RTLS helps a Texas hospital save a lot of time – and money – on patient discharge

A common struggle for many hospitals is knowing exactly when a room is vacated, ready to be cleaned, and when it’s clean and available for the next waiting patient. If the discharge date of the previous patient is unclear, this means that the waiting patient may stay longer in the emergency room or in the post-surgical unit, for example.

Together, these types of delays lead to inefficiencies in overall patient flow and negatively affect healthcare system capacity, reducing usable capacity.


CHRISTUS Santa Rosa Hospital-Westover Hills, a 150-bed hospital serving the fastest growing area of ​​San Antonio, faced this problem. With specialist care including orthopedic and surgical services, intensive care, women’s services, newborn nursery, comprehensive cardiovascular care, emergency services and more, it was essential for the establishment of find ways to maximize capacity and use each bed efficiently to meet community needs.

CHRISTUS Health is one of the top Catholic health systems in the United States, with more than 600 centers, including long-term care facilities, community hospitals, walk-in clinics, and ministries of health.

What is piloted and successful at one site can then be shared across the system. Due to its size, CHRISTUS Santa Rosa Hospital in Westover Hills often serves as a testing site for new technologies and processes that ultimately benefit the system as a whole.


Real-time location system technology, or RTLS, integrated with a patient flow technology platform and supporting workflows, helps ensure that dirty bed notifications (when a patient is discharged) are accelerated. The process, in turn, speeds up bed turnaround time by environmental services staff. So San Antonio Hospital turned to TeleTracking, a provider of RTLS and other technologies.

A patient, for example, receives a wristband with an RTLS tag upon admission. When they reach the appropriate discharge milestones, the process continues with the discharge order entering the workflow.

“RTLS technology notifies staff of open beds approximately 2 hours and 40 minutes earlier than manual entry into the electronic health record.”

James Pharr, CHRISTUS Santa Rosa-Westover Hills Hospital

When the patient with the completed discharge order is near one of the designated hospital exits, the bracelet is removed and it is placed in a drop box which sends an automatic alert to environmental services informing them that the bed is ready to be cleaned and prepared for the next patient.

By focusing on when the patient physically leaves the patient room, rather than waiting for documentation to be completed, beds are available sooner and hospital management can improve admission rates and increase revenue from existing capacity, said James Pharr, hospital transportation manager at CHRISTUS Hospital Santa Rosa-Westover Hills.


There are many real-time location system technology vendors in the market today, such as CenTrak, GE Healthcare, Hewlett-Packard, Midmark RTLS, Mojix, Siemens, Skytron, Stanley Healthcare, TeleTracking, Vizzia Technologies, and Zebra ManufacturingSolutions.


In February 2019, the CHRISTUS team decided to implement RTLS technology to safely and efficiently accelerate patients ready for discharge, meeting the challenge of opening up additional capacity for the hospital.

RTLS equipment was installed at seven entrances/exits, and patients were given wristbands upon registration or when entering through the emergency department. The RTLS technology integrated seamlessly with the core patient flow solution they were already using of TeleTracking for visibility.

“The team members who were part of the implementation represented a range of departments,” Pharr explained. “Patient registration and emergency department registration have been trained on how to bracelet patients on admission. Patient transporters have been trained on how to remove wristbands on discharge and place them in a designated drop box. Nurses on each of the units have been trained in the use of whiteboards to monitor patient comings and goings and prioritize them for discharge.

The combined result gives the patient placement the ability to immediately see when a patient is unloaded so they can then assign the next patient.

“RTLS technology notifies staff of open beds approximately 2 hours and 40 minutes earlier than manual entry into the electronic health record and helps avoid what is often referred to as discharge clustering,” Pharr said. “Batch processing is a situation where staff wait until the end of the shift to enter a batch of patients into the electronic health record who have been discharged earlier, so that new patients entering the unit will be managed by the incoming shift.”

This type of technology and workflow prevents that from happening and literally “pulls” the next patient waiting in the ER on the floor with the next bed open – reducing what is known as “lost bedtime “, he added. The main thing is that sick patients get a bed and can start treatment earlier.


From February 2019 to February 2020, patient-wristband marking, compliance and durability remained at over 90% – with over 4,000 patients exiting this process in those 12 months.

“With insight into the 2,339 hours it took to prep and remove the next patient by not bunching and wasting approximately two hours and 40 minutes, caregivers regained bedside time,” Pharr reported. “Additionally, the increased capacity resulted in an increased return on investment, based on gains of 117 beds, with an average daily patient contribution margin of $3,000, resulting in a revenue gain of $351,000. $ in one year – a significant increase for a 150-bed community hospital,” Pharr said.


“Discharge efficiency is an important component of strong overall health system operations, and a best practice that focuses on when the patient physically leaves the patient room, rather than waiting for documentation to be completed. “, advised Pharr.

“Automated workflows driven by RTLS maximize patient throughput, free up staff time and increase revenue. And like any major change, staff engagement is important – it needs to be part of the culture, with everyone understanding and respecting the process across all units. »

It’s also important for environmental services and patient transport departments to understand how their workflows will be impacted – and improved – by knowing where patients have been, when they’re going to be discharged, and by speeding up the process of turning rooms around. next patient, he concluded.

Twitter: @SiwickiHealthIT
Email the author: [email protected]
Healthcare IT News is a HIMSS Media publication.

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