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GE Healthcare Camden Group Insights Blog

Humber River Hospital in Toronto Turns to Advanced Analytics to Improve Patient Care

Posted by Matthew Smith on Jul 26, 2017 11:36:47 AM

As populations grow and age, many hospitals are being stretched past their limits. Rather than apply temporary or partial fixes to address the challenges that underlie this busy, acute care hospital, Toronto’s Humber River Hospital has chosen to implement a holistic, state-of-the-art hospital Command Center that will enable it to achieve radical gains in quality and efficiency.

The hospital partnered with GE Healthcare Partners to conceive, design, and build the new 4,500 square-foot Command Center, a cornerstone of which will be GE’s Wall of Analytics that processes real-time data from multiple source systems across the hospital. Using complex algorithms, predictive analytics and cutting-edge engineering, the hospital intends to do two seemingly contradictory things: improve quality of care and patient access while at the same time reducing costs.

That may sound like an out-sized ambition, but there’s a good precedent for such a radical increase in efficiency: airports. Air traffic control technology was a guiding inspiration as GE designed a better way to extend reliable healthcare to meet the needs of more patients.

Blue-Sky Thinking

The introduction of air traffic control technology in the 1960s allowed airports to swiftly transition from scheduling a few hundred flights a day to managing thousands. Whereas, the volumes of aircraft and flights have increased tenfold, they all vie for the same space. Many airports now see millions of passengers pass through every day.

Despite the vast complexity of such a logistical challenge, the airline industry became significantly safer and more efficient in the process. So it’s no surprise that when GE Healthcare began developing a comprehensive approach to enable hospitals to better manage congestion, they modelled their solution on air traffic control.

Adding a digital Command Center was a natural fit for Humber River Hospital, not only because it’s recognized as North America’s first fully digital hospital, but also because the busy facility must serve a region representing more than 850,000 people. 

The extremely high demand became quickly apparent. After construction of the new hospital was completed in 2015, the hospital was slated to reach full capacity in five years. Instead, they reached that point in just five months.

“We’re at full capacity and we’re only going to see more and more patients through our front door. How are we going to deal with that?” asks Peter Bak, the hospital’s CIO. “We can’t just say, Sorry, you’re going to wait longer. That’s not acceptable.”

Powered by Digital

Bak and his team have overseen the implementation of the many tools that earned the hospital its high-tech notoriety, from software that empowers patients to review their own health records, to fully automated robotic systems for delivering supplies and dispensing medication.

These digital systems offer incredible efficiency, quality and safety benefits. For example, a doctor at Humber River Hospital can expect the results from a lab test in under sixty minutes, guaranteed. In a traditional hospital, the same manual process can take up to four hours and is prone to labelling errors and other defects.

But even though Humber River Hospital’s digital approach has yielded great results, it has not yet been fully harnessed. What the Command Center will do is amplify the impact generated from digitized processes, work flow and information flow by offering a holistic real-time view of how the hospital is operating.

Seeing the Big Picture

“People work in their focus area, and so they don’t see the big picture,” Bak explains. “They’re not seeing what’s happening at the other end of the hospital, and how what they do might have a bearing on what’s happening somewhere else.”

The aim of the Command Center is to empower a team of co-located staff to monitor, prioritize and expedite activities with the goal of driving far greater efficiencies. At Humber River Hospital, those efficiencies are anticipated to enable the hospital to deliver care to more patients with the same number of beds its operates today, and avoid a projected shortfall of 40 or 50 medicine beds by the year 2021.

Increased capacity isn’t the only outcome that the hospital is anticipating from its new Command Center. Another is improved reliability. “We need to drive hospitals to a point where they don’t make errors,” says Bak. “The Command Center acts as a second set of eyes and allows us to reduce the potential for mistakes.” By integrating systems and applying analytics a small team can observe the “outliers” and intervene ensuring that delays will not go unidentified, resources will not go under-utilized and patient care actions are taken accordingly.

The Command Center will also enable much better integration across levels of care. “We want the hospital to be the hub of an ecosystem that drives health for the 850,000 people in our community,” Bak explains. “Instead of patients having to physically go to the hospital to access specialty services for diagnosing and monitoring a condition, in many instances the patient can remain in the community and be serviced remotely with the use of technology.” Someone in the Command Centre will be monitoring, intercepting risk and expediting action when it is required, using analytics powerful enough to monitor the status of thousands of people, and not just the ones in the physical building.

