Hey Reader,

In healthcare, the question, "Where are my assets?" is more complex than it seems because the answer depends on who's asking and why. Different stakeholders view this challenge differently, so technology needs to consider a complex set of requirements. Sadly RTLS implementations often end up using a "spray and pray" approach that results in an expensive and dense implementation of sensors that disappoint when it comes to ROI. A better approach uses "Lean Infrastructure" and adapted workflows to help everyone get what they need from Asset Management.

TLDR: Effective asset management in hospitals requires a strategic approach, starting with inventory management using RFID, followed by loss prevention, and then targeted use of RTLS for remaining issues.

Defining Key Concepts:

RFID: Radio-Frequency Identification, uses electromagnetic fields to identify and track non-powered tags on objects.

• Pros: small, inexpensive, unpowered tags
• Cons: shorter range sensors, limited location fidelity

RTLS: Real-Time Location System, uses minature battery powered transmitters attached to equipment that are sensed by fixed receivers.

• Pros: longer range sensors, enhanced location fidelity
• Cons: larger, expensive tags, requires batteries

The Details

The first thing to understand is there are interdependent processes for each of the stakeholders when it comes to the equipment. In theory, if each of the processes work perfectly you never lose equipment and there is always equipment where you need it.

In reality the process for inventory management are very weak with multiple touchpoints and interdependent processes that need tools to strengthen them. Can location help? The good news is, a well instituted design with location services can deliver significant ROI. But, each of the components of the flow has specific requirements for the design of the tracking. Done correctly this will result in less sensors and what I call "Lean Infrastructure".

Stakeholder Perspectives:

• Clinical Engineering (CE): CE needs to locate specific equipment for maintenance and recalls. They take the devices out of the main flow the result is a reduction in availability, so special attention should be given to them.
• Nurses: Require immediate access to equipment at point of use. If they need to use the RTLS to find something the process has failed.
• ​Central Sterile Processing or Central Equipment: Manages inventory, cleaning, and distribution. They are dependent on the nurses and CE to properly execute in their parts of the process.
• Patient Care Units: Track their "owned" equipment and struggle with managing it. Shared equipment is a risk for availability so trust is required to get active participation in the process of central equipment.
• Hospital Operations: Concerned with overall asset management and loss prevention. Someone should look at the trends in the data and "champion" the initiative.

The Three-Step Approach to Asset Management:

1) Manage the Inventory First:

• Use PAR (Periodic Automatic Replenishment) to drive the nominal cycle of stocking, using, cleaning and retrieving devices.
• Use "Lean Infrastructure" and install sensors only in the PAR locations (stocking and retrieval locations), cleaning areas, repair shops and central storage.
• Measure the flow of the devices and identify bottlenecks.
• Show where the bottlenecks are occurring to all stakeholder ("let the data be the bad guy").
• Encourage the high performing teams to build trust and demonstrate the improved availability.
• Capture the trends and respond accordingly.

2) Stop Losing Assets:

• Install sensors at exits and choke points (more Lean Infrastructure).
• Ensure that the system can create reliable alerts.
• Manage loss based on risk rating in addition to real time.
• Assign a department to "own" loss prevention.
• Capture the trends and respond accordingly.

3) Address Remaining Issues based on Trends:

• Add sensors for zone level coverage.
• Address remaining issues such as persistent hoarding.
• Implement targeted expansion of sensors where bottlenecks are found in the flow.
• Continue to "Blame the Data".

The Role of Technology:

Once the Asset Management workflows are settled for each of the steps the technology can be choosen. Sensors should selected in accordance with a location-based services strategy with asset management representing a portion of that strategy. That said we will list some of the capabilities of the IoT that impact asset management the most. Those capabilities will be matched against the requirements that are driven by the newly adapted workflows. In all cases the lean infrastructure approach will be used.

• RFID: Excels at counting and tracking a large numbers of items.
• RTLS: Excels at wide coverage for fewer critical assets.
• ​Hybrid approach: Combine RFID and RTLS for more comprehensive asset management.

Future Proof with Care Traffic Control:

• Use the digital twin to drive workflow automation.
• Focus on the transport flow rather than asset location.
• Understand device location history and usage patterns.
• Expand central equipment dispatch and merge with loss prevention.
• Expand sensors for ubiquity for devices and geography.
• Add the concept of "possession" from the 4Ps of location.

Key Takeaways:

• Asset management is about more than just locating equipment; it's about optimizing flow and utilization of assets.
• A strategic, phased approach allows a targeted, lean expansion of the infrastructure.
• Building trust through reliable inventory management is crucial for reducing hoarding and improving efficiency.
• Understanding different stakeholder needs is essential for implementing an effective asset management system.
• Care Traffic Control concepts can enhance traditional asset management by focusing on flow and patterns.

Conclusion:

Effective asset management in hospitals goes beyond answering "Where are my assets?" It requires a strategic approach that addresses inventory management, loss prevention, and targeted tracking. By understanding stakeholder needs and leveraging technologies like RFID and RTLS, hospitals can create a system that not only locates assets but optimizes their use, reduces loss, and ultimately improves patient care. The goal is to reach a point where equipment is always "right where it's supposed to be," creating a more efficient and effective healthcare environment.

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Until next week,

Paul E Zieske ​Location Based Services Consulting ​​​