In a recent review of a Joint Commission Online Article titled, “Managing Corridor Clutter,” TeleTracking’s RTLS Workflow Services group identified several opportunities to address specific Joint Commission and CMS corridor clutter policies with a well-planned, creatively-utilized TeleTracking RTLS system.
According to the article, the requirement for keeping corridors clear and unobstructed originates from the National Fire Protection Association (NFPA) Life Safety Code®. Federal law requires compliance with the Life Safety Code, which mandates that new health care “aisles, corridors, and ramps required for exit access in a hospital or nursing home shall not be less than 8 feet in clear and unobstructed width” (see NFPA 101-2000, 184.108.40.206). Clear width is defined as the net unobstructed width of the door opening, without projections. This width is essential for building occupants to exit unimpeded in a fire emergency. If an existing hospital has 8-foot-wide corridors, the 8-foot width must be kept clear.
Here is a look at some of the items that the Joint Commission article pointed out as potential causes of corridor clutter, followed by TeleTracking’s suggested RTLS-based solutions to these problems.
Crash carts and isolation carts: The Joint Commission allows certain items, such as crash carts and isolation carts, to be stored in egress corridors (exit ways) as long as they are “in use.” Good medical practice dictates that a crash cart be ready for use at all times, so for purposes of the Life Safety Code, it can be considered to be always “in use.”
RTLS Solution: The issue with isolation carts is their disciplined removal once they are no longer necessary. RTLS can send alerts (via email, pager, phone) to inform the appropriate staff of any tagged item that has exceeded a customizable, predetermined “dwell time.” This can be used to verify whether a deployed cart is, in fact, still required or can be removed and readied for use elsewhere.
(An important side-note on crash carts: Though considered “in use” at all times, important drug expiration dates must be monitored (typically, manually) in order to ensure patient safety and policy compliance. Product maintenance-date fields in RTLS can help to automate the tracking of expiring drug drawers and produce reports that make locating and compliance much simpler).
An isolation or chemo cart may be in the corridor outside the room of a patient associated with the cart. The cart may remain if the patient leaves the room for any reason, such as for diagnostic testing. However, when the patient is discharged, the cart must be removed.
RTLS Solution: Information about pending discharges can be shared with the appropriate teams to target and plan asset retrieval activities throughout the day. In addition, explicit discharge notifications can also be triggers for retrieval activities.
30-minute rule: Per the article, any item that has not been used in the past 30 minutes is considered stored. The 30-minute limitation was defined by CMS in a May 2010 “Survey & Certification” memo. According to this 30-minute provision, patients on gurneys who are waiting to be admitted to the medical/surgical units are considered “stored” in the egress corridor after 30 minutes. Patient storage, sleeping, or treatment in corridors is prohibited.
RTLS Solution: Alerting can be established to address any equipment type and/or one or more zones in a hospital. For example: For a stretcher that is in a restricted corridor, an alert can be set up to notify based upon any specified time (immediately, 30 minutes, etc.); alerting the appropriate functional team to ensure the stretcher is removed from the restricted area. The automated alerting capabilities are highly customizable and can be specific to location, time, tagged item or any combination appropriate to the scenario. So, an alert can be created to notify that [Tagged Item A] has been in [location X] for [N amount of time].
Computers on wheels: Specifically mentioned in the Joint Commission article were mobile workstations. These devices can pose a common corridor clutter problem. In a typical day, there are definite periods of mobile workstation use. But there are also periods when the computer on wheels sits idle. During these idle periods, the workstation must be stored in an acceptable place – which is not the egress corridor.
RTLS Solution: The same alerting mechanisms noted above can help address computers on wheels; specifically, their “dwell time” in potential problem areas. Items exceeding predetermined amounts of time can be addressed with automation.
To close their article, the Joint Commission suggested three possible solutions to corridor clutter:
1. Educate staff on the importance of clear corridors to patient safety.
2. Maximize the use of spaces on floors where items can safely be stored (i.e. dead-end corridors)
3. Reduce the amount of unused equipment
A robust, well-executed TeleTracking RTLS system can help address all three of these suggestions; with a powerful, specific, automated impact on point three, the reduction of unused equipment. This is important, as it helps hospitals look at RTLS beyond its simple ability to locate, but also as solution to maximize patient safety, maximize asset utilization, minimize corridor clutter and assist in compliance and accreditation.
How do you eliminate corridor clutter? Do you use RTLS?
Rob Teachout and John Cutshall
TeleTracking Real-Time Locating System (RTLS) Workflow Consulting Group