Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
J Am Med Inform Assoc. 2021 Jun 12;28(6):1308-1317. doi: 10.1093/jamia/ocab026.
Modern health care requires patients, staff, and equipment to navigate complex environments to deliver quality care efficiently. Real-time locating systems (RTLS) are local tracking systems that identify the physical locations of personnel and equipment in real time. Applications and analytic strategies to utilize RTLS-produced data are still under development. The objectives of this systematic review were to describe and analyze the key features of RTLS applications and demonstrate their potential to improve care delivery.
We searched MEDLINE, SCOPUS, and IEEE following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Inclusion criteria were articles that utilize RTLS to evaluate or influence workflow in a healthcare setting. We summarized aspects of relevant articles, identified key themes in the challenges of applying RTLS to workflow improvement, and thematically reviewed the state of quantitative analytic methodologies.
We included 42 articles in the final qualitative synthesis. The most frequent study design was observational (n = 24), followed by descriptive (n = 12) and experimental (n = 6). The most common clinical environment for study was the emergency department (n = 12), followed by entire hospital (n = 7) and surgical ward (n = 6).
The focus of studies changed over time from early experience to optimization to evaluation of an established system. Common narrative themes highlighted lessons learned regarding evaluation, implementation, and information visibility. Few studies have developed quantitative techniques to effectively analyze RTLS data.
RTLS is a useful and effective adjunct methodology in process and quality improvement, workflow analysis, and patient safety. Future directions should focus on developing enhanced analysis to meaningfully interpret RTLS data.
现代医疗保健需要患者、员工和设备在复杂环境中导航,以高效提供优质护理。实时定位系统 (RTLS) 是一种实时识别人员和设备物理位置的本地跟踪系统。应用和分析策略仍在开发中,以利用 RTLS 生成的数据。本系统评价的目的是描述和分析 RTLS 应用的关键特征,并展示其改善护理提供的潜力。
我们按照 PRISMA(系统评价和荟萃分析的首选报告项目)指南搜索了 MEDLINE、SCOPUS 和 IEEE。纳入标准是利用 RTLS 评估或影响医疗保健环境中工作流程的文章。我们总结了相关文章的各个方面,确定了将 RTLS 应用于工作流程改进所面临挑战的关键主题,并对定量分析方法的现状进行了主题评论。
我们最终进行了定性综合分析,共纳入 42 篇文章。最常见的研究设计是观察性研究(n=24),其次是描述性研究(n=12)和实验性研究(n=6)。研究最常见的临床环境是急诊科(n=12),其次是整个医院(n=7)和外科病房(n=6)。
随着时间的推移,研究的重点从早期经验转变为优化,再转变为对既定系统的评估。常见的叙述主题强调了在评估、实施和信息可见性方面的经验教训。很少有研究开发出有效的定量技术来有效地分析 RTLS 数据。
RTLS 是流程和质量改进、工作流程分析和患者安全方面有用且有效的辅助方法。未来的方向应侧重于开发增强分析,以有意义地解释 RTLS 数据。