Access. The definition is simple – the ability, right or permission to approach, enter, speak with, or use. However, things get much more complicated when the topic turns to a patients access to care – because in order to give one patient access to services, you must move another one out.
To help healthcare executives see the possibilities within their organizations, and how streamlining patient access and throughput via centralized command centers can help, we assembled a team of experts who were successful with implementations at their own facilities. The team included:
- Holly Meisner, VP, Patient Access, NewYork-Presbyterian Hospital, NY
- Amy Finnell, Director, Patient Logistics, St. Elizabeth Healthcare, KY
- Melanie Morris, Sr. Director, Emergency Services, Carilion Clinic, VA
- Russell Rooms, Clinical Specialist, Emergency Services, Oklahoma University Medical Center, OK
- Joy Avery, VP, Clinical Strategy, Maria Romano, Client Success Manager & Josh Wenzel, Client Success Manager, TeleTracking
Then we took things on the road – Transforming Patient Access – an executive forum – with interactive sessions in New York and Chicago.
Holly Meisner, Vice President of Patient Access, talked about how NewYork-Presbyterian is a long time TeleTracking user, but wanted to further optimize their utilization of our patient flow solutions. This led to the launch in February 2016 of a Patient Placement Operations Center at their Columbia University Medical Center campus.
The NYP Patient Placement Operations Center brings together key patient placement staff at one central location—equipped with TeleTracking’s automated patient flow data and real-time patient information. The command center structure provides the communication, collaboration, and operational visibility they need to efficiently place patients in the most appropriate beds as quickly as possible. With the efficiencies however come some significant cultural changes.
“To really make it work required direct observation—walking the floors and seeing firsthand how the operations are working. Then we focused on spending time with the department chairs and learning about the challenges physicians were dealing with in getting their patients in,” says Meisner.
Just a few months in and the numbers tell a compelling story. From January to April – admissions have increased, ED boarding has decreased and most importantly, Press Ganey scores are on the rise.
“We are using data to change culture and deliver a positive patient experience,” concludes Meisner.
To read more about NYP in TeleTracking’s second issue of Patient Flow Quarterly, click here.
Amy Finnell, Director of the Patient Logistics Center at St. Elizabeth Healthcare [SEHC] in Northern Kentucky, built their patient placement center and has been leading it for five years. The facility uses a single system solution to streamline patient flow processes between the six SEHC campuses, along with all outlying bed requests. The center and staff makes it easy for other medical professionals and the patients they’re looking to place—one number, one call and the patient is placed.
“We built the center from the ground up. We had to develop a scope, workflows, and then gain acceptance for the new workflows from our staff and physicians,” says Finnell. “Developing a throughput committee to collaborate on the issues and decide what was important to report and measure was an important part of the engagement process.”
The patient placement center is open 24 hours a day, seven days a week and is always staffed by one RN and one senior admission specialist. Other staffing requirements include a clinical supervisor, Mondays through Fridays, 8:00AM-4:30PM and that all the RNs have critical care experience. The capacity of the center was also optimized by putting transport and staffing under the same umbrella, creating a dotted line to EVS and placing portal boards at nursing stations system-wide with observation times and patient LOS added to the views.
“The new throughput processes led to decreased length of stay; decreased readmissions; increased customer satisfaction and made it possible for us to capture a larger market share,” says Finnell.
Melanie Morris, Senior Director, Emergency Services, at Carilion Clinic shared her insights about Carilion’s approach to becoming a High Reliability Organization (HRO). Because all HROs have an organized control center, Carilion developed the CTaC – Carilion’s Transfer and Communications 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.
Russell Rooms, Clinical Specialist, Emergency & Access Services, Oklahoma University Medical System [OUMS] in Oklahoma City, OK created the patient logistics center at the 600 bed academic medical center. Back in 2010, OUMS had an outsourced transfer center and the result was a lack of connectivity among the bed management process, 46 different protocols for specialty services, problems accessing the latest call schedules, and other resource challenges. So the main goals of establishing the patient logistics center included improving customer service by decreasing physician bouncing and including satisfaction scripting (AIDET); accurate time stamping in order to see where performance improvements needed to be focused; as well as issue tracking and follow-up, reporting ability and decreasing the number of calls by getting things right the first time.
“It was a step by step process to build our center,” says Rooms. “We started off by developing a coalition of advocates within hospital administration, including creating an executive role to oversee the program. We also focused on protocol development with process improvement in mind and situated patient placement and transfer center staff with housekeeping and transport coordinators in one location. This way with leadership on the same floor, they were able to solve challenges real time.”
The end result? Improved physician engagement, an increase in external transfers and direct admits, improved communication that reduced bottlenecks, and cross application interactions with case management reports and portals.
Each session also included an interactive workshop led by Joy Avery, Vice President of Clinical Strategy and Josh Wenzel & Maria Romano, Client Success Managers at TeleTracking. Avery, Romano and Wenzel shared the common challenges that other clients have had to work through, such as calls coming in through different points of access and physicians accepting patients around the transfer center. They also shared the key themes that have led other clients to success with their access programs, including executive ownership that makes access an organizational priority; a centralized, visible approach among departments; a one call process; utilizing the power of data; and making sure everyone is accountable to their piece.
Ready to take patient access to the next level? We’ll be hosting another event September 15, 2016 in Denver, CO. More information / registration for this event coming soon – check our website; be on the lookout for an email from us.
Interested in learning more? Contact us at firstname.lastname@example.org.
Check out the photos from our event on TeleTracking’s Flickr page!