“There are plenty of digital tools to make healthcare better, but they’re less effective when they are working independently of one another,” explains Bak. “Humber River Hospital’s new Command Center provides the much-needed synthesis to make all those systems work together.” The outcome? Reliable, high-quality care for more people.

Topics: Command Center, Hospital Command Center, Wall of Analytics

Command Centers: Shining the Light Between the Seams

Posted by Matthew Smith on Mar 16, 2017 1:09:49 PM

Don't miss Command Centers: Shining the Light Between the Seams--co-presented by GE Healthcare Camden Group and The Johns Hopkins Hospital at Becker's Hospital Review 8th Annual MeetingApril 17-20, 2017 in Chicago.

Session Overview:

Physicians want the best outcomes for their patients, but have minimal control at the juncture where treatment delays and many problems develop--at the seams between caregivers, facilities and hospital units in a patient’s journey. That’s about to change. The emergence of command centers in hospital settings delivers real-time and predictive decision-support tools, enabling optimal decisions at the moment they are required. These technological resources permit multiple systems in an enterprise to work in harmony with each other by applying data science to redesign system dynamics across a delivery network.

The Johns Hopkins Hospital, for example, employs GE’s Command Center to reduce patient wait time in the emergency department, accept more highly complex patients, and reduce waits following surgery. The facility has experienced a 70 percent reduction in OR holds and a 24 percent increase in pre-9:00 a.m. discharge orders.

Command Centers shine a light into the seams in care, maximizing efficiency, enhancing utilization, reducing risk and improving outcomes. While there’s a lot of talk about delivering seamless care, these resources offer the missing link providers need to explore this territory and retrieve vital information at the moment it is most essential.

Presented by:

Bree Theobald, Vice President, GE Healthcare Camden Group

James Scheulen, PA, MBA, Chief Administrative Officer, Emergency Medicine and Capacity Management, The Johns Hopkins Hospital

Date:

Wednesday, April 19

3:05-3:45 PM

Location:

Hyatt Regency Chicago
151 E. Wacker Drive
Chicago, Illinois 60601

Register for Becker's Hospital Review 8th Annual Meeting:

Command Center, Capacity Command Center

Topics: Care Management, Command Center, Bree Theobald, Capacity Command Center, Capacity Management

GE Healthcare Included in Fast Company's "Top 10 Innovative Companies in Health"

Posted by Matthew Smith on Feb 13, 2017 1:42:10 PM

GE Healthcare is featured as one of Fast Company's Top 10 Innovative Companies in Health of 2017. As part of the magazine's World's Most Innovative Companies ranking, the Fast Company reporting team reviewed thousands of enterprises searching for those that tap both "heartstrings and purse strings" and use the engine of commerce to make a difference in the world.

From Fast Company:

GE Healthcare works with partners ranging from the University of California San Francisco to Johns Hopkins to develop both hardware and software technologies that solve some of the most pressing problems in health care. Some are drawn from health systems; for example, UCSF needed a partner to develop machine learning algorithms for medical imaging, and Johns Hopkins needed a NASA-style command center to better manage patient flow in and around the hospital. Early results from Johns Hopkins have been promising: The hospital has reported a 60% improvement in the ability to accept patients with complex medical conditions from other hospitals around the region and country; its ambulances are able to get dispatched 63 minutes sooner to patients at outside hospitals; and its emergency department is assigning patients to beds 30% faster.


To learn more about The Johns Hopkins Capacity Command Center, watch this short video and click on the links to Modern Healthcare and Health Facilities Management, below.

 

To speak to the GE Healthcare team about Capacity Command Centers, please click the button below:

Capacity Command Centers

 

Topics: Hospitals, Hospital Operations, Command Center, Capacity Command Center, Capacity Management, Hospital Occupancy

Two New Hospital Command Center Articles Highlight Increased Efficiencies in Patient Flow and Facility Operations

Posted by Matthew Smith on Dec 7, 2016 12:22:01 PM

Two recently published articles showcase the new Judy Reitz Capacity Command Center at the Johns Hopkins Hospital in Baltimore. Designed and built by GE Healthcare Partners, the Command Center takes a page out of the aerospace and aviation industries by combining the latest in systems engineering, predictive analytics, and problem-solving to better manage patient flow in and through the hospital and other operations.

