With violence against caregivers up 115% since 2021, ensuring the safety of healthcare workers is paramount. One important component of a thoughtfully designed safety infrastructure is real-time locating system (RTLS) technology, which tracks the location of individuals (and equipment) in real-time. This technology becomes especially crucial in emergencies like workplace violence events against caregivers, where immediate location information can be the difference between quick help and a delayed response.
The varying locating technologies on the market all serve a purpose but their different levels of precision affect their usefulness in staff duress situations.
Let’s explore the accuracy, impact, and cost of each technology.
1. GPS-Based Duress Systems
Global positioning system (GPS) technology uses a network of satellites to determine device location. A common GPS-based system is a duress app on a mobile phone, or a personal badge with a button that communicates to a staff member’s phone. The phone in turn communicates its GPS location to the duress system.
- Accuracy: Known for providing location in outdoor spaces, GPS can identify if a person is in the parking garage or within the walls of a hospital, for example. However, it falls short when pinpointing the specific floor and room the duress event is occurring in.
- Impact: While useful for outdoor alerting or for home care workers, within multi-story buildings or complex facilities, the lack of floor- and room-level detail can be a significant drawback. A rapid response hinges on knowing the exact floor, department or room of an emergency, so GPS will not meet the specific needs of indoor duress alerts.
- Cost: When used through GPS-capable devices the provider may already be carrying (like a cell/portable phone), it’s an inexpensive option.
2. Wi-Fi Signaling Technology
Wi-Fi signaling uses a facility’s existing wireless network to estimate the location of an RTLS badge that emits Wi-Fi signals.
- Wi-Fi Accuracy: Wi-Fi signals are located based on which access points are receiving the Wi-Fi signal, offering zone-level accuracy within 10-20 meters. This means the system may report an incident occurring in a different department or a floor above or below the actual event location.
- Wi-Fi Impact: For duress notifications, the location inaccuracy can be problematic. Although better than GPS for indoor settings, systems using Wi-Fi signaling may still leave room for error when floor-level or better information is needed for a quick and effective emergency response.
- Wi-Fi Cost: Although relatively inexpensive to implement due to using existing Wi-Fi networks, we often see health systems add supplemental locating technology to increase accuracy, which adds to overall costs. And because Wi-Fi signaling generally takes a fair amount of battery life, this also adds to the cost analysis. In general, Wi-Fi locating is comparatively mid-expensive due to all the variables in accuracy and badge battery usage.
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3. Bluetooth® Signaling Technology
Bluetooth Low Energy (BLE) locating technology operates either over Wi-Fi networks capable of receiving BLE, dedicated networks of Bluetooth sensors placed throughout the facility, or a combination of both, interacting with Bluetooth badges worn by staff. Similar to Wi-Fi signaling, locations are calculated depending on the density of the BLE sensors in the environment.
- Accuracy: Modern, standalone plug-in technology placed throughout the facility will typically provide near-room level accuracy within three meters. For BLE-capable Wi-Fi access points, typically one for every 2,000 square feet, accuracy ranges within five meters. Unlike Wi-Fi signaling, BLE is floor certain, making it beneficial for locating individuals who are in need of help.
- Impact: This near-room, floor-certain granularity enhances the effectiveness of emergency responders, reducing the time needed to locate and assist individuals in duress. While it is not room-certain precise technology, health systems often weigh the cost benefits of choosing BLE over more expensive room-certain technologies. And because BLE runs on low energy technology, badge battery life is also very favorable.
- Cost: Bluetooth is gaining ground in healthcare because of its open standards interoperability and cost-effectiveness compared to traditional room-certain accurate RTLS technology. It’s also quick and easy to install. When using a BLE-capable Wi-Fi network, you may run into extra licensing requirements from the access point vendor for IoT services. This can be expensive, often more than general Wi-Fi signaling. Be sure to weigh the costs and benefits of deploying a stand-alone BLE network versus utilizing existing infrastructure.
4. Infrared, Ultrasound, and Ultra-Wideband (UWB) Signaling Technologies
Infrared (IR), ultrasound and ultra-wideband (UWB) technologies represent some of the most precise locating technology available. Each one uses different methods, with different pros and cons, to achieve very precise, room-level or better location accuracy.
- Accuracy: These technologies are all particularly valuable where definitive location data is needed, for example when automating nurse call systems to accurately clear a patient call when the nurse enters the room, or documenting patient location in the EMR. Achieving room-certain or better precision, these locating technologies offer the highest degree of accuracy, down to three feet.
- Impact: If you need to know the exact location of an emergency, you’ll need a room-certain technology. However, this certainty does come with a cost trade-off.
- Cost: IR, ultrasound and UWB signaling require a locating device in each location or room, making it the most cost- and labor-intensive to install. Both wired and battery-powered systems are available. Wired devices have a higher installation cost compared to battery-powered devices, but frequent battery changes will incur expenses over time. Keep in mind that these technologies have been installed in hospitals for the past 20+ years, so your health system may already have existing infrastructure to leverage for staff duress. It may be part of your nurse call system or installed to track mobile equipment. Investigating what you have already could bring costs down substantially for a staff duress system while leveraging room-certain capabilities.
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Looking Ahead: Hybrid Technology Solutions
Choosing the right locating technology is a strategic decision that involves balancing accuracy, cost and existing infrastructure. While zone-level location is okay in some scenarios, like tracking equipment, more precise location data is the catalyst for staff safety. For this reason, GPS and Wi-Fi based signaling technologies are quickly coming out of favor.
While the most precise locating technology is highly desirable, cost is a consideration, which is allowing BLE technology to gain ground. For some health systems though, BLE may not meet all their RTLS needs. As a result, we’re seeing an opportunity to deploy hybrid locating technologies. For example, combining the room-level or better location precision of IR with BLE. Using staff badges that emit a combination of IR and BLE signals means you can deploy a precise locating network where highly accurate location information is needed, and then rely on a less expensive BLE-capable network elsewhere for near-room information. This innovative design accounts for flexibility, accuracy and results.
No matter the locating approach, RTLS is a substantial investment. Before you make the commitment to any locating technology, consider how your health system can leverage RTLS and scale the platform to other use cases like nurse call automation, asset tracking and patient flow. With plans in mind, and knowing the granularity needed for different initiatives, you can create future cost-saving measures.
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HT Snowday is director of research and development at Midmark, a manufacturer of medical, dental, and veterinary products and related services.
