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Q&A with Jim Engelstad

August 22, 2017DOTmed

Jim Engelstad, Process Improvement Coordinator at Sanford Health, describes the thinking behind incorporating RTLS as a key strategic technology in the newly opened Sanford Medical Center - Fargo.

Sanford Health is the largest, rural, not-for-profit health care system in the nation with 45 hospitals and 289 clinics in nine states and three countries with 28,000+ employees, including 1,300+ physicians, in more than 80 specialty areas of medicine. Here, Jim talks with HealthCare Business News about the what, where and why of RTLS at Sanford.

HCB News: What are some of your key objectives in building your new facilities? 

Jim Engelstad: My role is in continuous improvement. From my standpoint, we need to continue to look for technologies that make people's jobs easier and which make improvements across the board workable. We ask staff to do more with documentation and rules and regulations. The hospital of the future must be designed to lessen those burdens on the staff enabling them to keep a sharp focus on patient care. 

HCB News: What have you learned from the integration of RTLS in building new facilities in particular? 

JE: One of the benefits of RTLS in patient flow we have seen at our new Moorhead Clinic and other facilities is that this is a very visual medium. We can see where in a process an object is whether it is a piece of equipment or a patient. One of the big things we've seen is the ability for patients to "self-room" made possible because RTLS gives everyone from the staff at check in to the doctor back in the clinic instant visibility into room availability. Everyone knows the status. Patients can go directly to the exam room without staff intervention. This saves quite a bit of time for the staff in the short run and an enormous amount of time in the long run. The deployment of RTLS in patient flow has allowed Moorhead to see more patients in a shorter amount of time.  

HCB News: You have also referred to people in your supply chain group as benefitting from this visibility. How does RTLS impact their work? 

JE: For our supply chain group, knowing the exact quantities and locations of equipment makes the process of replenishing that equipment significantly easier increasing productivity and eliminating wasted steps. 

HCB News: Has RTLS had an impact on staff utilization and rightsizing capacity? 

JE: One of the big things about rightsizing staff is understanding cycle times. RTLS provides up-to-date cycle time capability. We can understand how much work there is for our staff members, daily schedules, patient appointment numbers and more. We can then translate that information into the proper amount of resources and take away the guessing game about the number of staff needed to properly serve patients. 

HCB News: What do you see in the future for RTLS in your various facilities? 

JE: For us the greatest promise of RTLS is the use of the data it generates. On the ambulatory side, we can derive a great deal of insight from RTLS. We can also get a lot of insight from what is going on with the use and deployment of assets. 

The amount of data that RTLS allows us to collect is substantial. Looking at patient satisfaction scores and finding correlations between how long they were in the clinics and how long they spent with their care team is incredibly valuable. On the inpatient side, we can look at length of stay versus frequency as well as amount of time that certain staff spend in impatient rooms. Impactful metrics derived from this type of data provides invaluable information for our facilities. 

HCB News: Do you have a vision for using RTLS data in analytics packages? 

JE: Right now, we are using this real time data for workflow and asset management. Looking forward, we have teams at Sanford who analyze a lot of data on the enterprise level. They are beginning to look at how to use RTLS data. As we think about badging patients and staff in the inpatient setting - right now we are just doing that in our outpatient clinic - we believe that we will be able to derive a great deal of information that we can utilize. We will probably start by understanding what we want to learn and then derive our answers from that data.  

HCB News: Can you provide any examples? 

JE: Yes. There was an effort by our Sioux Falls and Fargo supply chain teams to develop analytics by querying the RTLS data to create a PAR dashboard. They have also used the data to attempt to analyze usage rates in order to determine the best locations for equipment. We're still at the dawn of RTLS analytics but it is certainly a gold mine of information that we intend to access and utilize. 

HCB News: What's next for Sanford and RTLS? 

JE: We are moving toward hand hygiene to reduce infections. We plan to aggressively document that. We are also interested to use this technology so that patients will know who their caregivers are when they come into the room and for staff duress. We see many uses in the inpatient world. The sky is really the limit.