Use of a Real-Time Location System to Understand Resident Location in an Academic Medical Center

Background: There is great interest in understanding how residents spend their time in the hospital, but traditional time and motion studies are resource intensive and limited in scale. Objective: We determined whether a real-time location system (RTLS) that uses infrared emitting badges can be used to track resident time and location. Methods: Residents rotating on an internal medicine service in January 2018 were given the option to wear an RTLS badge. RTLS data were compared to the call schedule for each participating resident in a deidentified manner. Rules were created to identify work periods to be manually reviewed for data integrity. Reviewed work periods where there were extended periods of time without RTLS badge movement (eg, greater than 300 minutes) were excluded from analysis. Results: Data were collected from 18 residents and included 236 work periods (2922 hours). Based on prespecified rules, 146 work periods were included, representing 83% of total eligible residents (n = 15) and 82% of total hours recorded (2397 hours). Residents spent the highest percentage of their time in physician workrooms (44%, SD 15%), followed by ward hallways (25%, SD 7%) and patient rooms (17%, SD 7%). Several work periods were excluded because residents left their RTLS badge in physician workrooms after the work period ended. Conclusions: This study demonstrates the potential utility of RTLS to measure resident time and location in the hospital.