Finding the balance between capacity and demand is tough in any healthcare environment. Hospitals and health systems continue to face challenges with workforce management, patient flow, and real-time knowledge and understanding of the unique situations they face every day, especially in crowded emergency departments.

THE PROBLEM

The University of Tennessee Medical Center in Knoxville had been working to improve its operational efficiency for nearly a decade – since 2010 – to solve for bottlenecks in patient flow.

"Through many years of improvement, we were at a point where we needed new technology to get us to the next level," said Devin Fladd, process engineering manager at The University of Tennessee Medical Center. "Oracle Cerner's capacity management tools furthered our efforts to solve these issues by pairing enterprise dashboards with automated bed management."

PROPOSAL

The Oracle Cerner tools provide visibility and transparency to throughput operations.

"It has enabled us to enhance productivity and capture data that we can use to continually improve our operations," Fladd explained. "The decision to implement a centralized clinical operations center like Cerner Command Center and CareAware Patient Flow proved vital to our ability to serve our community across East Tennessee.

"With the competitiveness in the healthcare market today, we must look at how to better use technology to automate human processes, because we know there's a huge demand for people and not a huge supply," he continued. "Oracle Cerner offered us the best solution to address our needs, and we were able to build upon our existing partnership to ensure we implemented the best approach."

MEETING THE CHALLENGE

The University of Tennessee Medical Center set a go-live date for December 2020, which wound up being around the same time it got hit with a COVID-19 surge.

"CareAware CareView and Patient Flow enable us to use and see COVID-19 attributes," Fladd noted. "Floor clinicians were able to see their CareView boards and know which patients were positive and which were pending; and radiology, environmental services, patient transport and other team members knew patients' status at the moment.

"Prior to implementation, transport and EVS were dispatched from manual lists," he continued. "A phone call was required to request transport. Oftentimes, the line was busy. We wouldn't have been able to sustain that way."

The Cerner Command Center gave the provider organization new capabilities to manage crowding in the ED, patient flow and staffing issues to help relieve pressure on clinical and non-clinical team members and ensure timely access to care for patients.

RESULTS

After redesigning and automating patient throughput processes in Capacity Management, the provider organization experienced a 51% reduction in full-time equivalent, or FTE, daily hours worked in the logistics center. This included a drop from 116 to 56 hours per day.

"We have automated our entire room turnover process," Fladd reported. "In the past, we would have to wait for nursing to discharge the patient to trigger housekeeping. For years, it was a manual process. Capacity Management's proximity- and rule-driven dispatching algorithm helps the logistics center dispatch team members – transport and EVS – effectively and efficiently based on the prioritized needs of the health system.

"We are evolving," he added. "Now that we've adopted the technology and built systems around it, it has become part of our culture and an expectation for senior leadership. By using the same system for capacity management, we have standardized the data structure, which helps us use data to guide us to future needs."

Staff members have shifted from a practice of looking at what happened yesterday to looking forward to what is going to happen next. The technology has helped them become more proactive in bed management than they had ever been before.

ADVICE FOR OTHERS

"Healthcare organizations know the importance of providing timely patient care," Fladd said. "The ability to do so relies heavily on the secure and timely flow of information and being able to optimize that to make the right decisions at the right time.

"Having access to a real-time health system is not just essential to managing the most up-to-date patient data; it also supports workflow and staff challenges," he concluded. "Healthcare is an industry of innovation and best practice. When serving our community, we must always look at what we are doing and how we can make it better. Technology is only as good as the processes that support it."