A retrospective study of smart spot, a Bluetooth low‑energy real‑time location system supporting quality improvement efforts in Uganda
5 affiliations
- 1Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada
- 2Institute for Global Health, BC Children’s Hospital and BC Women’s Hospital + Health Centre, Vancouver, British Columbia, Canada
- 3Uganda Martyrs’ Ibanda Hospital, Ibanda, Uganda
- 4World Alliance for Lung and Intensive Care Medicine in Uganda, Kampala, Uganda
- 5Uganda Catholic Medical Bureau, Kampala, Uganda
Abstract
Real-time location systems track assets and individuals, and in high-income clinical settings, they have improved patient flow. However, their use in low- and middle-income countries remains limited. Smart Spot, a low-cost Bluetooth low-energy real-time location system was integrated within the Smart Triage quality improvement platform in the outpatient department of Uganda Martyrs’ Hospital Ibanda. The primary objective was to evaluate whether Smart Spot data could be used to detect differences in time spent across clinical locations associated with Smart Triage implementation. The secondary objective was to assess the accuracy of Smart Spot data. At triage, children (or their caregivers) received a beacon attached to a lanyard. The beacons tracked patients’ locations throughout their time in the outpatient department. Smart Spot data were collected during a 4‑month baseline phase (pre-Smart Triage) and a 12‑month Smart Triage intervention phase. An algorithm was developed to reduce noise and generate more accurate records of each patient’s journey. The resulting pathways were compared to expected paths to evaluate Smart Spot’s accuracy. The median durations of patient time spent in specific areas were compared between phases using quantile regression. Data cleaning improved the matching to the expected patient flow from 13.0% to 73.1%. Compared with baseline, the median time patients spent in the assessment area decreased by 51.7% (-81.9 min; CI: -95.1 to -68.8), in the emergency room by 69.1% (-44.3 min; CI: -67.7 to -20.8), and total visit duration by 58.2% (-122.9 min; CI: -138.4 to -107.3), all with p-value < 0.001. Real-time location data supported the demonstration of the Smart Triage platform’s benefits. In the cleaned dataset, the intervention phase had shorter total visit time and time reductions within specific areas. Our evaluation demonstrates Smart Spot’s feasibility as an effective data-collection platform for quality improvement and its utility for retrospective analyses in low-resource settings. Author summary: Healthcare infrastructure in low- and middle-income countries often falls behind that of high-income countries. Significant resource constraints in these settings contribute to this difference, ultimately resulting in patients lacking the optimal care they need. Additionally, without digital health infrastructure tools, low-resource healthcare settings do not have the resources to record any data to track their progress on quality improvement goals. To address this issue, we developed Smart Triage, a triage platform for children in the outpatient department of hospitals in Uganda. The platform provides data-driven triage and can also be used to track quality improvement. Our study focused on Smart Spot (a wireless tag), which is part of Smart Triage and offers live tracking of patients’ locations. We found that the data collected through Smart Spot was noisy, so we developed a method to clean this data to provide a more accurate measurement of the children’s movement. While the system can benefit from further accuracy improvements, it showed us where improvements were made during the Smart Triage implementation. Our study shows that an affordable tracking approach can be used to monitor the process of care, guide local improvements, and enhance patient outcomes.
