Objective Measure wait times, characterise current information flow and define requirements for a technological information system that supports the patient’s journey.
Design First, patients were observed during eight random weekdays and the durations of actions performed at each phase of the surgical trajectory were measured. Patients were grouped into patients receiving general anaesthesia or local (or topical) anaesthesia. Second (active) Radio Frequency IDentification (RFID) technology was installed and patients were tracked during 52 weekdays. Length of hospital stay, length of stay and wait times per phase, and differences in wait times between the two types of administered anaesthesia were analysed. Third, interviews were conducted to characterise the current information flow between staff, and between staff and escorts (patients’ family/ friends escorting them throughout their journey).
Results Observations (198 patients) showed that the average duration of actions for general anaesthesia patients took longer than for local anaesthesia patients, especially at the recovery phase (general anaesthesia: 0h16, local anaesthesia: 0h01). RFID tracking (622 patients): Significant differences were seen for wait times between general and local anaesthesia patients at: preoperative ward (p=0.014), recovery (p<0.001) and postoperative ward (p<0.001). The average percentage of wait time during the entire hospital stay ranged from 64% to 68% (with variation in groups being substantial). Interviews (30 escorts, 9 ward nurses and 8 holding/recovery nurses): Escorts did not use the current information system and ward nurses indicated problems with exchanging information concerning bringing/picking up patients to/from the holding/recovery that resulted in unnecessary wait times for some patients (mainly local anaesthesia patients).
Conclusions Most time spent in hospital is wait time. A Patient Tracking System was designed to automatically display the phase in which a patient is in. It provides transparency for patients and staff in the surgical trajectory and is expected to reduce intermittent communication, improve patient flow, reduce wait times and improve patient and staff satisfaction.

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doi.org/10.1136/bmjinnov-2015-000038, hdl.handle.net/1765/94559
BMJ Innovations
Erasmus School of Health Policy & Management (ESHPM)

Wauben, L. S. G. L., Guédon, A. C. P., de Korne, D., & van den Dobbelsteen, J. (2015). Tracking surgical day care patients using RFID technology. BMJ Innovations, 1(2), 59–66. doi:10.1136/bmjinnov-2015-000038