A story featuring the implementation of the Johns Hopkins Wall of Analytics appeared recently in the Innovations column (print edition) of Modern Healthcare. Command Centers Help Manage Flow highlights how command centers bring together patient-flow decision makers and equip them with data and analytics to help them prepare for surges and avoid delays in care.

To read this article on the Modern Healthcare website, please click the button below. Current Modern Healthcare nonsubscribers may register for free. Upon registration, viewers will have access to 12 free articles every 30 days.

Command Centers, Wall of Analytics,

Likewise, Command Center Leads to More Efficient Facility Operationswas recently published by Health Facilities Management. This article delves into some key areas of operational improvement and highlights results already realized, including:

  • Patient transfers. There has been a 60 percent improvement in the ability to accept patients with complex medical conditions from other hospitals around the region and country.
 
  • Ambulance pickup times. Johns Hopkins’ critical care team is now dispatched 63 minutes sooner to pick up patients from outside hospitals.
 
  • Emergency department flows. A patient is assigned a bed 30 percent faster after a decision is made to admit the person from the ED. Patients are transferred 26 percent faster after they are assigned a bed.
 
  • Operating room transfers. Delays from the operating room after a procedure have been reduced by 70 percent.
 
  • Patient discharges. Twenty-one percent more patients are now discharged before noon compared with that of last year.

To read this article in its entirety, please click the button below to be taken immediately to the Health Facilitites Management website:

Command Center, Capacity Management, Operations


To request more information or to contact the GE Healthcare team about Capacity Command Centers, please click the button below:

Capacity Command Centers

Topics: Command Center, Capacity Command Center, Facilities Operations, Patient Flow

Last Chance for Webinar Registration: The Academic Health Center of the Future—New Approaches to Capacity Optimization and Command Centers

Posted by Matthew Smith on Nov 9, 2016 3:43:11 PM

As a reminder, registration closes soon for tomorrow's webinar, The AHC of the Future—New Approaches to Capacity Optimization and Command Centers. The webinar is complimentary and is hosted by the Association of Academic Health Centers. Please consider attending this webinar, featuring GE Healthcare Camden Group thought leaders.

Webinar Details

Webinar Title: The AHC of the Future: New Approaches to Capacity Optimization and Command Centers

Host: Association of Academic Health Centers

Date: Thursday, November 10, 2016

Time: 1:00pm to 2:00pm (Eastern Standard Time)

About this Event

Today, academic health centers (“AHCs”) across the country are experiencing capacity challenges, including: admitted patients wait too long; patients are held in OR and/or PACU; patient bed assignment is not optimized for patient and overall flow, patient flow is not well integrated between facilities, and so on.

Not only does this result in a poor patient experience, but the challenges are further compacted by the need to lower costs under payment reform while still expecting strong volume. There is an urgent need for new approaches to capacity management as AHCs are forced to either build new capacity or function at higher levels of utilization. Capacity is a costly and ultimately scarce resource, and every effort must be made to value it accordingly. But how can you create more access for higher acuity patients in a way that is cost effective? How can you efficiently manage capacity and the care model while still leaving time for meaningful teaching/mentoring? How do you truly enable innovative transformation in organizations with deep-rooted cultural traditions?

Most AHCs have exhausted the low-hanging fruit of optimizing care in one area and need to optimize for the entire system. This session, presented by University of Michigan Health System (“UMHS”) and The Johns Hopkins Hospital, in collaboration with national healthcare business advisory firm, GE Healthcare Camden Group, will focus on innovative, forward-thinking approaches two leading AHC systems have undertaken to improve patient flow and optimize capacity to achieve measurable outcomes, including designing and implementing a first-of-its-kind command center. Using both systems as case studies, the speakers will share their experiences, challenges, and successes with achieving capacity transformation without expansion, as they enable the transformation needed to thrive as an AHC of the future. 

About the Presenters

James Scheulen, PA, MBA

Jim Scheulen is the Chief Administrative Officer for Emergency Medicine and Capacity Management for Johns Hopkins Medicine. He is responsible for the operations of the 5 Johns Hopkins Health System Emergency Departments which together manage nearly 300,000 patient visits per year.  Read more...

