Penn State Health Milton S. Hershey Medical Center, in Hershey, PA is a leading provider of specialized medical care in central Pennsylvania, and is the only hospital with dual adult and pediatric Level 1 trauma accreditation in the state. Before making patient flow a priority in 2012, Hershey was at critical capacity for years. As the volume of patients increased, it became more challenging to move patients through the system in order to accept new patients—especially those coming in as transfers. In addition, the system was decentralized—while calls were coming into one number, it took a series of steps to accept the patient and get them to the right place for the right care.
THE RIGHT SOLUTION WITH THE RIGHT PEOPLE
“In 2012 our Chief Administrative Officer knew something
had to be done,” says Heather Boyle, Director of Patient
Logistics. “He knew if we wanted to maintain our leadership
role in the community we needed to grow our referral network,
centralize our efforts, and create efficiencies around a patient
flow strategy. We enhanced our working relationship with
TeleTracking in 2012 and within six months launched our Patient
The Patient Logistics Center is staffed with clinical, nonclinical
and IT staff, including transfer liaisons [RNs with a critical care background], clinical liaisons, a nurse manager, bed management associates [non-clinical staff responsible for registration and patient placement], a data analyst, a TeleTracking system administrator, and a medical director [physician support for clinical decision-making].
The Patient Logistics team regularly monitors ED boarding, PACU boarding, patient transport response times, EVS response times and bed request to assign times. Since the center launched, these metrics have steadily improved— positively impacting the throughput process.
EXECUTIVES AND USER ENGAGEMENT
To engage employees directly impacted by the new technology
and workflows, a cross-functional capacity throughput council
was launched initially to discuss barriers and obstacles to patient flow and quality care. Over time the council evolved into an update at daily safety briefings on capacity and related quality and safety issues.
A daily bed meeting is also held. “We discuss capacity issues first at these meetings—focusing on admissions and discharges, ED boarding, transfers and overall barriers to care,” continues Boyle. “In addition, the charge nurses find a lot of value in the daily bed huddles—the quick, 15-minute meetings are a proactive way of keeping things on track and avoiding problems.”
In addition to the team dedicated to patient flow, Hershey has an Operational Excellence department that manages Six Sigma initiatives and other organizational improvement projects. The Chief Medical Officer [CMO] is highly engaged and works closely with Patient Logistics and Operational Excellence on ongoing quality projects. The CMO, along with the Chief Nursing Officer and the hospital Managing Director are focused on capacity issues. The data provided by Patient Logistics in conjunction with the value stream
mapping completed by Operational Excellence is extremely valuable in decision-making. For example, this information was shared with the board of directors when deciding whether or not to launch a capital expansion project at the Children’s Hospital.
Even with these significant logistic improvements, Hershey needs more space. Over one year ago, Hershey acquired St. Joseph Hospital in Reading, and is now in the process of expanding their facilities and adding three floors to their Children’s Hospital—the Patient Logistics Center played a role in making the case for both of these decisions.
“We were able to use the robust reporting capabilities to demonstrate a concrete business case for the acquisition and launching this capital project,” adds Boyle. “We’ve also been able to improve our reputation dramatically in the community. We’ve lowered the number of concerns, and the number of issues related to hospital transfers and patient flow. We accept more patients, more often—and the overwhelming comment we hear from everyone is how nice the people they come in contact with in the
Patient Logistics Center are!”
With the success that they’ve had, the team’s next project is focused on taking transfer calls from St. Joseph’s Hospital. They are also in the process of working on space planning for a full Command Center, which will incorporate all critical operational functions, including EMS.
“I am so proud of the work that has been done within our transfer center—both the increase in transfers and the speed at which we’re able to accept a patient,” concludes Boyle. “We’re excited for the next phase of this journey which will further enhance our ability to deliver excellent care to every member of our community.”
This story originally appeared in TeleTracking’s Summer 2017 issue of Patient Flow Quarterly.