A Next Generation, Low Cost Tracking System for Healthcare Process Validation

Real-Time Location Systems (RTLS) identify and locate tagged assets, staff, or patients as they move through a hospital. RTLS can address a variety of other practical problems in healthcare such as inventory management and patient tracking and monitoring. Most RTLS employ some flavor of Radio Frequency (RF) angle-of-arrival, time-of-flight, time-difference-of-arrival, or Received Signal Strength Indicators (RSSI). However, these techniques have several significant disadvantages. Among these are confusion from multipath and environmental clutter, line-of-sight operation, need for synchronization, range restrictions, and expense. Furthermore the human body, composed mainly of salt water, occults high frequency signals making fading a serious problem. Wi-Fi tracking, in particular is, limited to an accuracy of 10-20ft and cannot provide the precision data required for high-fidelity applications in healthcare such as workflow management.

In the current study, the investigators will validate location system performance against manual observation of nursing activity. The investigators will correlate nursing activity metrics against patient outcomes as measured by SOFA score. The anticipated outcome is actionable, location-based data to describe, analyze, or validate healthcare processes with a maximum error of 5% relative to manual observation. Also, the investigators will identify specific location-based metrics useful in monitoring nursing activity. The investigators will deploy and test the system in a medical ICU at the University Hospital ICU. The anticipated outcome is a real-time statistical quality control chart capable of monitoring nursing processes and detecting anomalies with user-configurable statistical power.

Prospective participants will receive an individual email from co-investigator explaining study including the need for participants willing to wear location tag for the duration of their shift. The Informed Consent form and Demographic Question will be attached to this email. Those willing to participate will also be asked to send the completed Demographics Questionnaire attached to their email response. Receipt of the completed Demographics Questionnaire will signify their consent to participate.

The co-investigator will explain in the individual email that this study is to solely gain knowledge regarding their workflow as they deliver patient care and is not an evaluation of their performance or clinical judgment. Their participation in the study will not be revealed to their manager unless the participant wishes. The co-investigator will explain that participation is voluntary, they can withdraw at any time without risk to their employment and all aspects of their participation will be confidential.

A Waiver of documentation of consent form will be attached to the individual's email as well as the Demographic Questionnaire. The Waiver of Documentation of Consent form will provide an overview of the study. They will be informed both in the form and in the text of the email that the return of the completed Demographic Questionnaire signifies their consent to participate in the study and that participation is voluntary and confidential. They will be provided with the co-investigator's contact information should they have questions or concerns. In addition, information from the EMRs of patients assigned to the nurse participants will be abstracted retrospectively under the Waiver of Consent after the patients have been transferred from the ICU. Patient factors will be used to help interpret the nurse participant data. However, concurrent patient data abstraction is not necessary for data analysis in this research project as there will be no intervention introduced that would impact the patient data. Further, patients in this ICU are usually unable to provide informed consent due to the presence of mechanical ventilation and continuous sedation.