The phrase “command center” is used often these days in the world of hospital operations. At its core, the idea just makes good practical sense – the coordination of patients, staff and resources is complex, multifaceted and involves several organizational groups at any hospital or health center. Bringing those groups together under the same umbrella allows for easier coordination and less redundancy, which in turn leads to smoother patient flow and better utilization of scarce resources.
As an aviation nerd, I’m partial to the “air traffic control” analogy: It’s a Herculean effort in the US to guide over 40,000 daily flights safely into the air and back down again, and it’s a job that needs to be done every single day by dedicated people. Likewise, in a healthcare world where lives are on the line daily, the smart, careful orchestration of patient and staff movements has a profound effect on safety, satisfaction and utilization.
Indeed, many American hospitals today have matured from running decentralized operations, to centralizing key functions into transfer centers, and increasingly to organizing fully fledged command centers that coordinate transfers, discharges, transportation, staffing and support services across entire health systems. Hospitals in Canada and the United Kingdom have also been organizing this way over the past few years.
One major issue in this early stage, though, is that most command centers today are managing to the moment, not to the future. It’s not the fault of the operators here; it’s that solid, understandable predictions around patient demand, flow and staffing needs simply aren’t available to them. I’ve spoken with many hospital systems over the past several years, and the most advanced ones tend to rely on current information on census and capacity – for example, seeing that key patient units are full and the ED is currently overcrowded, leading to a surge-management response. While that’s a big improvement over using only historical data and effectively being blind to current events, managing to the moment just doesn’t allow for a truly effective response: if you wait until beds are full and staff is on shift, you’ve missed a valuable opportunity to act preemptively.
The Institute for Healthcare Improvement’s real-time demand capacity (RTDC) framework calls for demand prediction as a necessary step to managing staff and workload: “Demand forecasting is the first critical step to inform bed capacity planning. The second equally crucial step in bed capacity planning is to ensure that there is adequate staffing to meet the needs of patients on each hospital service and inpatient unit.”[i]
Some institutions have attempted to develop their own predictive capacity models in place however, when speaking to them, you quickly learn that they tend to be narrow in scope, difficult to maintain, and tough to act upon. In short, they require a huge amount of manual effort, and they’re not scalable to everyday use at the hospital level, let alone for a health system.
Hospital IQ plays a vital role in any health system’s command center by automating easy-to-understand predictions of census and patient throughput days in advance, so managers across the system can plan for surges and dips in demand well before those events take place. At the individual patient level, length of stay and discharge predictions allow teams to monitor their inpatient populations and take action in advance. With Hospital IQ, hospitals and health systems can move beyond managing to the moment and make smarter decisions proactively. The ability to anticipate and avoid crisis before they occur is more cost effective, results in better care and a more satisfied workforce.
[i] Rutherford PA, Provost LP, Kotagal UR, Luther K, Anderson A. Achieving Hospital-wide Patient Flow. IHI White Paper. Cambridge, Massachusetts: Institute for Healthcare Improvement; 2017. Available at www.ihi.org.
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