: Unfortunately, you are not the only hospital that saw their system deteriorate. What was your next step?

Judy Travis: We put together an RTLS Committee – a working group consisting of both the representatives from the management team as well as our front-line staff. After thorough evaluation of all costs and benefits of the system, we determined that we basically have to restart our RTLS deployment. We decided to use our RTLS system for asset management only, while putting other use cases on hold until we get all asset related processes working in sync and optimized. Another big decision that we made was a creation of the Mission Control team.

Infinite Leap: Can you explain the purpose of creating a Mission Control team and what they do on a daily basis?

Judy Travis: Our Mission Control team is a centralized group that consists of 8-10 full-time employees whose sole responsibility is retrieving dirty medical equipment, cleaning it, and restocking clean equipment throughout the hospital. They establish PAR Levels for each equipment type and for each specific location, so that they can be proactive and redeploy clean equipment to locations as they are needed. As result, our nurses don’t need to make phone calls to get the equipment, they don’t even need to search for equipment in the RTLS system. They just know that if they open a supply closet a clean equipment will be right there. That’s a huge shift in thinking and process and a huge benefit that the Mission Control team was able to create. The organization went from being reactive to being proactive and anticipating and delivering against the needs of our care team even before they asked.

Infinite Leap: What was the key to this successful process change?

Judy Travis: First, we properly identified what our front-line staff needed. It wasn’t an RTLS system; what they wanted was to have the equipment available to them where and when they needed it. It was ours to figure out how to make it work for them in regards to people, technology, and processes. Beyond solving a real problem, I believe that a critical component was for our Mission Control team to have strong rapport with a front-line staff. Your nurses need to fully trust your team. I am proud to say that we have established this strong relationship. The result is that our nurses don’t hoard equipment any more. They trust that the Mission Control team will make sure that they have what they need to care for their patients.

Infinite Leap: And what other changes have you applied in your RTLS “redo”?

Judy Travis: Other lessons we learned was that you don’t need to tag everything in your hospital – it adds to the start-up cost and the cost of maintaining the system. Be meticulous about it, ask questions such as: “how often this type of equipment moves around?”, “how much the unavailability of this type of equipment slows down the patient care process?”, “if we tag this asset, who will be responsible for finding it on the floor and bringing it to the bed site?” Asking these types of questions allows our RTLS Committee to make smart decision around expanding the use of the RTLS system.

Infinite Leap: Do you see a value in the use of Real-Time Location System?

Judy Travis: I have never doubted in the value of RTLS. With the assistance of the RTLS system, we can provide better care to our patients and better service to our front-line staff. On top of all soft benefits that we experience, such as higher patient and staff satisfaction, we are able to prove the hard dollar savings the system delivers. For example, last year we were able to save over $400,000 in reduced equipment purchases and rentals, and this is a net savings – after paying salaries and benefits of our Mission Control staff and the cost of the RTLS system.

Infinite Leap: And what is your advice for hospitals just starting with RTLS?

Judy Travis: Before you even decide what RTLS system you are going to install, you need to think the entire process through. You have to consider all operational changes that need to take place, staff resources needed to sustain the RTLS technology, and how you are going to measure the return on your investment. Once you have these answers you can work on executing your plan. And remember, RTLS is not just a one-time project – it needs to be evaluated and adjusted so it supports your front-line staff, not hinders their daily work. And don’t forget – you need full support from your executive team and this in only possible if you are able to show them hard dollars savings and the value it provides to patients. Finally, ensure that the organization is willing to properly resource the team as it does take ongoing care and feeding. If you don’t do that, then all the hard work up front will be wasted and the value that the organization receives will diminish.

Infinite Leap: Judy – as we are building our Community, can you please share with us some of your personal interests?

Judy Travis: I love spending time with my family, my church community, and my animals.

If you would like to share your thoughts and best practices on RTLS, drop me a note – I’d love to chat with you to capture your experiences.