RTLS for Operating Room Efficiency: Reducing Turnover Time, Tracking Surgical Assets, and Improving Patient Flow

The operating room is the most expensive real estate in any hospital. According to industry benchmarks, OR time costs between $30 and $100 per minute depending on the facility and procedure type. Every minute of unnecessary turnover, every delayed case start caused by missing equipment, and every inefficiency in perioperative patient flow translates directly to lost revenue and reduced surgical capacity.

Real-Time Locating System (RTLS) technology offers operating room directors and perioperative leaders a data-driven approach to reducing waste, improving throughput, and ensuring that the right equipment is in the right OR at the right time. This article explores how hospitals are using RTLS to transform surgical operations.

The Three OR Problems RTLS Solves

1. Surgical Equipment and Asset Visibility

Hospitals invest millions in surgical instruments, specialized scopes, positioning devices, sequential compression devices (SCDs), and mobile imaging equipment. Yet surgical teams routinely waste 15 to 30 minutes per case searching for equipment that has been borrowed by another department, left in a soiled utility room, or sent to sterile processing without being logged.

SecurTRAK AsseTRAK attaches small RFID tags to mobile surgical assets and locates them to within 7 feet in under 10 seconds. Instead of calling department after department, OR staff pull up a screen, find the asset, and retrieve it. The same system tracks assets through the decontamination and sterile processing cycle, so teams know whether a specific instrument tray is in cleaning, sterilization, or ready for use.

The operational impact is significant:

• Reduced first-case delays: When morning setup begins and a specific piece of equipment is missing, the team locates it instantly rather than delaying the case start.
• Fewer rental costs: Hospitals frequently rent equipment they already own but cannot find. RTLS asset visibility eliminates unnecessary rental expenses.
• Improved utilization rates: Data on equipment usage patterns reveals whether the hospital owns enough of a given asset or is over-purchasing due to perceived shortages caused by poor visibility.

2. OR Turnover Time Reduction

OR turnover, the time between when one patient leaves the room and the next patient’s incision, is a critical efficiency metric. National benchmarks target 25 to 35 minutes for routine cases, but many hospitals average 40 to 60 minutes due to coordination breakdowns.

RTLS addresses turnover inefficiency by providing real-time visibility into every step of the process:

• Patient readiness tracking: Tags on patients in pre-op holding allow OR schedulers to see which patients are checked in, consented, IV-started, and ready for transport. This eliminates the “where’s my next patient?” phone calls between the OR and pre-op.
• Environmental services coordination: When an OR is vacated, the system detects the patient has left and can automatically notify EVS that the room needs cleaning. Time-stamped entry and exit data measures actual EVS response and cleaning times.
• Anesthesia and surgeon paging: When the next patient arrives at the OR door, the system can automatically page the anesthesiologist and surgeon, reducing the dead time waiting for the team to assemble.

3. Perioperative Patient Flow Optimization

The surgical patient journey touches pre-admission testing, same-day surgery check-in, pre-op holding, the OR, PACU, and either inpatient admission or discharge. Bottlenecks at any stage ripple through the schedule. RTLS transforms this from a manual whiteboard-and-phone-call process into a data-driven workflow:

• Automated milestone tracking: As a patient’s tag moves from pre-op to OR to PACU, the system logs timestamps at each stage. Charge nurses and OR directors see a real-time dashboard showing where every surgical patient is in the perioperative process.
• PACU throughput management: When PACU beds fill up, cases back up in the OR because patients cannot be moved out. RTLS data shows PACU dwell times by patient and by recovery phase, helping charge nurses identify discharge-ready patients and prioritize bed assignments.
• Family communication: Some facilities use RTLS-driven status boards in surgical waiting areas that show anonymized patient progress (e.g., “In Surgery,” “In Recovery”) without requiring staff to make individual update calls.

Measuring the ROI of OR RTLS

The financial case for OR RTLS is straightforward because the costs of inefficiency are high and measurable:

A mid-sized hospital performing 8,000 surgical cases per year that reduces average turnover by even 5 minutes per case recovers over 650 hours of OR time annually. At $50/minute, that represents over $2 million in recovered capacity, enough to add hundreds of additional cases without building new ORs.

Why 433 MHz RF Matters in the Perioperative Environment

Operating rooms present unique RF challenges. ORs are typically constructed with lead-lined walls (for radiation shielding), thick concrete, and heavy metal doors. Equipment like C-arms, MRI machines, and electrocautery devices generate electromagnetic interference.

Higher-frequency technologies like BLE (2.4 GHz) and Wi-Fi struggle in this environment because short-wavelength signals are absorbed by dense construction materials. The 433 MHz frequency used by SecurTRAK has a longer wavelength that penetrates walls, floors, and equipment far more reliably. This means tags on assets inside ORs, sterile processing, and PACU are consistently visible to the system, not just when they happen to pass through a doorway equipped with a reader.

For perioperative operations, this continuous visibility is the difference between knowing where an asset is versus knowing where it was the last time it passed a reader.

Implementation Considerations for OR RTLS

Deploying RTLS in the perioperative environment requires thoughtful planning:

• Tag selection: Surgical assets need tags that withstand repeated cleaning and sterilization. Tags rated for autoclave exposure or designed with detachable mounting brackets are essential for instrument trays.
• Integration with surgical scheduling: RTLS data is most valuable when linked to the OR scheduling system, allowing the platform to show not just where a patient is, but which procedure they are scheduled for and which OR they are assigned to.
• Workflow design: The technology must fit the clinical workflow, not the other way around. Successful OR RTLS deployments involve perioperative nurses and OR directors in defining alert rules, dashboard layouts, and escalation paths.
• Sterile processing integration: Tracking instruments through decontamination, assembly, sterilization, and storage creates a complete chain of custody that supports both OR efficiency and regulatory compliance.

Frequently Asked Questions

Related Solutions from MGM Solutions

• Wander & Elopement Management
• Wireless Staff Duress
• Asset Tracking & Management
• Temperature Monitoring
• Infant Security
• Corrections Facility Solutions
• Why Not Wi-Fi, BLE, or 900 MHz for RTLS?
• How We Are Different