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When Florida Hospital's medical facility in the town of Celebration began building a new wing in 2010, administrators wanted better information on nursing workflows to help plan the floor layout, optimize workloads and ultimately improve operational efficiency and patient care. So they turned to a wireless location-tracking system that captures GPS coordinates transmitted by electronic badges worn by the nurses. The system gave the administrators a more detailed and real-time view of how nurses made their rounds through the wing's medical-surgical unit, including time spent with individual patients, than they could get through the manual observation and data collection methods used previously.
After its new wing opened the following year, the hospital's Celebration Health facility used the location data to better balance patient assignments among nurses on the same shift and streamline nurses' movements around the floor. The initiative went so well that Celebration Health expanded the deployment to its operating room and oncology and telemetry units in 2013. Now, Florida Hospital, a healthcare system with 22 medical campuses located primarily in central Florida, is in the early stages of pushing out the location-tracking technology to other facilities.
Monitoring the location of employees as well as analyzing the resultant data is still a niche application in a limited number of industries. And it can create thorny issues internally if organizations aren't transparent with employees about what they're doing and why. But location-based services are paying substantial business dividends for the likes of healthcare providers, trucking and package delivery companies, and organizations with mobile field-service staffs -- the types of businesses that can benefit from knowing where their workers are and can use location data to improve operations.
Distributing the workload
Ashley Simmons, director of innovation development at Florida Hospital, said the tracking system at Celebration Health provides up-to-date information on nursing processes on a scale the organization couldn't collect manually. Actionable data of that kind is generally scarce in healthcare, she added, even though there's a glut of information available in electronic health records systems, clinical applications and various other hospital medical systems.
Andy CainGIS analyst at Con-way Freight
"We have more data than we know what to do with, but it's retrospective," Simmons explained. "It's not giving our clinicians the ability to do something in real time." Location tracking, on the other hand, is a capability that the hospital's administrators "are finding can be our secret sauce" for process improvement, Simmons noted.
For example, tracking the location of nurses on an ongoing basis shows how the distribution of their patients on a floor affects the amount of time they spend in transit between rooms. That, in turn, can determine how much time the nurses are able to spend with each patient while making their rounds. Florida Hospital's tracking system, based on technology from vendor Stanley Healthcare, also generates heat maps visualizing the level of attention different types of patients receive from nurses.
Using the information from the system, hospital administrators can adjust staffing levels and nursing assignments as needed to distribute workloads more evenly and better meet care demands, Simmons said. Now, a nurse isn't overloaded with patients whose medical conditions require a greater amount of time and attention, such as people who have undergone head or neck surgery. In addition, Simmons said the location data gives hospital administrators and nursing supervisors more insight into the treatment needs of patients. That helps them work with nurses to ensure that all patients receive an appropriate amount of attention.
Nurses also can view their own location data. For example, they can access a "spaghetti" map with colored lines that show a visual compilation of their movements about the floor during a shift [see "Fewer Steps"]. The idea is to help them identify ways to reduce the number of separate trips to see patients, get supplies and carry out other tasks.
Overall, the new processes have helped the hospital attain two critical goals: improving compliance with a policy that all patients be visited by a nurse at least once every hour and reducing the amount of turnover among its nursing staff. Simmons said the Celebration Health units where the tracking system has been installed are now 90% compliant with the hourly rounding policy; they're also better equipped, she added, to implement a "purposeful rounding" strategy that emphasizes meaningful interactions between nurses and patients. Meanwhile, the so-called separation rate for registered nurses has been reduced to about 8.5% per year, according to Simmons, who wouldn't disclose the turnover rate or the hourly rounding compliance percentage before the system was deployed. Another benefit she cited is that nurses can be quickly located when emergency situations require additional resources.
Tracking in trucking
Tracking trucks and their drivers on the road is a common corporate application for LBS -- one that proved to be a good investment for Con-way Freight. An internal sales team noticed that the subsidiary of Con-way Inc., based in Ann Arbor, Mich., was losing money on deliveries to a corporate customer, even though its delivery trucks were going to eight warehouses on a regular basis.