Mary Martin, MPA

Mary Martin joined the UMHS as Associate Hospital Director - Surgical Services, University of Michigan Health System (UMHS), beginning July 28, 2014. Her areas of responsibility include the departments of Anesthesia, Orthopaedic Surgery, Otolaryngology, Physical Medicine & Rehabilitation, Speech-Language Pathology, Psychiatry, Surgery, Transplant, and Urology. Read more...

Bree Theobald

Ms. Theobald is a vice president at GE Healthcare Camden Group and has been leading healthcare organizations through transformation efforts for more than eight years with GE Healthcare Camden Group, focusing on utilizing simulation modeling and advanced analytical tools to optimize inpatient, procedural, and clinic capacity. Read more...

Jennifer Naylor

Ms. Naylor is a senior manager with GE Healthcare Camden Group specializing in the areas of capacity management, care delivery, and hospital operations. She also has experience in patient access, designing/implementing governance models, and leading transformational change as a certified change agent. Read more...

To Register

To register for this complimentary event, please click the button below to be taken directly to the webinar registration page.

AHC Webinar Command Center

Topics: Webinar, Command Center, Capacity Command Center, Association of Academic Health Centers

Complimentary Webinar: The AHC of the Future—New Approaches to Capacity Optimization and Command Centers

Posted by Matthew Smith on Nov 4, 2016 11:33:06 AM

Webinar Details

Webinar Title: The AHC of the Future: New Approaches to Capacity Optimization and Command Centers

Host: Association of Academic Health Centers

Date: Thursday, November 10, 2016

Time: 1:00pm to 2:00pm (Eastern Standard Time)

About this Event

Today, academic health centers (“AHCs”) across the country are experiencing capacity challenges, including: admitted patients wait too long; patients are held in OR and/or PACU; patient bed assignment is not optimized for patient and overall flow, patient flow is not well integrated between facilities, and so on.

Not only does this result in a poor patient experience, but the challenges are further compacted by the need to lower costs under payment reform while still expecting strong volume. There is an urgent need for new approaches to capacity management as AHCs are forced to either build new capacity or function at higher levels of utilization. Capacity is a costly and ultimately scarce resource, and every effort must be made to value it accordingly. But how can you create more access for higher acuity patients in a way that is cost effective? How can you efficiently manage capacity and the care model while still leaving time for meaningful teaching/mentoring? How do you truly enable innovative transformation in organizations with deep-rooted cultural traditions?

Most AHCs have exhausted the low-hanging fruit of optimizing care in one area and need to optimize for the entire system. This session, presented by University of Michigan Health System (“UMHS”) and The Johns Hopkins Hospital, in collaboration with national healthcare business advisory firm, GE Healthcare Camden Group, will focus on innovative, forward-thinking approaches two leading AHC systems have undertaken to improve patient flow and optimize capacity to achieve measurable outcomes, including designing and implementing a first-of-its-kind command center. Using both systems as case studies, the speakers will share their experiences, challenges, and successes with achieving capacity transformation without expansion, as they enable the transformation needed to thrive as an AHC of the future. 

About the Presenters

James Scheulen, PA, MBA

Jim Scheulen is the Chief Administrative Officer for Emergency Medicine and Capacity Management for Johns Hopkins Medicine. He is responsible for the operations of the 5 Johns Hopkins Health System Emergency Departments which together manage nearly 300,000 patient visits per year.  Read more...

Mary Martin, MPA

Mary Martin joined the UMHS as Associate Hospital Director - Surgical Services, University of Michigan Health System (UMHS), beginning July 28, 2014. Her areas of responsibility include the departments of Anesthesia, Orthopaedic Surgery, Otolaryngology, Physical Medicine & Rehabilitation, Speech-Language Pathology, Psychiatry, Surgery, Transplant, and Urology. Read more...

Bree Theobald

Ms. Theobald is a vice president at GE Healthcare Camden Group and has been leading healthcare organizations through transformation efforts for more than eight years with GE Healthcare Camden Group, focusing on utilizing simulation modeling and advanced analytical tools to optimize inpatient, procedural, and clinic capacity. Read more...

Jennifer Naylor

Ms. Naylor is a senior manager with GE Healthcare Camden Group specializing in the areas of capacity management, care delivery, and hospital operations. She also has experience in patient access, designing/implementing governance models, and leading transformational change as a certified change agent. Read more...

