Patients used to wait as long as 2 hours to see a physician at the Nor-Lea Medical Clinic. Workflow problems and the size of the clinic were leading to long waits and unhappy sufferers. Although, the utilization of real-time location system technology, termed as RTLS, led to important insights into the practice and ways to make better performance at the Lovington, NM, clinic. Now, wait times have almost been eliminated at the practice, which has 5 nurses and twenty physicians.
Agencies adopting real-time location system technology require being very clear and upfront with staff when declaring the decision to execute the technology, not just about what it does, but also about how it will be utilized, said chief operating officer Dan Hamilton during an educational session at HIMSS17. At Nor-Lea, providers and employers considered the system would be tracking them. That was precise, but with a couple caveats.
Two maintenance individuals and an information technology staffer installed the RTLS system. Others inquired what they were doing and told they were installing cameras to watch what people do. Even though they were making a joke, and just wireless sensors were being installed, the damage was done, and stress levels were high.
One of the core benefits of real-time location system technology is to enable clinicians and staff to quickly be capable to locate each other. To ease fears of Big Brother watching over everyone, Hamilton made an agreement with providers and staff. If the RTLS system tracked someone doing something wrong, there would be no punishment—but coworkers were free to call out others for poor behavior.
Gathering data on how the practice operates, how the staff do their jobs, and how staff and sufferers move around the facility was critical to Nor-Lea at the time because patient wait times to see physicians could be as long as 2 hours. One key reason for such delays in care was because the clinic was poorly designed with long hallways and waiting rooms that were situated far from exam rooms. The aim was to get average wait times down to ten minutes, Hamilton elaborated.
Data from the real-time location system technology discovered that nurses were doing administrative tasks more than real nursing—they were coordinating care for doctors, ordering medications, scheduling same-day appointments, printing lab and X-ray results and scanning them into the electronic health record (EHR), conducting prior authorizations, and spending lots of time on the phones. Nurses also were being pulled aside to administer immunizations and injections.
Hamilton identified the practice was paying nurses $28 an hour for doing more administrative than nursing work, when the practice could pay $12 an hour for medical assistants, and that is what they did.
Another improvement brought by analysis of findings from RTLS technology was to enable staff to interact with each other via TV monitors situated in strategic sites in the practice. Nurses used to write data on the status of patient care on small adhesive notes taped on the doors of exam room. Now, monitors demonstrate physicians a color-coded status of patients, like when they are in the room waiting and how long they have been waiting so the doctors know which room they should go in first, and that assists decrease patient wait times.
Doctors also have a button on a badge to push and inform a nurse that they are ready for a sufferer, and then they push the button again when they are finished with the visit, so the nurse can come in and complete the encounter. “Physicians are glad because they no longer are chasing their staff,” Hamilton stated.
Nor-Lea also is utilizing RTLS to look at room utilization and room turnover, along with gathering and analyzing patient flow.
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