This study is investigating the feasibility of using the Wake Forest Real-time Location System (RTLS) in monitoring patient movement during their in-hospital postoperative recovery. The study involves patients who have undergone surgery requiring inpatient admission. An inventory of RTLS tags used by inpatients will be collected and tag movement evaluated.  

Introduction and Background  

Early mobilization after surgery can decrease postoperative complications and length of stay. Recognizing these improved outcomes, current enhanced-recovery after surgery (ERAS) programs emphasize rapid mobilization during the postoperative period even on the day of surgery. Unfortunately, patients face numerous real and perceived barriers to early mobilization including postoperative pain; multiple intravenous catheters; drains; lines, and staff resource limitations. Monitoring compliance with early mobilization programs rely on patient self-report, progress notes, and nursing documentation, all of which are unreliable. Our team has used accelerometers (Fitbit Zip and Kenz Lifecorder) to monitor postoperative movement after major gastrointestinal oncology surgery (CCCWFU 02114). Preliminary data from this study, demonstrates little to no movement by patients during their hospitalization. However, this may be an artifact of current accelerometer devices rather than lack of movement by patients.  

In an era of the Internet of Things (IoT) and emerging technologies, we recognized a unique opportunity to use the existing real-time location system (RTLS) at Wake Forest Baptist Health to monitor patient movement during postoperative recovery. The Wake Forest Office of Enterprise Visibility developed at program for the implementation of processes, supporting technologies, driving Service Excellence, Patient Safety and Satisfaction, Operational Excellence and Efficiency, and the Transformation of Healthcare Delivery (SPOT). The SPOT program installed the current real-time location system throughout Wake Forest Baptist Health initially to track high valued hospital assets. RTLS is a complex system of various tags and badges, platforms (Wi-Fi, Infrared, Ultrasound, and others), hardware infrastructure (readers & exciters) and other components (servers, middleware & end-user software).The Wake Forest RTLS solution consists of specialized fixed location sensors receiving wireless signals from small ID badges or tags attached to equipment or persons. Tags transmit a unique identifier in real-time that enable tracking. The granularity of the RTLS program varies throughout the health system with room-level tracking capabilities in the wards of the Wake Forest Comprehensive Cancer Center.  

The RTLS program at Wake Forest Baptist Health was introduced for asset tracking and not developed for monitoring patient movement. Therefore, we're testing the reliability of this system, and it shows great potential for numerous quality improvement initiatives particularly focused on decreased postoperative complications and successful implementation of early recovery after surgery programs.  

CHI Patient Mobile Event Summary Example


The main objective of the proposed study is to investigate the feasibility of using the Wake Forest RTLS to monitor movement of hospitalized patients after surgery. Preliminary data from this prospective cohort study will help determine reliability, accuracy, sensitive and specificity of the RTLS system.  


Primary Aim 

  • To demonstrate the feasibility of using the Wake Forest RTLS to track patient movement during the postoperative period.  

Secondary Aims  

  • To evaluate the ability of using patient-attached hospital equipment (IV pumps) as surrogate tracking devices.  
  • To characterize daily movement of in-hospital post-surgery patients.  

Outcome Measures

Primary Outcome:  

  • Determine if the SPOT system can detect movement in and out of a patient’s room.  

Secondary Outcomes:  

  • Characterize patterns of patient movement after surgery.  
  • Characterize number of times of patient exits a room per day after surgery.  
  • Characterize distances traveled per time out of room per day after surgery.