Centralized Patient Logistics Center: A Nurse's Perspective

Susan: Welcome to Patient Flow Podcast. Today, we have Lisa Maples, Director of Centralized Patient Logistics at Health First in Florida joining us. Lisa, thank you so much.

Susan: Lisa, you have been doing absolutely amazing things with your patient logistics center. Just to start off, could you give us a brief synopsis of your background?

Lisa Maples: Certainly. I am a RN. My background is mostly in Emergency Services. I spent about 20 years in being an emergency room nurse, department directors, those kind of things for that side of the hospitals, and I changed about eight years ago and decided to look into patient flow, because it was always one of the areas that I was very interested in, being in the emergency department, is how we flow our patients into the hospital. So I started looking into patient flow jobs in my area, found this role, and have absolutely enjoyed learning the different sides of patient flow. What happens on the inpatient side versus what happens in the ER.

Susan: In order to get new patients in and get them the care that they need, you have to get the patients who are ready to move onto the next step, on to that next step. So that's amazing the interest that you took in moving that forward. Lisa, it's certainly a major challenge, though, to take that on. How do you manage the daily challenges of running a fully-integrated command center?

Lisa Maples: Well, one of the first things is, I have some really great people working with me on my team. This is not something that you do alone. You have to have a great team around you that understands the reasons we're here, the reasons we're doing this. They're all committed to doing the right thing for the patient, so I'm really, really lucky to have those people on my team. The other thing is that this is a true centralized patient logistics center, so the majority of my team is all under one roof. So I can move easily, touch base easily with them, move from department to department without having to travel to different locations. We are basically looking at, we look at air traffic control for our health system, here. We can see every bed in our system, we can see where every patient is from a centralized location, and having that level of visibility and then having my team all under one roof is great to be able to manage the flow of the day to day operations.

Susan: You had mentioned that you're an RN, so your experience as a caregiver must really give you an interesting perspective on this, as well?

Lisa Maples: It most certainly does. Like I said, we are in a centralized location. We're not in one of our hospitals. We're actually at a off-sight location from many of our hospitals. You know, I have quite a few people that are RNs that work in the centralized patient logistics, and one of the nice things that I always try to remind them is that even though we aren't doing hands-on care, there's not a patient that comes into Health First that we don't touch or interact with by getting them in the right bed the first time, making sure that they're going to the level of care that they need to. So we're still making a huge difference in our patients' lives. It's just in a different way, a different way to look at it.

Susan: Lisa, you talked about your team. How do you manage staffing, turnover, and onboarding?

Lisa Maples: Well, one of the biggest things that we really try to do is that we try to start off right by getting the right person in the right role from the beginning. Our interview process involves a panel of my team, because these new hires are going to be working with my team, so I want to make sure that they have buy-in and that they are able to interact with these people and look at them and their skillsets and to make sure they're going to be a good fit for our team. Once we do that, we have a rigorous interview process that has behavioral questioning instead of just the yes/no answers, so we really get to know our candidates. Once we do that, we have a standardized six-week training program. This program has, of course, common core stuff around customer experience and quality, but it's then tailored to our individual role, depending on what they're hired in to do. We also set up our new team members with a department buddy, and a preceptor, kind of, so that they always have somebody that they're familiar with that they can ask questions to that it's that safe person that you can ask any question to that you need to. Yeah. And they're always a constant presence for that new hire. We try to keep our new hires with the same preceptor so that they're not changing people and changing the way different people train. So it's a very consistent orientation for them. Then we also have quite a few things that we do for onboarding across Health First, but of course it's incorporated into our department. We send out letters to our new hires, welcoming them to our department. I always send out an email to our current staff and tell them who's coming on board and what their qualifications are and what their background is and ask my team to please make sure that they feel welcome in our area. We put flyers up at our department on the first day saying, "Welcome, we're glad you're here" to our new associates. So with all this work that we do as far as trying to get the right people in the right job, working through onboarding, working through their orientation, we have very little turnover in our department. We've been really blessed to have really low turnover. We keep the same people. That gives us a good consistency as we move through doing what we do in patient flow.

Susan: Great, great. Lisa, starting a command center and running a command center is certainly quite an undertaking, getting buy-in from physicians, from nursing, from IT, from care management. What are three things that you can share that would assist somebody in getting their command center up and running?

Lisa Maples: Well, you're correct. The biggest thing that you have to have is the support from your senior leadership team. They have to understand how important patient flow is to the organization and really be there to support you through this whole process. Luckily, here at Health First we have a great senior leadership team, from our chief executive Steve Johnson on down, that are really engaged in patient flow and understand how important it is to every aspect of what we do as far as caring for our patients. A couple other things is that, you need to make sure that you have some sort of on-going education program in place once you centralize and move to a centralized patient logistics area. We get new hires, you get turnover, those things happen, and without that educator in place to make sure that everybody's getting the right education on how your systems work, how your processes work, you can start to see some areas that you erode if you don't have that educator that's constantly keeping people up to date. So an educator is extremely important to have to make sure that your new staff and existing staff are updated on changes and where we're going. One of the other things that we find really important is, because we are all in the same area, here, bed control and my centralized registration and my transfer center and all the areas that we do, we have found that cross-training our associates has been extremely helpful so that everyone has the ability to assist customers with what they need. So when our phone rings, if there's not a bed control person that's readily available to answer the phone, the transfer center nurse can answer it, or the registration person can answer it. They all have the ability to answer questions from our customers and make sure we're helping people when they call and getting things taken care of. So one of the big things is just making sure that you cross-train as many of your staff as you can so that they're flexible. Then also, always, always listen to your frontline associates that do the work. They have a realtime connection to the patient placement, and they're always the first to know when we have an area that we can improve in our process or that we have an area that we're starting to see some issues with. Those frontline associates pick up on it immediately and are able to come to you with great ideas in how we can improve and how we can move forward. So always listen to the associates that do that work. It's extremely important.