To Register

To register for this complimentary event, please click the button below to be taken directly to the webinar registration page.

AHC Webinar Command Center

Topics: Webinar, Command Center, Capacity Command Center, Association of Academic Health Centers

Early Data Show Hospital Command Center at The Johns Hopkins Hospital is Leading to Positive Impact on Patient Care

Posted by Matthew Smith on Oct 27, 2016 2:07:29 PM

The Johns Hopkins Hospital has launched a state-of-the-art, advanced hospital control center. The Judy Reitz Capacity Command Center, designed and built with GE Healthcare Partners (GE), combines the latest in systems engineering, predictive analytics and innovative problem-solving to better manage patient safety, experience, volume, and the movement of patients in and out of the hospital, enabling greater access to Johns Hopkins’ lifesaving services. The Capacity Command Center incorporates systems engineering principles, which are commonly seen in most complex industries, such as aerospace, aviation and power. But for health care, an industry that deals with critically ill patients, integrating these tools has been difficult.

Since it opened earlier this year, representatives from 50 health systems across the U.S. and from four countries have visited the Capacity Command Center. Early results demonstrate improved patient experience and operational outcomes in the following areas:

  • Patient transfers from other hospitals: There has been a 60 percent improvement in the ability to accept patients with complex medical conditions from other hospitals around the region and country.
  • Ambulance pickup: Johns Hopkins’ critical care team is now dispatched 63 minutes sooner to pick up patients from outside hospitals.
  • Emergency Department: A patient is assigned a bed 30 percent faster after a decision is made to admit him or her from the Emergency Department. Patients are also transferred 26 percent faster after they are assigned a bed.
  • Operating room: Transfer delays from the operating room after a procedure have been reduced by 70 percent.
  • Patient discharges: Twenty-one percent more patients are now discharged before noon, compared to last year.

To read more about the Command Center and its results, please click here.

To speak to the GE Healthcare team about Capacity Command Centers, please click the button below:

Capacity Command Centers

Topics: Command Center, Hospital Command Center, Capacity Command Center

Digital Twins Revolutionize Strategic Planning in Healthcare

Posted by Matthew Smith on Aug 29, 2016 1:04:36 PM

By Jeff Terry, MBA, FACHE, Managing Partner, GE Healthcare Partners

What’s a Digital Twin?

A digital twin virtualizes a hospital (or other) system to create a safe environment in which to test the impact of potential change on system performance. In other words, to play “what if?” with system dynamics. This is important because healthcare delivery is massively complex. Common sense, spreadsheets, and statistics just don’t have the horsepower to inform strategic decisions. 

Are Digital Twins New?

Not exactly. Digital twins use discrete-event-simulation techniques which have been around for 30 years and applied successfully in healthcare to model departments like radiology. But modeling a hospital above about 400 beds has proven too difficult for all but the most experienced modelers using the best tools. 

What is New?

What’s new is using digital twins to design efficient new hospitals and to redesign system dynamics in existing large hospitals. "System dynamics" includes bed mix, staffing, model of care, floorplan, bed algorithm, etc. This is becoming more common with better toolkits and more experienced practitioners at companies like GE and EY. For example: GE analytics consultants using our healthcare-specific simulation platform have modeled >1,000 bed academic medical centers 75% faster than teams of PhDs using traditional methods.  

How are Digital Twins Revolutionizing Strategic Planning?

Digial twins enable massively collaborative, data-driven, and scenario-based decision making. Without a digital twin, leaders rely on tribal knowledge and basic analysis to plan new facilities and next year’s budget for existing facilities. This is normal but it leaves much to be desired. With a digital twin, leaders virtually test changes to bed mix, bed algorithm, task assignment, floorplan, equipment, ALOS, model of care, staffing etc.

The traditional answer is to do our best and see what happens.

  • For example: neuro has recruited two new surgeons, medicine is closing a unit, we’re opening a transitional care unit, the State is buying our rehab unit to convert it to psych beds, and we expect to reduce ALOS for knees by .75 days and for general medicine by 0.2 days. What will that do to ED Boarding? What is our maximum volume with different scenarios of growth by cohort? Can we accommodate the neuro volume? What’s the best day to add these cases to the OR schedule?
  • With the Digital Twin, we learn that we can accommodate the volume but only if the ALOS work succeeds. We add the cases Wednesday and shift two orthopods from Thursday to Tuesday. Alternatively, we could upgrade the transitional care unit to an ICU (but that’s expensive). These answers lead to new questions… which are tested in the digital twin.

