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Real-time location systems (RTLS) can help hospitals find tagged equipment and, where appropriate, monitor the location of people or environmental conditions. Their clearest safety contribution is operational: teams can locate equipment, manage its availability, and organize maintenance more effectively. NHS England reported that a 2023/24 trial at Mid Cheshire reduced clinical incidents related to tracked equipment by 75% and saved frontline staff up to 30 minutes a day searching for devices. Those are results from one local case—not a measure of how much safer hospitals become worldwide.
What RTLS does in a hospital
RTLS combines tags attached to assets or worn by people with a receiving infrastructure and software that estimates location. Depending on the design, the system may also show equipment details, maintenance status, or alerts. It gives staff a shared view of where tagged items are, rather than relying only on memory, phone calls, or manual searches.
There is no single universal RTLS architecture. At Mid Cheshire, RFID and Bluetooth Low Energy tags communicated through hospital Wi-Fi; Cisco DNA Spaces and an AeroScout engine were used to estimate location. Staff could view location and device or maintenance information in a portal. That configuration is one implementation, not a requirement for every hospital.
What the Mid Cheshire case shows
NHS England Digital’s case study, last edited 22 May 2025, describes a trial at Leighton Hospital, a 540-bed site within a trust providing acute care to around 300,000 people and employing more than 5,000 staff. Those figures describe the setting, not the system’s effectiveness.
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Equipment availability and search time
NHS England reported a 75% decrease in clinical incidents related to tracked equipment during the 2023/24 trial. It also reported that frontline staff saved up to 30 minutes per day locating equipment. The case describes an earlier pilot involving 400 infusion pumps and an initial rollout of 200 tags; at a later stage described in the case, 450 tags/devices were active. These counts refer to different stages and should not be treated as one simultaneous deployment total.
The practical mechanism is straightforward: if staff can see where a device is, they may spend less time searching and be less inclined to hoard equipment near their ward. Jackie Cox, the trust’s Chief Nursing Information Officer, said the loan store was “rarely not stocked” after rollout and that biomedical engineering staff were alerted when replenishment was needed. This is the trust’s account of its experience, not a controlled comparison establishing that every RTLS deployment will have the same result.
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Maintenance and device readiness
RTLS can support maintenance as well as retrieval. At the point described in the case study, no tracked device had missed planned preventative maintenance. The system let staff order tagged devices by maintenance date so the team could prioritize equipment nearing its maintenance window. That can help teams find devices that need servicing and reduce the risk of overlooking them; it does not by itself prove that a device is safe or properly maintained.
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What the wider evidence can—and cannot—establish
A 2021 systematic review included 42 articles on RTLS in healthcare. The authors classified 24 studies as observational, 12 as descriptive, and 6 as experimental. The settings included emergency departments in 12 studies, entire hospitals in 7, and surgical wards in 6. The review concluded that RTLS can be a useful adjunct for process and quality improvement, workflow analysis, and patient safety.
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The study mix matters. Observational and descriptive work can reveal where systems are used and how workflows change, but it does not necessarily show that RTLS caused a safety improvement. The review also noted that relatively few studies used quantitative techniques to analyze RTLS data effectively. The literature therefore supports potential and practical uses more strongly than a single, generalizable estimate of clinical benefit.
An older, three-year qualitative study examined 23 U.S. hospitals through 80 semi-structured interviews. In those studied contexts, asset tracking emerged as the best use, and the authors emphasized whole-hospital deployment and centralized control. This is historical implementation evidence from that period, not a current ranking of hospital technology or proof that one approach fits every institution.
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Where hospitals may use RTLS for safety
Finding and managing equipment
Locating pumps and other tagged devices can support availability, return, cleaning, and maintenance routines. This is the best-supported use in the Mid Cheshire case, where the reported outcomes concern tracked equipment.
Patient and staff safety applications
HID describes product applications including infant security, vulnerable-patient wander management, and staff duress alerts. These are vendor-described capabilities; the product information does not independently establish that they reduce injuries or improve clinical outcomes. Any hospital considering such a use needs to assess the specific workflow, coverage, alert handling, and governance requirements.
Workflow and environmental visibility
Vendor materials also describe hand-hygiene monitoring, wayfinding, and environmental monitoring. These can make processes or conditions more visible, but visibility is not the same as compliance or a better outcome. Results depend on how reliable the data are and whether staff can act on alerts and information in time.
Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.What a hospital should plan before deployment
RTLS is an operational system, not simply a set of tags. NHS England’s Mid Cheshire case highlights several practical conditions that affect whether location information is useful:
- Current maps and zones: Floor plans and named areas must reflect the actual building so that displayed locations make sense to staff.
- Wireless coverage: Survey coverage before rollout; gaps can undermine location estimates and alerts.
- Usable staff routines: The process for finding, returning, cleaning, or servicing a device should be easy to follow. Engage frontline teams so the system fits how care is delivered.
- Integration and action: Decide how location, asset records, maintenance dates, and alerts will reach the people responsible for acting on them.
- Ongoing support and scale: Plan for system maintenance, tag management, and expansion rather than treating installation as the end of the work.
- Information governance: Tracking people raises different privacy and governance issues from tracking equipment. Mid Cheshire initially avoided person tracking because the information-governance requirements were complex.
How to assess an RTLS proposal
Hospitals should start with a defined safety or workflow problem, then assess whether a proposed system can address it in that setting. Useful questions include:
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- Is the target use case asset tracking, people tracking, or environmental monitoring?
- What location granularity and coverage are needed for the intended task?
- Are tags compatible with the existing infrastructure, and what network or map changes are required?
- How will data connect to clinical or asset-management systems, and who is responsible for alerts and maintenance actions?
- Can staff use the system without adding unworkable steps to care routines?
- What privacy, access, retention, and information-governance controls apply, particularly if people are tracked?
- How will the hospital measure outcomes against a baseline, and distinguish system effects from other operational changes?
The available evidence does not establish a representative global effect size or provide a neutral current vendor comparison. A hospital should therefore evaluate a deployment against its own use case and baseline rather than assume that a published local percentage will transfer to its site.
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