While many organizations have encouraged or required employees to work from home in response to COVID-19, one area where this approach has not been adopted is hospital operational command centers. Distinct from incident command centers, these NASA-style mission control centers are permanent structures that direct patient movement across one or multiple hospitals. Their success is dependent upon command center personnel working side by side, relaying up-to-the-minute information to hospital staff to ensure patients and caregivers are in the right place at the right time.
What Is a Command Center?
As patient movement has become more complex, hospitals and healthcare systems have recognized the importance of coordinating patient flow through a central hub to improve efficiency and create virtual bed capacity. Command centers, sometimes referred to as “transfer centers,” drive tremendous value by colocating key operational staff with real-time data and predictive analytics. This visibility provides a nucleus for quick decision-making around patient movement, which is even more essential when trying to manage capacity and resources during a pandemic.
In-Person Collaboration
ECG’s recent survey of leading healthcare organizations from across the country shows that none have moved their command center work to remote status or plan to do so. This decision is independent of geography or technology.
Such an approach, on its surface, may seem counterintuitive. A portion of the work conducted in command centers, such as facilitating outside hospital transfers, is phone- and IT system–based, and one would think these tasks would lend themselves well to remote work. However, getting patients in the right bed at the right time with the right care requires intense, time-sensitive coordination, which in turn requires in-person collaboration and the situational awareness provided by real-time data. And patients benefit.
“Effective communication, efficiency, and state-of-the art technology is essential for safe and quick patient transfers at highly effective transfer centers,” says Joe Moffa, Chief Administrative Officer for Perioperative and Procedural Services and Associate Executive Hospital Director at the Hospital of the University of Pennsylvania. Moffa said the hospital briefly considered remote work but quickly found it unfeasible due to technology and communication requirements. “The ability of employees going remote due to COVID-19 negatively impacts all aspects of the above and therefore leads to a less effective transfer center,” he said. ”All team members need to remain in the same room to ultimately keep our patients safe.”
That feeling is shared by Jim Scheulen, Chief Administrative Officer, Emergency and Capacity Management at Johns Hopkins Medicine. “We’ve made sure the team is appropriately distanced and the cleaning is at a whole new level, but the colocation is actually important for our best work,” says Scheulen.
The stakes are high for leaders like Moffa and Scheulen. Imagine a scenario where a nurse facilitating transfer requests is working from home, only to experience an internet outage or spotty phone coverage. When a trauma call comes in, there can be no delay in answering.
Managing Common Throughput Issues
Many busy hospitals face competing priorities for increasingly limited beds and equipment—a reality exacerbated by COVID-19. Real-time, in-person coordination from a command center can mitigate three familiar challenges: matching the supply of available hospital beds to best meet patient needs, easing patient flow bottlenecks, and prioritizing patient placement.
Patients are admitted 24 hours a day from various entry points. These can include incoming transfers, patients admitted from the emergency room, patients needing a bed after a planned or unplanned operation or procedure, and scheduled admissions. For some health systems, this demand often exceeded the supply of immediately available hospital beds even before the pandemic. Having a command center appropriately staffed with an experienced team increases the ability to quickly match limited hospital resources to serve the highest number of patients.
Large, complex health systems can easily develop silos, which create bottlenecks for patient movement. Command centers have shown impressive results in decreasing patient wait times and creating virtual capacity without adding more beds by streamlining patient movement and creating process and communication efficiencies. This is made possible by real-time data, colocation, and increased coordination around shared goals.
Patient placement requires a critical assessment of patient needs and available resources, which are frequently changing. It’s a complicated puzzle for staff, who are trying to prioritize placement based on acuity as patient conditions change and beds become available. The situational awareness provided by command center data combined with in-person coordination is the best way to immediately act on complex changing information.
All these pieces to coming together is made significantly more effective by colleagues collaborating in the same space, while safely distanced, to effectively assess available resources, patient needs, and actions needed to expedite movement. This allows health systems to care for the highest number of patients possible, which is especially important during a pandemic.
Hospital Command Centers 2.0
With experienced staff and real-time data and analytics, command centers can build upon their core functionality to further expand patient access and care coordination. While command centers have traditionally focused on inpatient operations, future applications span beyond the hospital walls. As healthcare systems become increasingly accountable for value-based care, alternative payment models (APMs), and managing the health of populations, organizations should broaden their lens to include patient movement before and after the hospital stay, including virtual care alternatives.
As COVID-19 continues to stretch limited healthcare resources, organizations have learned the critical importance of real-time visibility and streamlined operations to best meet patient needs. If your organization is interested in establishing a command center or enhancing existing throughput operations, ECG has the experience to help.
Published September 16, 2020