Digital Twins Revolutionize Planning in Four Ways:

Digital twins close the gap from “requirements” to system dynamics. Today this is a leap of faith. The simulation model closes that gap when we design new facilities, when we redesign existing patient flow, and when we convert service-line volume plans to annual budgets.

  1. Digital twins target process improvement efforts by putting each process improvement project into larger context. This enables us to charter projects with specific goals tied to both local and system performance. 

  2. Digital twins facilitate massively collaborative strategic planning. Health systems are full of super smart leaders with ideas. Those ideas need to be heard and tested. The digital twin gives us the tool do so. In many cases the result is to demonstrate that some ideas are bad. That’s a great result because it allows that leader to move forward and embrace the eventual strategy the Digital Twin helps to clarify.

  3. Digital twins can also power ongoing short-term forecasts. For example, when we build a digital twin in our Hospital of the Future Analytics Platform to redesign a medical center's system dynamics, we use the same simulation model to power predictive decision support apps outside-the- EMR.

In the end, digital twins help leaders design and execute models of care which are good for patients, families and caregivers. Revolutionary.

 
 Digital Twins, Capacity Management, Hospital Operations
 

Jeff_Terry.jpgMr. Terry is a Managing Principal of Healthcare Partners, the consulting arm of GE Healthcare that works with healthcare systems to define and achieve transformational outcomes related to quality, access, culture and cost. Partners' capabilities include management consulting, mobilizing change, technology integration and advanced analytics. He has a diverse background in consulting, sales, product development, Lean Six Sigma, business strategy, and services. Areas of focus have included clinical asset management, patient safety, patient flow, hospital operations, radiology and advanced analytics. He may be reached at jeffrey.terry@med.ge.com.

 

Topics: Hospital Operations, Command Center, Jeff Terry, Hospital Command Center, Capacity Command Center, Capacity Management, Digital Twins, Hospital Occupancy

NASA-like Command Centers are Coming to Hospitals

Posted by Matthew Smith on Jun 20, 2016 2:40:16 PM

By John Flannery, President and CEO at GE Healthcare

I often ask those who work in other fields how they view healthcare. Do they see an industry rife with cost challenges and complexity? Do they wonder why we want to be a part of it?

They wouldn’t be wrong, but I wouldn’t choose any other job.

Yes, the volume of patients needing care is rapidly increasing, but so is the data available to make decisions about that care. Resistant diseases are smarter, but advanced technology and medicines are outsmarting those diseases. Managing a hospital is more complex today, but building a digital and analytics infrastructure to manage these logistics is more possible than yesterday.

I saw this in action at The Johns Hopkins Hospital (JHH) this month. In the center of their campus in Baltimore, Maryland is a room with walls made of 22 high resolution screens. Numbers, charts and live video flash across them. The hospital staff flows in and out, scanning the screens and making quick decisions based on what they see. It’s what I imagine the inside of NASA might look like before a rocket launch – in fact, JHH calls it their Capacity Command Center. From here – the first predictive patient-experience control center – the staff is running their hospital with the help of a new source: predictive analytics.

One app on these screens uses a digital-twin of the hospital to predict patient activity for the next 48 hours. Another algorithm tells the staff which room turn or patient discharge would reduce wait time. Yet another senses when pressure on a unit is nearing a dangerous situation for patient care, a rare but critical measure.

When JHH, one of the leading health institutions, told the GE Healthcare Partners team that high demand was challenging their capacity to see more patients, we worked alongside the hospital staff to find a holistic solution. In this case, it was the Capacity Command Center, including GE custom-built software that could transform how they manage operations.

Back to my earlier questions: such transformations let a business like us seize the opportunity to be more than a technology provider. Because of our scale and reach, we work with healthcare providers of all shapes and sizes across the world, from Baltimore to Bangalore, to solve similar challenges. We have an obligation to use that vantage point to find and share solutions that work. To be a leading ideas provider.

For a 124-year old startup like GE, it’s an exciting time when we can adapt to what the world needs.

