Implementation considerations

This section highlights the considerations that should be made before undertaking the implementation of a Real Time Location Services (RTLS) solution.

When an NHS organisation is evaluating the introduction of an RTLS solution of any type, with the exception of passive Radio Frequency Identification (RFID) there are several challenges to address even before implementation starts. The primary one being the setting of goals for the RTLS application:

• which users will benefit. Staff? Patients? Management?
• in what ways will their user experience improve
• what are the things you do not want the application to address
• have point RTLS applications been in use at the trust in the past? At present? What is their remit?
• what non-IT stakeholders should there be
• what network enhancements are required? Additional access points? Power over ethernet considerations? Cabling?

Critical to the implementation of a successful RTLS solution should be the suitability of the current Wi-Fi infrastructure. Wi-Fi infrastructure tends to be refreshed in 3–7-year cycles and the position within that cycle will determine the investment size and budget requirements of the RTLS solution. If the current Wi-Fi solution lacks certain technologies, generally because of access point functionality (for example Bluetooth BLE 5) then there will be a natural reduction in the choices and capabilities of the RTLS solution.

Comparison of the refresh cycle to the current suitability of the operational Wi-Fi solution will illustrate the major decision on budget creation and project commencement, namely, should the RTLS solution wait for the next refresh cycle, is it able to be deployed on the current solution or will it require an independent enhancement of the current solution. Budget constraints may also 'force the hand' on this.

Beyond the technological suitability of the current wireless solution, if an increased number of access points are required, to provide coverage for asset tracking mainly, this will require not only budget for the items but also:

• site survey services
• network switching capacity
• power over ethernet
• cabling

If site surveys had been completed prior to the current installation, then they can be used to guide the suitability of the network for the RTLS applications required.

Even though an RTLS solution is an IT based solution, it combines application with infrastructure. As such, decisions on its scope, reach and content will require wider input to ensure it adequately covers its full usefulness to the trust. Departments to be consulted will differ depending on where RTLS capabilities will be deployed, who and what it will track and other local considerations, but would generally include those responsible for:

• clinical – particularly nurse practitioners
• medical equipment management – for asset management and device calibration
• user (staff and patient) experience – for wayfinding
• environmental  and estates
• bed management

RTLS solutions can become quite involved and use a lot of human resources in training, implementation, maintenance and programming. It is important that the initial scope of the solution is both achievable and achieves goals that will enhance the service provision of the trust. So it is necessary to baseline what the solution will provide and what it won’t. As can be seen elsewhere in this report each RTLS application can be taken on its own merits and many applications may be relevant. For each application added to the project, the complications, dependencies and involvements will increase the difficulty of the implementation.

Because of the different applications possible with RTLS, trusts can look at phasing any implementations by prioritising their requirements. This way infrastructure can be built up over time, for example access point density, so that RTLS capabilities can be added.

Planning in this manner may allow for a long-term approach to the area of RTLS. For example, if asset management is primary but the current Wi-Fi solution is inadequate then looking at passive RFID immediately but then looking to implement mobile asset management when a Wi-Fi refresh cycle is due.

Looking further ahead a wayfinding capability could be introduced as a later implementation phase reducing the complexity of the installation, at the cost of delayed implementation of some lower priority capabilities.  

It is important when using a phased approach to RTLS implementation to future proof the infrastructure as you go and make sure that the RTLS solutions adopted over time are complementary and able to use the phased infrastructure changes as they arrive.

Some trusts may have already invested in point RTLS solutions, these are most likely to be RFID or ad hoc workflow applications. There is no need to replace these with an overall solution and integration services can be used to make the information from these solutions remain useful and allow them to be presented together with the new capabilities. However, the addition of a comprehensive RTLS solution which could provide the same service may have admin advantages if the existing point solutions are dispensed with.

RTLS applications can supply many applications, as outlined in this report. Establishing the core requirements and ruling out what is not required is important to prevent the implementation becoming unwieldy and needing a large amount of training.