This past week I attended the HIMSS conference in Florida. At the conference, I repeatedly noticed something odd. Many companies were promoting visibility solutions to transform hospital operations. I thought about the simplicity of their message and understood; knowing where things are will definitely help in creating and maintaining an efficient and safe environment of care throughout hospitals. However, what struck me as odd was the over-reaching assumption that visibility in and of itself can optimize workflow, or as one company put it, “Visibility Drives Clinical Workflow Optimization”. That is simply not the case.
Imagine this scenario. A busy airport decides to implement an air traffic control system that provides real-time, pinpoint location information on a sexy map of the airspace around the airport. The system is so smart that it can even alert the air traffic controllers when aircraft are on collision courses. Sounds great, right? But what happens when you realize that there is no other information available, such as when aircraft are expected to enter the airspace, when they are supposed to land, what type of aircraft they are and what condition they are in–like how much fuel they have left. With this approach, the air traffic controllers find themselves constantly reacting to crises and fighting fires (hopefully not literally). The system is better than nothing, but it isn't exactly efficient or safe. It makes Greyhound sound like a good option for a coast-to-coast trip…I think I’ll take the bus.
To effectively manage logistics, whether it’s aircraft, medical equipment, supplies or people, you need more than visibility and alerts. You also need to understand what is supposed to be happening, if things are on track and, if they aren’t on track, why not. In the aircraft example, this would be accomplished through flight plans, real-time two-way communication, and aircraft information.
A good real-world example of the importance of streamlined, automated workflow is UPS. UPS ships millions of packages every day. They don’t put GPS tags on packages and they don’t expect the end user (you and me) to go hunting for packages if they don’t show up. Instead, they have well-defined processes and management controls to make sure that everyone in the chain understands what is on its way and what they are supposed to do with it when it shows up —or what they need to do if it doesn’t.
I have been known to rant about the hundreds of millions of dollars that have been dumped into Real Time Locations Systems (RTLS) that have delivered little, if any, value to many of the hospitals deploying them (as mentioned in this recent RFID Journal article). These orphaned systems were installed with the hope that they would fix problems like extended patient wait times, OR delays and equipment availability and utilization. Many hospitals learned the hard way that “dots on a map” and email alerts don't address the root cause —broken workflow.
The bottom-line is that automating dysfunction and broken workflow ensures that staff remains in firefighting mode and will eventually stop using the RTLS system. Many tracking companies have put themselves in a tough spot by overselling their solutions’capabilities as a panacea for any patient flow or mobile equipment challenge. By promoting visibility as the solution to deliver clinical workflow optimization, they are only perpetuating the problem they have created.
I recommend that any hospital considering RTLS take the following steps prior to placing that bet:
- Clearly define and prioritize the use cases that you are going to address with RTLS.
- Assess the current state for each use case to understand the scope and possible impact of fixing the problem.
- Establish key performance indicators (KPIs) for each use case to measure the impact of the solution.
- Address the root cause by applying LEAN Six Sigma techniques to streamline and error proof the workflow.
- Determine how RTLS and other tracking technology could further improve the workflow and design a “crawl-walk-run”approach to deploying the technology to match your organizations change management capabilities, budget and ROI requirements.
- Put controls in place to automate workflow compliance, i.e. use closed-loop system to make sure that folks are following the workflow.
- Create transparency into every step of the workflow to improve communication across all parties.
- Create high-level visibility into the workflow through dashboards and notifications to drive continual improvement.
It would be great if hospitals could solve complex operational issues by simply using technology to provide “visibility”, but that is not a reality. People and process are critical components that must be considered before making a significant investment in tracking technology. Otherwise, we are all better off taking the bus.
Want to see what it is like to direct air traffic with nothing more than dots on a map and alerts? Download Flight Control using one of the links below.
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