For patients, it promises to be a welcome improvement of less wait time and improved care. For clinicians, it can mean more time freed up to focus on those patients.

And if you ever want to meet people in healthcare who would never change what they do, speak with these clinicians, the care teams who work tirelessly, NASA-like Command Center or not, to help others get better.

Who wouldn’t want to be a part of that? That’s reason #2.


bio_Flannery.jpgJohn Flannery is the President and CEO of GE Healthcare, an $18 billion business unit of General Electric that provides transformational medical technologies and solutions to the global healthcare industry. GE Healthcare supports customers in over 100 countries with a broad range of services and systems, from diagnostic imaging and healthcare IT through to molecular diagnostics and life-sciences. John was appointed to his current role in October 2014.

 

Topics: Hospitals, Command Center, Hospital Command Center, Healthcare Transformation, John Flannery, Capacity Command Center

Top 10 Opportunities for Improved Acute Care Access and Capacity Management

Posted by Matthew Smith on Apr 22, 2016 11:19:31 AM

The time is now for health systems and hospitals to engage physicians, create actionable data, and plan for operational and financial changes in order to continue to drive better acute care access. Even with population health strategies that are successfully shifting care settings and expectations for target patient populations, there is a continued increase nationally in inpatient demand at large tertiary and quaternary facilities that are designed and required to continue to serve high acuity, time-sensitive conditions.

These facilities report a mid-week operating capacity often exceeding 90 percent occupancy. The hospital is not going away any time soon. To thrive in today’s environment, health systems must align operations with this new reality, and be judicious in expansion plans, as well as managing access to the costly but vital services that are provided.

Top performing health systems do not just look at improving acute care operations as a tactical, cost out effort – operational excellence is being executed as an organizational capability that drives competitive advantage in a market where patients are increasingly becoming consumers, physicians and staff expect a better workplace, and payers aggressively work to bend the cost curve. Here are ten opportunities for improving acute care access and better overall capacity management.

1. Embrace systems thinking. Companies like Amazon, Walmart, Uber, and many others have figured out how systems thinking across their delivery of goods and services can be a competitive advantage; leading healthcare organizations are starting to do the same. The days of finding big opportunity in localized optimization are limited; much of the low-hanging fruit is gone. Healthcare executives must shift their focus to the whole – the whole hospital, the whole health system, and the whole continuum of care – for big wins. This has been a slow process because of the existing fragmented delivery system and incentive structure. Cost pressures and payment reform are forcing “systems thinking” with the acute care setting in a way that we have not seen before, bringing a much wider group to the table in strategic planning and operational reviews to have real discussion around how to improve operations and patient experience.

 
2. Expand as a final resort. Organizations continue to be in a “wait and see” mode in regards to expansion efforts. They have spent a tremendous amount on expansion in the past decade and have heavily invested in healthcare information technology. The last thing most CFOs want to consider is another tower or other construction effort. This is forcing a new level of justification for expansion and deep discussion around how to maximize resources and eliminate duplication of services, including making very tough choices around moving services and appropriate care settings.
 
3. Greater focus on patient experience. After a while it can be easy for those in the operational world to grow numb to – or at least tolerant of – cancelled surgeries, declined transfers, long ED wait times, PACU holds, stretchers in hallways, and a host of other “last resorts” that have recently become permissible mitigations. It is not so easy for the patients. In a recent study commissioned by GE Healthcare Camden Group and Prophet, the gap between the perceptions of patients and health system leaders about the state of patient experience is widening. Despite the rising expectations of healthcare consumers, health systems struggle to move the needle given the myriad of challenges they face. There is not a healthcare professional in the world who does not think there is room for improvement, but it is a task that is too large for a single individual and needs to be approached in a transformative and collaborative way. It also needs to be integrated with efforts to enhance efficiency. The goals are the same:  improve access and streamline the patient care process. We are seeing many organizations take an executive commissioned fresh look at what the world could look like with “Patient Itineraries” and a world class type of experience standard that one would expect in other industries around billing, wait times, transparency to plans of care, and a long list of others. This can be incredibly powerful in creating a shared need and future vision for patient and family centered care.
 
