Gain Better Visibility to

Improve Clinical Workflow

Patty Jo Toor, Chief Nursing Officer

Ashley Simmons, Director, Performance Improvement

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Today’s Webinar

Understand the reasons for real-time staff workflow, and learn the keys to

successful implementation of an RTLS solution that will meaningfully impact

staff efficiency and satisfaction, care delivery and the patient experience:

• Building a team - who you need to have at the table?

• Critical steps for success with an RTLS staff flow solution

• Developing a positive, non-punitive culture using RTLS

• Defining and measuring success

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Florida Hospital Celebration Health

“RTLS…a Strategy”

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Who we are

• Part of the Adventist Health System

• Mission – “To extend the healing ministry of Christ”

• 1 of 7 Florida Hospital Campuses making up 1 license

in Central Florida with over 2400 beds, founded in

1908

• Market Leader in Central Florida

• Most Wired Award Recipient

• HIMSS Level 6

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Change is here

“We know we have to cut 20-40% of costs”

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Evolution of Healthcare

Quantity Vs. Quality

Era of Quantity Era of Quality

Advance planning emphasis Customer feedback emphasis

Mechanical Technology Programmable control

Economies of Scale Economies of speed

Hierarchical organizations Team-based organizations

Value from volume Value from performance

Technology islands Technology overlaps

Environmental exploitation Environmental concern

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Industry Pulse

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Poll Question #1

• What’s your main tool to drive improved workflow?

(check all that apply)

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Evolution of Data in Healthcare…

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…Big Data Analytics

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RTLS Data Provides the Context

It meets 2 critical needs:

1. Event DataAdding context to the patients pathway, trending and predictive

modeling, actionable data at the right time to the right person

2. Customer SatisfactionReal time access, information and flow – engagement in care process,

alerts for wait states, knowledge of their progress in their care

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Our Today

Temp and Asset Tracking…it’s a no brainer and critical to

efficient use of resources…but think beyond that!

Capacity and Throughput

• Patient Flow – OR to Unit

Staff Workflow

• Efficiency

• Standardization

• Productivity

• Unit Design

Patient Experience

• Rounding

• Bedside Report

• GWN Integration

Safety

• Hand Hygiene – Patient Contact based

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Patient Transitions

Takeaway: Built transparency between PACU and UNIT for

patient flow and communication

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Patient Flow

Patient Average Hour Spent in PACU

Takeaway: Leverage the data to improve and validate

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Staff Workflow

Takeaway: Real time access

to their data and flow

Takeaway: Improve the daily

flow thru assignments and

organization

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Staff Workflow

Before Workflow Coaching After Workflow Coaching

Takeaway: Reduce burn out!

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Analysis by Patient Type

78%91% 83%

109%

79%91%

78%

74%

79%80%

69%

74%75%

79%

0%

20%

40%

60%

80%

100%

120%

140%

160%

180%

200%

20-29 30-39 40-49 50-59 60-69 70-79 80-90

RO

UN

DIN

G %

Rounding % By Age Group By Gender

Female Male

4.6 4.1 4.73.7

4.4 4.04.6

4.54.5

4.7

5.14.9

4.84.8

0.0

1.0

2.0

3.0

4.0

5.0

6.0

7.0

8.0

9.0

10.0

20-29 30-39 40-49 50-59 60-69 70-79 80-90

AV

ER

AG

E M

INU

TE

S S

PE

NT

Average Minutes Spent By Age Group By Gender

Female Male

Takeaway: Dissect nurse rounding to proactively manage

workflow

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Analysis by Service Line

69% 82%105% 96%

80%

83%72%

78%

72%

0%

20%

40%

60%

80%

100%

120%

140%

160%

180%

200%

EAR,NOSEAND THROAT

GENERALSURGERY

GYNECOLOGYORTHOPEDICS UROLOGY

RO

UN

DIN

G %

Rounding % By Service By Gender

Female Male

3.7 3.95.6

4.5 4.4

5.0 4.8 4.4 5.0

0.0

1.0

2.0

3.0

4.0

5.0

6.0

7.0

8.0

9.0

10.0

EAR,NOSEAND THROAT

GENERALSURGERY

GYNECOLOGY ORTHOPEDICS UROLOGY

AV

ER

AG

E M

INU

TE

S S

PE

NT

Average Minutes Spent By Service By Gender

Female Male

Takeaway: Again, dissect nurse rounding to proactively manage

workflow

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5.5%5.6%4.8%4.7%4.9%4.9%3.6%3.8%4.9%5.0%4.5%4.8%

6.3%6.0%4.6%

3.1%3.9%3.0%2.1%2.0%2.8%3.4%3.2%2.7%

7AM

8AM

9AM

10AM

11AM

12PM

1PM

2PM

3PM

4PM

5PM

6PM

7PM

8PM

9PM

10PM

11PM

12AM

1AM

2AM

3AM

4AM

5AM

6AM

0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

14.0%

16.0%

18.0%

20.0%

Hourly Chart

Nu

rse M

inu

tes S

pen

t P

erc

en

tag

e

Nurse Minutes Percentage By Hour By Month

December

November

September

Bridging Cultures

0

200

400

600

800

1000

1200

1400

1600

1800

2000

Day Night

Min

ute

s

Patient Room BoxPlotMax

Min

Median75%

25%

Takeaway: Understand

the age old question…

“what’s the difference

between night and day

shift workflow?”

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Patient Experience

Rounding Compliance

0

1000

2000

3000

4000

10% 40% 70% 100% 130% 160% 190% 220%

Min

ute

s S

pe

nt

Rounding %

Day Shift – NurseRounding Compliance

Takeaway: Understand team variation and compliance

0

500

1000

1500

2000

2500

3000

3500

4000

4500

30% 50% 70% 90% 110% 130% 150%

Night Shift - Nurse Rounding Compliance

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Our Tomorrow

Value Based Purchasing & Pay for Performance

Capacity and Throughput

• Patient Flow – OR Expansion to all patients, ER to Unit Tracking,

Wait State Alerts, Obs Patient Tracking, Core Measure Patient

Alerting

• Capacity Management – Cerner Integration

Staff Workflow

• Integration of EMR and Bed Management Data (3 D!)

Safety

• Falls Prevention (Stryker Integration)

• OR Suite and Sterile Supply Temp/Humidity Monitoring

Patient Experience

• Continued GWN Integrations

• Waiting Room Real Time Flow Data

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Poll Question #2

• What is your biggest barrier to improving workflow?

(check all that apply)

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Key Stakeholders

• IT

• Sr. Leadership

• Nursing Leadership

• Finance

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IT Support Model

• Support model includes dedicated and shared staff

• Server team oversees the Windows Server

• Server maintenance, patches, and updates

• STANLEY Healthcare/AeroScout team oversees deployment and use

• Technical staff to help design and manage

• Tag provisioning, user activities, escalations, etc..

• Field staff to deliver and replace tags, batteries

• Analytical staff to help with reporting

• Domain experts should “own” many of these aspects

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Operations Support Model

• System Deployment of Learnings

• Base and Change measures for improvements

• Staff Workflow Analysis

• Patient Flow Analysis

• ROI

• Invested People, Time and Product

• Savings due to RTLS

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The Goal

Questions?

Patty Jo Toor, Chief Nursing Officer

Ashley Simmons, Director Performance Improvement

Joel Cook, Director Healthcare Solutions, STANLEY Healthcare