Operational Command Centers Yield Positive Results at Carilion & Rush

“Patient Access” – two simple words that convey the obstacles that can affect a patients ability to get the right care, at the right time, with the right resources.  While patient access is not as familiar a phrase as population health management, health system CEO’s and executive teams around the country are saying that improving access is critical to efficient health care operations according to a piece by the Advisory Board Company in March 2014.

To bring attention to the topic of improving patient access and overall throughput, Healthcare Informatics and TeleTracking partnered to present an Executive Exchange at the Nine Zero hotel today in Boston.

 

Only a highly coordinated and seamless approach to getting patients the care they need, when and where they need it, will enable health systems to capture market share, remain competitive, increase revenue and continue to provide top-quality care. This strategy is important because:

• More than ½ of all hospitals will cease financial viability over the next 5 years
• In the next 2 years there will be more than 19.4 million new enrollees
• Over ½ of the U.S. will have at least one chronic condition by 2030

Chicago’s Rush University Medical Center and Roanoke’s Carilion Clinic are examples of medical systems that have designed operational command centers, similar to NASA’s Mission Control Center, for complete enterprise visibility. Not only have they streamlined patient admissions from referring facilities through their transfer centers, but they have made improvements to ED diversions, left without being seen, time spent in the ED, capacity constraints, etc.

Tim Chapman, former President of STERIS Healthcare and experienced McKinsey consultant, kicked off the event and stressed the importance – and need – for health systems to transform their operations now in order to remain competitive in the future.  Chapman’s advice:

1. stop the clinical vs. operational debates
2. think expansively
3. create a CEO of ‘everything’ (integrated leadership)
4. measure, measure, measure
5. define a realistic road map for change
6. pace yourself
7. be demanding but fair

Carilion Clinic’s Vice President, Emergency Services, Paul Davenport, and Sr. Director, Transfer & Communications Center, Melanie Morris took the stage next to talk about their approach to becoming a High Reliability Organization (HRO). Because all HROs have an organized control center, Carilion developed what they refer to as the CTaC – Carilion Transfer and Communication Center. The CTaC is the nerve center for the health system’s operations, with all patient transfers, placements, transports, etc. going through the impressive mission control-like center. The real-time information related to capacity and placement needs, the one-call does it all approach to accepting patient transfers, and the predictive capabilities around patient discharges gives the team in the CTaC complete oversight and management of daily operations. Since the CTaC opened, Carilion has:

• improved their discharge process
• improved patient satisfaction related to seamless entry into the system
• increased total transfer requests by 18%
• Increased capacity and reduced transfer declines

“Your transfer center is your hand shake into the health system, and you only have one chance to get it right,” said Melanie Morris.

The next presentation was from Rush University Medical Center (RUMC), one of Chicago’s longest standing healthcare institutions. Over the past several years, RUMC has seen a significant increase in patient transfer volumes. The team from RUMC, Shonda W. Morrow, JD, MS, RN, Director of Operations, and Jason Rosenberg, MS-HSM, Manager of Business Operations and Finance, presented, “Becoming a Transfer Center of Excellence.” RUMCs patient flow strategy is centered around its people – patients and staff, its processes – specific to predictive modeling, and the tools and technology that provide real-time information. Much like Carilion, RUMC also has an operations center and a ‘one call does it all’ approach to accepting patients through its transfer center. Rosenberg outlined the 7 steps to building an effective transfer center, and their transfer volumes and financials are quite astounding.

• transfer volume requests have increased by nearly 1,500 from FY13 to present day
• despite an increase in volume and acceptance, their declination rate remains constant at 2.8%
• in the last 6 quarters, their contribution margin from the transfer center is nearly $75 million

Rush attributes their success to people, process & tools, performance monitoring, and their aggressive and strategic outreach in the community.

The day concluded with a panel discussion moderated by editor-in-chief of Healthcare Informatics, Mark Hagland. Panelists from Carilion Clinic and Rush University Medical Center were joined by TeleTracking subject matter expert and Vice President of Clinical Strategy, Joy Avery. The topic – ‘A Better Way to Save Lives, Improve Patient Outcomes and Generate Health System Revenue’.  Panelists discussed their approach to creating operational command centers, the differences between clinical and operations systems and the need for both in order to run efficiently, recommendations for health systems looking to build operational command centers, and outcomes related to improved patient access, throughput, satisfaction and bottom line revenue for ongoing sustainability.