Command centers crammed with monitors displaying real-time data and staffed by personnel hunched over workstations serve as war rooms for the military and space operations facilities at NASA.
However, The Johns Hopkins Hospital in Baltimore has established a similar state-of-the-art command center that is a model for how healthcare organizations can increase their efficiency in managing patient care.
The 2,550-square-foot command center is touted as the first-of-its-kind in healthcare, combining the latest in systems engineering, predictive analytics and situational awareness to better manage patient care and safety, as well as the movement of patients in and out of the Johns Hopkins School of Medicine’s teaching hospital.
“We realized that we, like most hospitals in the future, are going to have to be very efficient and carefully manage the flow of patients into and through our hospital,” says Jim Scheulen, chief administrative officer for emergency medicine and capacity management at Johns Hopkins Medicine.
According to Scheulen, healthcare organizations need to think about operations from a different perspective by leveraging principles of systems engineering, which are more commonly utilized in other industries. At the same time, he acknowledges that managing an academic medical center like The Johns Hopkins Hospital is an incredibly complex undertaking in which all of the pieces of the system have to work together in perfect synchronization.
“We use some of the same tools and approaches industries like aerospace, automobile manufacturing, and others use—specifically systems engineering,” adds Scheulen. “Instead of just trying to manage and improve individual processes, you really have to look at how all the processes come together to form this complex flow through the institution.”
The Capacity Command Center, staffed by more than 20 personnel drawn from different existing departments at the hospital, manages the flow of patients—from admission to discharge—from one centralized location. On average, the center receives about 500 messages per minute from 14 different Johns Hopkins IT systems generating real-time data—which is refreshed every 30 seconds—about everything from bed availability and operating room efficiency to patient status and staffing.
Previously, the hospital used phone calls, emails, faxes and texts to communicate bed availability among disparate departments that were physically dispersed. Now, armed with information from multiple systems across the hospital displayed on the command center’s 22 monitors, the staff is able to take immediate action to prevent or resolve bottlenecks, reduce patient wait time, coordinate services and reduce risk.
“The idea was to bring everybody together who are managing the operations on a daily basis, to collocate our resources, and to give them as much actionable information as possible,” says Scheulen. “The data is aggregated and then is displayed on 22 screens that are in front of all of the people who manage the flow of patients.”
When it comes to predictive analytics, the command center is able to forecast future demand for patient beds. According to Scheulen, the software enables the hospital to “look two days into the future for what the occupancy of every floor is going to be” and the “specific expected number of patients coming in and going out on a daily basis for the next three days.”
Designed and built with GE Healthcare Partners, the command center has been in operation for about a year and has already generated significant results in terms of improved patient experience and operational outcomes.
For example, Johns Hopkins reports a 60 percent improvement in its ability to accept patients with complex medical conditions from other hospitals around the country, compared with its ability to take in those transfers before the command center went into operation. In addition, ambulance dispatches have been improved—the facility's critical care team is dispatched about 63 minutes sooner, on average, to pick up patients being transferred from other hospitals.
Within the hospital, a patient is assigned a bed in Johns Hopkins' emergency department 30 percent faster, after emergency clinicians make a decision to admit a patient. In addition, patients also are transferred 26 percent faster after they are assigned a bed. And after surgical procedures, transfer delays from the operating room after a procedure have been reduced by 70 percent.
Finally, the impact on patient discharges has been noticeable. Some 21 percent more patients are now discharged before noon, compared with last year, before the command center opened.
To meet incoming patient demand, the command center helps to prioritize which patients should be discharged and alerts the hospital’s environmental services team which beds should be cleaned first to accommodate those who will be admitted.
Jeff Terry, managing partner of GE Healthcare Partners, notes that since the Johns Hopkins command center opened last year, health systems from across the United States and around the globe have visited the facility to observe its capabilities firsthand.
“What’s special about Johns Hopkins is that it has a NASA-style command center for optimizing enterprise level patient care coordination and is the first of its kind in the world,” says Terry. “It’s a patient experience program that also delivers a lot of institutional efficiency.”
“I’m not going to pretend to tell you that we’re perfect at it yet,” concludes Scheulen. “The data is there, and we’re learning more and more every day. We’ve made great progress but we also know that we can do more. And, that’s pretty exciting.”
According to Terry, GE Healthcare Partners is in the process of implementing a command center at Rush University Medical Center in Chicago and at other undisclosed healthcare organizations in Orlando, Portland, as well as Canada. However, he hastens to add that each command center is unique. “They’re like snowflakes. Everyone is different.”
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