Ensure Staff Safety in High-Risk Environments with RTLS

The safety of behavioral health patients and staff is of paramount concern. Potential risks of violence affecting staff and other patients in behavioral health care facilities burdens caregivers as well as patients and the prevalence of violence in the behavioral health workplace is well documented. According to an article from the Occupational Safety and Health Administration (OSHA), patients are the largest source of violence in healthcare settings but they are not the only source. Approximately 80% of serious violent incidents reported in healthcare settings were caused by interactions with patients. Other incidents were caused by visitors, coworkers, or other people:

  • 21 percent of registered nurses and nursing students reported being physically assaulted – and over 50 percent verbally abused – in a 12-month period (2014 American Nurses Association’s Health Risk Appraisal survey of 3,765 registered nurses and nursing students). (1)

  • 12 percent of emergency department nurses experienced physical violence – and 59 percent experienced verbal abuse – during a seven-day period (2009-2011 Emergency Nurses Association survey of 7,169 nurses). (2)

  • 13 percent of employees in Veterans Health Administration hospitals reported being assaulted in a year (2002 survey of 72,349 workers at 142 facilities). (3)

In addition to ensuring safety, caregivers experience tremendous pressure and feel significant responsibility to respond to patients in a timely manner at all times – especially if a patient is in immediate need or in distress. However, even when patients are not in distress, caregiver productivity is impacted significantly when workflow information is not available or verifiable. Caregiver time is often under intense scrutiny by facility administrators.

Indoor positioning  or Real Time Location System (RTLS) technology in behavioral health is beginning to have an impact on how patients’ needs are identified and how they are met by caregivers. Facility administrators are also discovering the advantages this technology can provide in terms of ease of communication, workflow efficiency and, importantly, overall safety. RTLS technology should be included in any comprehensive safety and health management system. It can help facilities enhance employee and patient safety, improve the quality of patient care, and promote constructive labor-management relations.

Sonitor’s Sense RTLS technology is a discreet, flexible solution designed to integrate with nurse call and other third-party solutions to help manage and automate many patient-caregiver interactions giving staff more time to focus on patients and their care needs. When integrated with nurse call solutions, activities such as nurse call cancellation and nurse assist are fully automated. This can deliver enormous productivity gains and provides full transparency to administrative staff allowing them to maximize efficiencies. Most impactful in terms of safety is that caregivers in high-risk behavioral health environments that have RTLS deployed have the ability, at the press of a button, to indicate distress discreetly and in real-time which triggers the right response when timeliness and location accuracy are critical.

Quantifiable metrics about the impact of RTLS usage in behavioral health are hard to come by but sometimes it’s the hard-to-measure human impact that is most important. One behavioral health facility administrator serving high-risk patients describes their experience using the technology this way: “Armed with the ability to push a button on a wearable badge is major when a staff member is in danger. Staff can immediately be located even if they can’t talk! We moved from a culture of resistance to adoption of this technology very quickly based on safety. It has been quite a change around here. Staff went from not knowing where their wearable tag was to refusing to work without it! Safety is everything.”



1 American Nurses Association. 2014. American Nurses Association Health Risk Appraisal (HRA):  Preliminary Findings October 2013-October 2014.

2 Emergency Nurses Association and Institute for Emergency Nursing Research. 2010. Emergency Department Violence Surveillance Study.

3 Hodgson, M.J., Reed, R., Craig, T., Murphy, F., Lehmann, L., Belton, L., and Warren, N. 2004. Violence in healthcare facilities: Lessons from the Veterans Health Administration. Journal of Occupational and Environmental Medicine. 46(11): 1158-1165.