Sensors attached to the trucks stream data back to the home office at regular intervals, according to Andy Cain, a senior geographic information system, or GIS, analyst at Con-way Freight. When Cain analyzed the data, he found that the travel time between warehouses and the amount of gas burned along the way were pushing Con-way's costs above the revenue it was receiving. Armed with that information, he said, the sales team negotiated more reasonable contract terms with the customer.
The data captured from Con-way's trucks includes GPS coordinates, the time trucks are at specific locations and information on how drivers operate their trucks. Analyzing all that data gives Con-way executives and business managers a detailed picture of how location issues can affect the company's delivery operations, which involve transporting partial truckloads of goods to multiple customers. "There's so much data being collected to make sure [the delivery process] runs smoothly that it's kind of mind-blowing," said Cain, who spoke at the 2015 TDWI Executive Summit in Las Vegas.
Craig MathiasAnalyst at Farpoint Group
In addition to sensors on the trucks, a variety of back-end technology is required to make the location-tracking and analytics system work. Con-way stores the data transmitted by the sensors in an IBM Netezza data-warehouse appliance. On top of that are business intelligence and reporting tools from MicroStrategy. And to map out the location data, Cain uses GIS software from Esri.
Collecting, processing and analyzing the data is a lot to manage, he said, but the system has enabled Con-way to become more data-driven in its decision making. In another example that Cain detailed, he and other analysts layered weather data on top of maps of delivery routes to help develop more accurate delivery-time estimates and determine if schedules were affected by weather conditions.
Updating info on the fly
Package-delivery company UPS is using an even more expansive location-tracking system to track driver locations and plot optimized routes and delivery sequences that can be updated on the fly. The system collects location data from GPS tracking equipment and sensors installed in delivery vehicles as well as from the handheld devices drivers use to record data about deliveries. The devices' homegrown software also records the amount, location and scheduled time of the day's remaining deliveries.
The data is processed through an analytics application called ORION -- or On-Road Integrated Optimization and Navigation -- to calculate and modify routes sent to drivers via their handhelds [see "Where to Now?"]. Atlanta-based UPS first deployed ORION in 2013 and is using the technology on about half of its 55,000 daily routes in North America, with plans for including nearly all those routes by the end of 2016.
Speaking at the 2014 Predictive Analytics World conference in Boston, Jack Levis, senior director of process management at UPS, said one of the biggest challenges to rolling out ORION was getting drivers on board with the new, more automated approach. To tackle that problem, UPS launched a broad change-management campaign. For example, Levis' team created "UPSTube," a collection of videos that shows drivers how to use the location-tracking tools and explains why the company's executives consider the new system a priority. UPS also instituted a scorecard system that monitors how closely drivers are following ORION's recommendations.
Levis said that after some initial resistance, drivers generally like the system. The main draw for them, he added, is that it eliminates the stress of having to manage delivery schedules themselves.
Transparency is essential
Still, Levis and others noted that employers need to tread carefully in monitoring the location of employees and analyzing their movements. Levis said UPS notifies its drivers' union before any changes are made to the company's location-tracking policies and procedures.
That kind of transparency is crucial to the success of employee tracking initiatives, said Craig Mathias, an industry analyst at Farpoint Group who specializes in wireless and mobile technologies. He advises businesses to involve their lawyers before implementing a location-tracking system. "Don't make the assumption that it's OK," Mathias said. "I've seen every kind of problem with this technology imaginable, and the technology itself is rarely the problem."
Transparency with workers has been a key element of Florida Hospital's location-tracking program, Simmons said. Managers at the Celebration Health facility were initially concerned that deployment of the system might increase turnover, she acknowledged. To avoid that possibility, they spent the time necessary to explain why the hospital was interested in monitoring nurses' locations and how it could be a benefit to them.
"The Big Brother concept arose," Simmons said. "So we had to be extremely open and honest about why we were doing this." Providing the nurses with access to their location data, she added, went a long way toward convincing staffers of the technology's benefits and easing their concerns about being tracked: "It gave them a voice that they didn't previously have, which became a huge win for them."
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