If grocery stores, overnight couriers and car rental chains are using automated tracking systems to speed their businesses along, then why are we still relying on paper charts and whiteboards to oversee and coordinate our patient care? Keeping electronic tabs on your patients, personnel and inventory can immediately answer the questions you need answered countless times a day.

1. Where's your staff? Our electronic charting offers the additional benefit of letting us know exactly where our personnel are and what they're working on, and helping us manage the surgical throughput of the patients we're caring for. Our practice management software, which we deployed in each of our 8 surgery centers about a year ago, includes an electronic medical records system that serves us the double duty of tracking and charting. The main advantage of tracking your personnel and patients is to improve communications among clinical staff, but it can also enable workflow gains. If you've observed and measured OR times for different cases, it's possible to schedule your facility's cases more efficiently and allocate your facility's surgical support staff to handle more patients per hour or per day.

Our electronic charting is linked to our scheduling software, which names the surgeons, anesthesia providers and nurses who've been slated to work on particular patients' cases. Since the cases' participants have logged into the system in order to add information to the chart in real time, we know who's working in which OR by looking at who's logged in. Unlike a paper chart, a single document that perioperative staff must take turns compiling and reviewing, an electronic medical record can be added to and viewed simultaneously by multiple staffers.

The tracking system uses touchscreen technology for most charting. Touching a person's current case on the OR schedule brings up the chart, then the user can see whether the procedure's still going on or whether the patient has been moved to recovery (as evidenced by surgical staff members or a post-op nurse having logged in to the chart) to know who's on the case and who's available.

In addition, we can visually track the progress of the cases and the positions of personnel on video monitors installed in the employee break room. We have ceiling-mounted, wide-angle cameras in each OR. Those, as well as a feed from the microscope-mounted camera, are routed to individual monitors in the break room, where everyone gathers between cases.

2. Where are your patients? In a large, acute-care hospital, it may be highly useful to track the moment-to-moment whereabouts of patients during a multiple-day stay. Some inpatient hospitals use radiofrequency identification chips or bar codes on wristbands or clipped to patients along with automated scanning systems (the hardware, software, installation and support costs of which can run as much as $90,000 to $100,000) to monitor patients' locations.

While patients are limited in their locations in an ambulatory surgery center — once they've entered the process, they're either in pre-op, the OR, post-op or they've been discharged — it's still important to know where they are along the surgical circuit in order to direct their caseflow and allocate your staff.

An annunciator panel — a monitor screen like the arrival and departure boards you see in airports — can be installed in clinical areas to note where patients are, the staff member they're currently with and their next stop in the process. This tracking system can ensure patients get the attention they need and lets managers alter the case schedule if logjams block patient flow.

Tracking systems are also a potential value-added service for surgeons. Our physicians contract with our practice management software vendor to purchase a companion system for their offices that lets them not only book surgeries at our centers and transfer electronic patient records to our system, but also input and track the status of their patients through their offices' triage-like processes.

3. Where are your supplies? When an order of supplies is received, the staff member who stocks the storeroom shelves uses a gun- or wand-style scanner to input the supplies' receipt into our inventory and purchasing system. When items are retrieved from the storeroom, they're scanned again and automatically subtracted from the electronic inventory system's records. We set minimum and maximum levels for each type of supply, and when the amount of any particular item has been reduced to the minimum level, the system (which is linked directly to our accounting software and our business operations) automatically generates a purchase order to replenish the supply to the set maximum amount.

Tracking the purchase and use of your surgical supplies — for most facilities, the second-largest budgetary expense after staffing — can bring efficiency gains to your fiscal performance. If you've analyzed your case-costing data and know the quantities of supplies your surgeons use, an inventory tracking system can help you set and enforce par levels and, in turn, better control your supply budget. We've seen the direct effect of this in our facilities. When we implemented such a system in one of our busier facilities, we reduced the inventory we were carrying from $250,000 down to $100,000. Because the nurses who would normally have requested supply orders knew that frequently used items were on hand, and that the system would ensure that they would be on hand, they weren't worried about the supplies running out and weren't inclined to over-order them.

No regrets
Once you buy a system, it's unlikely you'll regret going high-tech. Tracking technology is one advance that can make a big difference in the speed and ease with which you run your facility. There's no right or wrong option when deciding on a patient, staff or inventory tracking system. The right choice might depend on your facility's tracking needs and how the installation meshes with your current infrastructure.

In the end, the key is to look at as many options as you can, taking your time reviewing and getting demonstrations of each one. If it's intended to play a part in a larger information technology system, compatibility with the other applications is essential. And be sure to inquire about the technical support the vendor offers to maintain the system once it's been installed and implemented.