Automatic tracking helps staff and management in the emergency department
(ED) make better, more informed decisions when managing patient care and
department resources. It does so by giving caregivers accurate, real-time
information that is collected without doctors and nurses making computer
entries.
Specifically, PCTS’s automatic
tracking systems provide up-to-the-second information about the
- physical location of patients, charts, equipment, and (if desired)
staff;
- current status and overall progression of visits;
- utilization and status of rooms;
- caregivers responsible for individual visits; &
- bottlenecks that may be affecting patient flow through the department.
This information (and more) is immediately accessible with just a click
or two of the mouse.
Automatic Tracking
When installing standard tracking systems in an ED, the problem that most
frequently arises is who is going to enter information. The fast-paced,
high-volume EDs do not have sufficient personnel to make manual entries.
That problem is what brought about automatic tracking.
Manual versus Automatic Tracking Systems
Most emergency department computer tracking systems on the market are manual systems:
somebody has to (or multiple somebodies have to) enter every single piece
of data the system displays. Some data (e.g., patient demographics or
lab/imaging results) can flow in from other computer systems via interfaces,
but the vast majority of information used to track patients and department
resources is manually entered by a person sitting in front of a computer
screen. Ironically, a system that’s supposed to simplify the emergency
department’s operations and improve patient flow actually ends up
doing the opposite because people have to constantly stop caring for patients
to enter data. Also, to compound the problem, when the department is busy,
people stop making entries to the system and the data becomes useless.
Yet it is when the department is busy that the data is most needed.
Automatic Locating in a Nutshell
All ED patients and staff wear small badges, which emit
a signal roughly every
three seconds. The badge signal uniquely identifies the badge. The
signals that badges emit are received by sensors located
in the ceilings throughout the emergency department and ancillary areas
(CT, radiology, ultrasound, nuclear medicine, etc.) that patients frequently
visit. These sensors collect the signals from the badges, translate
it into electrical impulses, and forward those impulses to hardware devices
that filter the signals to find the signatures they contain.
These devices — known as collectors and concentrators — then
convert the infrared signatures into badge location data that software
can understand. Through Amelior, users associate badge numbers with individual
patients, staff, or equipment. Likewise, the system links individual sensors
to specific locations. For example, during a particular shift, badge 12345
might be associated with John Doe. Similarly, sensor ABC is associated
with ED exam room 14. Thus, if sensor ABC receives a signal from badge
12345, Amelior can check the associations and determine that John Doe
entered exam room 14.
As a result, ED personnel can use the system’s locating capabilities
to find the current location of patients, charts, equipment, and even
staff (if desired).
Although valuable, simple locating is just the most basic application
of the locating technology. By applying business rules to location, movement,
and interaction data, we can track the progression of visits and determine
both what has been done and what still needs to be done. For example,
- When a patient’s badge is first tracked at any sensor back
in the main department (i.e., not in the waiting room), we can assume
that the patient has entered the ED—one of the primary “milestones”
in the visit.
- If a patient’s badge is tracked at a sensor representing a treatment
room and the system shows that room as available, we can automatically
assign the patient to the room.
- If a patient badge and a nurse badge show up together at a sensor
representing the patient’s assigned room, we can mark the “Nurse
at Bed” milestone. (Essentially, the same logic applies to doctor
assignment and registration as well.)
- If a patient badge is tracked at a sensor representing a CT room,
we can indicate that a CT is in progress. When the patient is tracked
in the department again, we can indicate that the CT is complete.
- If a badge attached to a portable X-ray or EKG machine shows up at
a sensor representing a treatment room while a patient is also there,
we can indicate that a portable X-ray or EKG is in progress. When the
machine leaves the room, we can show it as complete.
These are just a few (somewhat simplified) sample rules for translating
location, movement, and interaction data into useful information about
the visit. We also keep a log of all interactions between patients and
staff member. As a result, department managers can accurately measure
time spent with patients, identify potential bottlenecks, and assess how efficiently patients flow through
the department. In addition, if a patient complains that nobody checked
on him even though he pressed the nurse call button for more than an
hour, with the infrared interaction log, it’s easy to counter
such claims.
Put simply, with the locating technology—which can keep an eye
on everyone in the whole department at once—we can gather the kind
of comprehensive data people are hard-pressed to keep track of themselves.
But more importantly, we can do so with very little human-computer interaction.
In the end, caregivers get the information they need, but they don’t
have to interrupt care for annoying data entry.
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