Improving OR Patient Flow – Florida Hospital – RTLS | STANLEY Healthcare


The patient flow solution is really a
technology that allows you to monitor the movement and activity around the
patient care processes, where ever you apply it. So we applied it for example
first here in a surgical unit and in the OR, so we were able to leverage the way
they designed it. This way one, we understand the movement of a patient through a process
but then the cool part in the back end of it is, that is real-time dashboards
that all of the key stakeholders and players in that care process can
monitor and be a part of so that they’ve got proactive downstream, upstream
movement and understanding around what’s going on with that patient. A patient
comes in, they’ve been scheduled for a surgery procedure. So they’ll often come
in usually pretty early in the morning, they will register at the department,
they will then be seated in within the waiting room which we have set up to be
able to identify where those particular patients are, so that whenever we get
ready to take them into the pre-op area to prep for their operation we know
exactly where they are so the physician you can go right out there to them.
When I first received the badge and they put it on your name immediately goes up
on the screen and you see that you have been logged in and that you’re waiting
to go into surgery. So it was comforting to know that they had a track of where I
was and then when they took me into surgery it changes at time. So
like a tracking of a GPS that automatically knows exactly where you
are which is comforting to the family so that when they’re waiting and they have
that time period they know exactly how long you’re in surgery and when you get
to the recovery room. So it gives them a sense of, okay the
surgery is supposed to last an hour, I can go down to the cafeteria and I can
go get a quick cup of soup or a cup of coffee and I can just come back
and still know that I’ll be able to see the board and that she’ll still be there.
It’s a feeling of relief for them going okay the surgery’s over, I haven’t talked
to the doctor yet but I know the doctor will be out soon to
talk to me about the surgery, so it was very comforting for that immediacy of
where the patient is at all times. Whenever the pre-op is ready and usually
we try to set up for pre-op about an hour before the procedure, someone would
come out and get the patient take them into pre-op and then they would prep
them for the procedure. Once the room is ready to receive them and the team has
been able to come in with the patient, they can meet with them in the pre procedure
dialogues and setups. Then the patient would be wheeled in the proper OR for
the procedure. RTLS is able to provide us with the data on a daily basis,
meaning, are the patients coming on time to the OR, how long is the turnover of the
operating room between the procedure. This is just the beginning of what we are
able to do with that information. When the button is pushed for closing we
have on average about 20 to 30 minutes prior to that patient coming out. So it
has increased the amount of time that we have to prepare ourselves and our nurses.
From there they would leave and then go to PACU which is the recovery
main recovery unit. If it’s a minor surgery they might go to what we call
PACU tube which is a secondary recovery unit for those that in a lot of
cases may be going home. When the patient is ready to go, they have a wristband and
we push the button and hold it for three seconds and thats when the patient
will appear to be ready. So then that signals the the nursing unit where the
patient’s going to, that the patient is ready to come to them. So what they’ll do
is, they can make they pre-assign the patient to a room and it to a nurse. So
that when I’m ready to call report I have the nurse and I have the room the
patient is to go to. Now on my end if something happens that their
blood pressure is low or we can’t control their pain enough, I can put in
and under a notes on the board and it gives them a note as to why the patient
isn’t coming. From PACU they are being stabilized by nurses until they’re in a
stable enough condition to then be moved to the unit in which they’re going, in a receiving standpoint. We were working from paper which has its own
challenges and so there were times when patients were in the PACU recovery for 3-4 hours. It just bottlenecks and now with the system
having that ability to really predict and see where they’re at in the surgery
and when they’ll be released we’re able to
strategically place those patients with certain nurses. Before having the system
to be able to view where the patients were the calls were tremendous. Everybody
knows every time you get a call you lose your focus and you lose your concentration.
They would ask, is the room ready yet, is the nurse ready yet, has the patient left
yet so that we can have that room, it was just call after call. So we also
have the ability to enter reasons to communicate back to the recovery room;
hey the room is not ready yet, the rooms not clean, MobileView has now eliminated
those nuisance calls basically. On a day-to-day basis I really feel
technology has benefited me in my position greatly. It wasn’t uncommon for
me to be interrupted by phone calls I’d say 20 to 30 times a day from the
recovery room for various needs prior to using MobileView. Since we’ve gone live
with it I’d say my calls from the recovery room have been cut down to two
to five per day and the biggest benefit as far as patient experience goes is
that, when I’m really trying to
listen to the patient my phone’s not ringing and the patient feels like I can
truly listen to them and not be interrupted. If there’s anything else
that the system is worth, it is worth having the ability to eliminate the
calls for that receiving unit that is trying to place all the patients, that’s been a beautiful thing. Probably 80% of the cases that we have
we can follow that patient all the way through from arriving at reception, all
the way through to them now being discharged and out the door. In fact, we
follow them all the way through it. Seeing the ability to open up the
communication between units that were before siloed and disconnected, has
allowed for time to be saved in the movement of patients,
creating an efficiency in the process that was lost before because there wasn’t
that open communication platform to provide the visibility into both worlds.

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