4. Staff smarter. Patients do not get sick Monday through Friday on a defined schedule, yet this is the way many hospitals are run. There is also intense pressure to manage expense budgets by controlling costs in areas such as nursing or support services, but when not done thoughtfully, these efforts can have an impact on patient access in a way that compromises the overall financials in a much greater way. This is a very difficult nut to crack, but one where real progress is being made with approaches such as acuity-based staffing, realignment of staffing models, and smarter use of services based on data models that link demand to the consumption of services.
 
5. Increase flexibility. As beds become more constrained, hospitals are seeking creative ways to increase flexibility which often takes the form of adding flex capacity to absorb fluctuations in demand or increasing the versatility of the existing beds. This includes increasing tele coverage, sharing of beds between departments in times of peak census, rethinking incentives to promote better collaboration around patient care vs. optimizing for an area or department, redesigning processes to say “yes or no” faster, and more. The key for organizations is to promote collaboration and innovation around positive change – this takes data to build a case and strong leadership to overcome a long history of siloed operations.
 
6. Adopt hub and spoke models. Large integrated delivery networks are being much more judicious in aligning their operational strategies around where care is delivered. Increasingly, organizations are seeking to increase the complexity of care at their largest facilities where the most complex and costly services are provided, and use other satellite hospitals in a health system as virtual step downs. This requires a huge degree of coordination to rationalize and relocate services, redefine access patterns, and communicate the change to patients and staff. When done in a thoughtful way, this can be an incredibly effective approach to improving operations, patient experience, and the overall cost structure.
 
7. Target underlying issues. There is no shortage of process improvement effort underway in the acute setting related to access, patient flow, patient experience, and overall capacity management. This is often done in a fragmented way, putting out the fires that burn the hottest instead of taking a comprehensive look to deeply understand the issues and the impact those issues (process/capacity/cultural) are having on our operations. Firefighting can easily result in a “squeezing of the balloon,” where tremendous resources are invested in one area only to shift the issue to another. To truly make a dent in today’s capacity challenges, organizations need to take big swings, building holistic solutions to chronic issues such as long LOS, misalignment of discharges to admissions, inconsistent or misdirected patient placement practices, variation driven by surgical schedules to reduce variation, and more. Though never easy to address, these are the sorts of underlying issues at the root of capacity challenges, and the results of solving them tend to warrant the investment it takes to do so.
 
8. Find partners. A comprehensive look at acute care access and capacity management sheds light on those tough patient populations where we must work smarter and not harder. Organizations are exploring aggressively how they can prevent admissions and shorten stays through the use of retail clinics, partnerships with other hospitals, and improved relationships with post-acute providers that leverage data and establish service level commitments.
 
9. Use smarter operational analytics. Certainly institutions may tout their new EMR or a new bed management system as the solution to all of their problems – but in reality, this is not the case. The sophistication required to understand information in real-time from multiple systems and make critical decisions exists only in small pockets. Innovative organizations are investing in real-time analytics that can help solve their most complex problems in the moment. A problem back approach to analytics is critical. More proactive tools are also being developed that allow organizations to predict operations 24 to 48 hours in advance with amazing precision.
 
10. Consider command centers. In one of the most complex industries in the world, teams are asked to work in silos, often communicating via pagers, fax, and telephone to navigate and resolve complex daily issues. Healthcare may be one of the last industries to actively use pagers in daily work. There is a growing trend to co-locate staff, supported by real-time information from dozens of systems that generate insights and drive action, and well-defined procedures to run hospitals like a busy airport or mission critical space shuttle launch.
 
This is an incredibly exciting time for hospital operators to rethink the Hospital of the Future. It often seems like an overwhelming task because of the complexities of daily operations, the heroics that occur, and the time required to drive change. With a well-informed plan on activities that can truly move the needle, strong leadership, and effective change practices, a better state is just around the corner.

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Mr. Martin is an Executive Vice President with GE Healthcare Camden and leader of the Care Design and Delivery Practice. Mr. Martin specializes in the areas of hospital operations, process improvement, and the use of advanced analytics to develop innovative solutions. He also has extensive experience in strategy development, care design, population health development, value management, and large scale technology implementations. Mr. Martin has worked with leading academic medical centers and large integrated delivery networks across the country to improve clinical, financial, and operational performance. He may be reached at geoffrey.martin@ge.com.

Topics: Acute Care Hospitals, Acute Care Efficiency, Geoffrey Martin, Command Center, Capacity, Capacity Management

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