Related
- Incidence and prevention of postprocedural bacteraemia and complications following water vapour therapy of the prostate: a retrospective review and quality improvement initiative at a tertiary care centre
- Impact of a Continuous Quality Improvement Committee on Outcomes for Patients Undergoing Percutaneous Coronary Intervention: A Single-Center Retrospective Cohort Study
- Virtual reality as a non-pharmacological intervention for pediatric preoperative anxiety: A quality improvement initiative and retrospective analysis
- Anticholinergic Burden Scoring in Orthogeriatric Patients: A Two-Cycle Quality Improvement Audit
- Standardising Emollient Prescribing in Critically Ill Patients: A Quality Improvement Project
BibTeX
@article{choi2026retrospective,
title = {{A retrospective study of smart spot, a Bluetooth low‑energy real‑time location system supporting quality improvement efforts in Uganda}},
author = {Daniel Choi and Ediketh Tugume and Isaac Mwesigye and Aine Ivan Aye Ishebukara and Charly Huxford and Yashodani Pillay and Gotharido Tumubugane and Nathan Kenya-Mugisha and Ronald Kasyaba and J. Mark Ansermino and Dustin Dunsmuir and Pediatric Sepsis CoLab},
journal = {PLOS Digital Health},
year = {2026},
month = nov,
doi = {10.1371/journal.pdig.0001790},
url = {https://journals.plos.org/digitalhealth/article?id=10.1371/journal.pdig.0001790},
note = {CC BY},
}
RIS
TY - JOUR
TI - A retrospective study of smart spot, a Bluetooth low‑energy real‑time location system supporting quality improvement efforts in Uganda
AU - Daniel Choi
AU - Ediketh Tugume
AU - Isaac Mwesigye
AU - Aine Ivan Aye Ishebukara
AU - Charly Huxford
AU - Yashodani Pillay
AU - Gotharido Tumubugane
AU - Nathan Kenya-Mugisha
AU - Ronald Kasyaba
AU - J. Mark Ansermino
AU - Dustin Dunsmuir
AU - Pediatric Sepsis CoLab
PY - 2026
DA - 2026/11/01
JO - PLOS Digital Health
DO - 10.1371/journal.pdig.0001790
UR - https://journals.plos.org/digitalhealth/article?id=10.1371/journal.pdig.0001790
AB - Real-time location systems track assets and individuals, and in high-income clinical settings, they have improved patient flow. However, their use in low- and middle-income countries remains limited. Smart Spot, a low-cost Bluetooth low-energy real-time location system was integrated within the Smart Triage quality improvement platform in the outpatient department of Uganda Martyrs’ Hospital Ibanda. The primary objective was to evaluate whether Smart Spot data could be used to detect differences in time spent across clinical locations associated with Smart Triage implementation. The secondary objective was to assess the accuracy of Smart Spot data. At triage, children (or their caregivers) received a beacon attached to a lanyard. The beacons tracked patients’ locations throughout their time in the outpatient department. Smart Spot data were collected during a 4‑month baseline phase (pre-Smart Triage) and a 12‑month Smart Triage intervention phase. An algorithm was developed to reduce noise and generate more accurate records of each patient’s journey. The resulting pathways were compared to expected paths to evaluate Smart Spot’s accuracy. The median durations of patient time spent in specific areas were compared between phases using quantile regression. Data cleaning improved the matching to the expected patient flow from 13.0% to 73.1%. Compared with baseline, the median time patients spent in the assessment area decreased by 51.7% (-81.9 min; CI: -95.1 to -68.8), in the emergency room by 69.1% (-44.3 min; CI: -67.7 to -20.8), and total visit duration by 58.2% (-122.9 min; CI: -138.4 to -107.3), all with p-value < 0.001. Real-time location data supported the demonstration of the Smart Triage platform’s benefits. In the cleaned dataset, the intervention phase had shorter total visit time and time reductions within specific areas. Our evaluation demonstrates Smart Spot’s feasibility as an effective data-collection platform for quality improvement and its utility for retrospective analyses in low-resource settings. Author summary: Healthcare infrastructure in low- and middle-income countries often falls behind that of high-income countries. Significant resource constraints in these settings contribute to this difference, ultimately resulting in patients lacking the optimal care they need. Additionally, without digital health infrastructure tools, low-resource healthcare settings do not have the resources to record any data to track their progress on quality improvement goals. To address this issue, we developed Smart Triage, a triage platform for children in the outpatient department of hospitals in Uganda. The platform provides data-driven triage and can also be used to track quality improvement. Our study focused on Smart Spot (a wireless tag), which is part of Smart Triage and offers live tracking of patients’ locations. We found that the data collected through Smart Spot was noisy, so we developed a method to clean this data to provide a more accurate measurement of the children’s movement. While the system can benefit from further accuracy improvements, it showed us where improvements were made during the Smart Triage implementation. Our study shows that an affordable tracking approach can be used to monitor the process of care, guide local improvements, and enhance patient outcomes.
SN - 2767-3170
ER -