Command centers help manage flow
The people who manage patient flow at hospitals might like a crystal ball that shows them when their resources are about to be overwhelmed. Hospitals are trying out what might be the next best thing. They’re wiring command centers with monitors that display predictive analytics fueled by every conceivable data source that gives a glimpse of a patient’s movement through the facility.
Johns Hopkins Hospital in Baltimore, like many major tertiary and quaternary providers, has faced growing demand for emergency services that runs up against bottlenecks in the operating room and inpatient units. So Johns Hopkins leaders worked with GE Healthcare Partners to redesign the hospital’s approach to patient flow by co-locating employees involved in the process and equipping them with near-real-time information about patients’ movements as they enter the hospital, move between units and await discharge.
Taking a cue from other industries that assemble command centers to manage complex logistics, GE Healthcare equipped Johns Hopkins with the company’s first Wall of Analytics, which features 22 information screens that can pull data from 14 sources, including the electronic health record, admission software and OR scheduling applications. GE is working with a handful of other hospitals to deploy the technology.
The tiles in the display provide the staff in the command center with an array of information, including incoming ambulances, patients awaiting discharge and the status of ORs. The staff can configure the wall to highlight specific tiles based on the situation at hand, and any tile can be viewed on an individual computer or mobile device.
The technology promises something more than an elegant presentation of the available data. It incorporates predictive analytics based on a hospital’s current systems and its historical data—a so-called “digital twin”—to forecast when the hospital may approach or exceed its capacity. It can also alert the staff when a deviation from the norm may signal a unit is at a high risk for a safety lapse.
The GE consulting group—which the company beefed up last year with the acquisition of the Camden Group—also worked with Johns Hopkins to revamp OR schedules and the admission process. They implemented status “huddles” on a regular basis within units and trained command center employees on how to work together and best respond to various scenarios the wall may present.
Jeff Terry, a managing principal at GE Healthcare Partners, said the group envisioned an air traffic control-style command center where technology and redesigned workflows would support quicker, better-informed decisions. They sought to make connections among departments that manage admissions, transfers, operating rooms, staffing and other tasks; staff members who perform those duties typically make decisions in silos and communicate by fax, phone or email rather than in person.
Although the command center at Johns Hopkins has been up and running for less than a year, the hospital has seen a 30% reduction in ER patients who have to wait for an inpatient bed and a roughly 70% reduction in patients who must be held in the OR because there’s no recovery or inpatient bed for them, according to Jim Schulen, Johns Hopkins Hospital’s chief administrative officer for emergency medicine and capacity management.
“If the healthcare system is going to constantly pressure academic centers and hospitals in general to be efficient—to make the most of every bed every minute—then I don’t think we can do it without these tools,” Schulen said. “You have to do this in order to reach the levels of efficiency that are going to be required to operate successfully.”
GE customizes command centers based on the specific issues a hospital is hoping to resolve. While Johns Hopkins wanted to use the center to improve capacity, other models may focus on delays and patient experience, coordination with other facilities, or diagnostics. Future systems are planned at Rush University Medical Center in Chicago and Humber River Hospital in Toronto.
Terry said the command center, in addition to the harnessing of analytics, is an excuse to get the decisionmakers in the same room and an impetus for a hospital to transform its processes. “The Wall of Analytics is a necessary but insufficient part of the outcome,” Terry said. “What we’re selling, what we’re trying to get our clients to do, is to design and achieve a new way of delivering complex medicine.”