KEEPING TRACK: Administrative Assistant Mike Baig, administers a wristband to patients upon arrival, which allows them to move more freely through a system that keeps them connected to family.

It might not be immediately apparent that real estate and healthcare have a key element in common. At White Memorial Medical Center (WMMC) in Los Angeles, they've discovered the secret similarity to efficiency and customer service: location, location, location. With real-time, pinpointing precision of a patient's location and every minute spent during a hospital stay, WMMC is evolving patient tracking into a new science of satisfaction.

It doesn't matter who or where you are. Anyone who's visited a hospital in the last decade has had the same experience. From the patient's point of view, it tends to be a real-life version of the TV reality show, The Amazing Race. You're dropped in the middle of a strange location. Everyone seems to pass by your gurney or wheelchair like you're invisible or don't speak their language. As hours pass by, all you can think is, "When and how am I going to get out of here?" For nurses dealing with inter-department communication challenges and patient gridlock, the experience turns into a metaphor of the famous children's book, Where's Waldo? as they search for their patients and fight to move them upstream through the system.

"In our industry today, we don't really have good applications to monitor how long it takes to move a patient through the system," expressed Lynne Whaley, MS, RN, chief nurse executive and senior vice president. "Realizing this void in the industry, we began to look at the possibility of providing this kind of service to patients as well as staff. We were really looking for something automatic and that we didn't have to utilize extra time to enter data into. The ideal system would calculate all that automatically as the patient moved from one point to another."

That system became a reality recently when the California HealthCare Foundation approached WMMC about demonstrating various applications of management engineering within the hospital. This new collaboration presented the perfect time to institute a new, innovative program for patient flow management.

In January, a completely hands-free, real-time data processing system was put in place that moves the previous concept of patient tracking into an entirely new realm. This isn't simply radio frequency identification (RFID) applied to patients. Hospitals have been using RFID for years to track down missing equipment. The new system uses ultrasound technology for room-level tracking and ability to work around leaded walls in radiology.

IN THE LOOP: With the new tracking system, nurses like Eva I. Cristobal, BSN, RN (left), and Dana Martinez, RN, are saving more time and no longer having to hunt down patients. photos by Kyle Kielinski

Push vs. Pull

Currently in use in the GI lab and radiology, the only human intervention necessary in the system is when patients are administered a wristband upon arrival. From a live feed linked into the hospital's scheduling system and sensors placed throughout the departments' receiving stations, nurses and clinical technicians can locate any patient at any time along the service line. If a patient has been waiting too long or is held in a specific area, nurses, technicians, managers and transporters are alerted through specific color-coded flags at their command center and pager messages. By having a minute-by-minute, patient-by-patient, bird's-eye view of an entire department, WMMC nurses always know where their patients are, what's happening and what they can do right now to move the process along. Patient gridlock is quickly becoming a thing of the past.

"A nurse who happens to be waiting on a patient can tell immediately if that person is late, has not checked in, is in the process of registration or anywhere else along the service line," said Neeraj Bhavani, founder and CEO of Tagnos, manufacturer of the data processing system. "The nurse can now adjust accordingly by continuing to prep for that patient and/or adjust her workflow on a real-time basis. This eliminates waiting and keeps the process constantly moving. Most importantly, clinical staff can now locate every patient and act proactively to move them through the system. This changes the old dynamic of having to push patients through a line of obstacles to pulling them along a synchronized track."