Command center enable the hospital to take real-time action on data to reduce bottlenecks and improve the patient experience.
CareComm enables providers to accelerate care through access to real-time data.
A departure lounge frees up patient beds immediately after discharge and provides a comfortable setting for those waiting on medications and transportation.
Capabilities will expand to include combining remote monitoring and sepsis protocols with artificial intelligence and predictive analytics to further improve care.
The center will also expand its purview outside the hospital walls into ambulatory settings, physician offices, and postacute care.
In the quest to reduce cost, improve the patient experience, and wrangle a massive amount of data into actionable insights, some hospitals and health systems are building NASA-style command centers, fueled by artificial intelligence (AI) and predictive analytics. They also corral teams of people who once worked in separate areas into one space to enhance collaboration and decision-making.
With expenditures that can easily exceed $10 million for construction, information technology, and consultation, are they worth the effort and cost?
John Couris, president and CEO of Tampa General Hospital in Florida, says the proof is unequivocal. After less than a year of operation, the 1,007-bed nonprofit academic medical center has saved about $10 million by reducing inefficiencies and decreased average length of stay by nearly half a day per patient.
Couris and vice president of care transitions Peter Chang, MD, take our readers behind the scenes, sharing a case study about their journey that touches on the problems that led to building a command center, the solution, how things are different at the hospital, the results, and what the future holds.
PROBLEM: TURNING DATA INTO ACTION
When Couris arrived at Tampa General Hospital in 2017, he found kindred spirits in his mission to improve the patient experience while simultaneously reducing costs: Chang, who was then chief medical informatics officer, and Scott Arnold, executive vice president and chief information officer.
"We knew we needed to rebuild our healthcare system from the inside out," says Couris, "and we were not going to build ourselves—through brick and mortar—out of our problems. We had to change the way we think about our work."
Like other hospitals, Tampa General was generating a lot of data, but unable to turn it into useful real-time information. "As an industry, says Couris, "historically, we have not done a great job of taking that data and turning it into action."
In addition, the inability to view data across the organization was an issue, says Chang. Team members only knew what was happening in their direct areas of responsibility. "We wanted to get that situational awareness spread across the organization," says Chang.
To rectify this, "We came to the conclusion that we needed to leverage technology in a very different way," says Couris, who reached out to GE Healthcare Partners to help build a command center, which was dubbed CareComm.
SOLUTION: TECHNOLOGY FEATURING AI AND DATA ANALYTICS
The new 8,000-square-foot facility officially opened in August but had been operating on a more limited scale since last December. CareComm includes 38 wall-mounted LCD screens displaying live data, 32 workstations, multiple computer systems, and a multidisciplinary clinical team that includes doctors, nurses, and allied health professionals. Physical highlights include:
20 artificial intelligence apps, or “tiles,” from GE Healthcare that process hundreds of messages every minute, apply advanced analytics, and provide decision support for CareComm staff.Individual tiles monitor patient flow and track delays in care.
Four of the giant monitors feature touch screens so staff can easily manipulate information during huddles and meetings.
The same information displayed in the command center is available on computers throughout the hospital.
WHAT'S DIFFERENT: 'REAL-TIME INSIGHTS'
The hospital now has a 360-degree view of activity throughout the organization, says Couris, which includes information about each patient. It also identifies potential issues that could disrupt their experience. Caregivers, he says, have the ability to transform data into information and knowledge that enables team members to take real-time action to treat patients more expediently.
Before CareComm, Chang says he had to glean insights from retrospective reports and data while attempting to affect real-time management of patient care. "Now, [we have] real-time insights that we're able to give to our team members to empower them to make decisions at the point of care that results in higher quality, better patient flow, and, most importantly, a better experience for our patients."
Among the innovative processes spawned by the CareComm system are zero harm safety huddles. Tampa General's huddles involve clinicians, nurse managers, and department leaders who review "the state of the house" and the flow for the day. They examine "how we're moving patients across the organization to get them the best care," says Chang. They also address any barriers that exist to getting a discharge or diagnosis sooner in the patient's journey.
To further improve the patient experience and flow, Tampa General also has opened a departure lounge. Rather than holding up a hospital or emergency room bed while waiting for medications or rides, once patients are discharged, they are transported to the lounge. The area offers comfortable chairs, televisions, wi-fi, and free refreshments. The lounge is staffed by a patient care technician and a registered nurse who can support patients and make sure they understand their discharge instructions. While an individual might be there as long as nine hours, the average length of stay is 30 minutes.
"When you look at that eight- or nine-hour patient," says Chang, "that patient was medically ready to go home, but couldn't leave the hospital quite yet and was essentially occupying a bed that a patient in our post-procedural areas or our emergency department could use."
RESULTS: 'WE'VE TAKEN $10 MILLION OF INEFFICIENCY OUT OF OUR SYSTEM'
CareComm has accelerated patient's movements throughout the hospital, says Chang. In essence, it has compressed the time between when a patient enters the facility and sees a clinician to the moment they receive a diagnosis, treatment, or discharge. It's also elevated "situational awareness to the point where we're actively managing patients at the bedside—at the point of care," says Chang.
It's also elevated "situational awareness to the point where we're actively managing patients at the bedside—at the point of care," says Chang.
Even more, the hospital has concrete results to report. Since December, when CareComm went live on a limited basis, "we've taken $10 million of inefficiency out of our system, and we've lowered our length of stay by half a day," says Couris.
"We've brought in all sorts of innovations to make this work, "he continues. "We're doing more efficient, more effective care, and we're putting tools into the hands of our caregivers where and when they need them.
NEXT UP: 'WE HAVE TO DO BETTER WITH WHAT WE HAVE'
The hospital is in the process of devising solutions that will combine remote monitoring and sepsis protocols with artificial intelligence and predictive analytics and feed that information into CareComm to further improve care.
"It's not just about movement and flow through the hospital," says Chang. "It's about providing that highest-quality, world-class care to make sure that our patients are getting identified earlier in the disease process … and getting that patient on a specific pathway that we know is evidence-based and results in a decreased mortality and a better outcome and experience."
In addition, there are plans to use CareComm capabilities to proactively manage the entire system of care outside the walls of the hospital into ambulatory settings, the hospital's acute care enterprise, postacute care business, and its physician organization.
"That's how I believe we are going to fix healthcare—not by adding more buildings and more infrastructure," says Couris. "We have to do better with what we have. That's the journey we're on."