Real-time location system implementation in dementia care: Stakeholder perspectives.

Area of Science:

• Gerontology
• Health Informatics
• Sociology of Health

Background:

• Limited research exists on implementing real-time location systems (RTLS) in long-term care settings.
• Interest in RTLS is high for improving care quality, efficiency, and developing clinical algorithms.
• This study investigated RTLS implementation failures in a long-term care home.

Purpose of the Study:

• To identify failure points in RTLS implementation.
• To examine ethical tensions and sociotechnical misalignments.
• To understand reasons for RTLS abandonment in long-term care.

Main Methods:

• Conducted semistructured interviews with 47 participants (residents, care partners, staff, managers, administrators).
• Utilized thematic analysis guided by the Non-Adoption, Abandonment, Scale-up, Spread and Sustainability (NASSS) framework and Sociotechnical Systems theory.
• Collected demographic survey data from all participants across two time points.

Main Results:

• Initial enthusiasm for RTLS based on safety and efficiency expectations was unmet.
• Misaligned functionalities, poor staff engagement, and ethical tensions hindered adoption.
• Residents removed wearables due to discomfort and privacy; staff faced integration barriers; autonomy was overridden.

Conclusions:

• Implementation failures highlight the need for iterative, participatory approaches and stakeholder alignment.
• Sociotechnical complexities of surveillance technologies in long-term care are significant.
• Future RTLS implementations must address ethical concerns regarding resident autonomy, workforce surveillance, and data governance.