William Newton Hospital is a 25-bed critical access hospital in Kansas that serves patients in Winfield, Cowley County and neighboring regions. The nonprofit community general hospital is locally managed and financially self-sufficient, relying entirely on patient revenue and philanthropic support. It is not supported by local taxes and does not receive outside health system assistance.

THE PROBLEM

Things were quite hectic for the hospital, especially in 2020. It is not the typical critical access hospital. It has its own cardiologist and cath lab, an audiology clinic, a pediatric and podiatry clinic, internal medicine providers, and seven family care clinics.

It also has a working relationship with orthopedic surgeons that come in and perform surgeries. Further, the hospital delivers about 300 babies per year.

PROPOSAL

William Newton Hospital onboarded patient transfer technology vendor Motient in January 2021 amid the pandemic. Prior to Motient, it would take one RN off the frontline of patient care to make phone calls to find hospitals with available beds. The goal was to find a facility that might have a bed, and then find a physician to accept.

"There were times we would spend a total of 48 hours doing this, literally pulling nurse managers to make calls to find an accepting facility – it was awful," said Debbie Marrs, chief nursing officer. "Our team would start with the potential receiving facilities closest to WNH and work their way out.

"Now, we can quickly coordinate transfer and transport across greater distances, giving patients more and better options for care."

Debbie Marrs, William Newton Hospital

"It did not do our patients justice with these long delays in much-needed care that we were just not able to provide," she continued. "This hurt our patients and our community, being rural our patients wanted to stay here at home. This time-consuming process had a negative impact on patient care and contributed to the stress on our staff, which was already tremendous."

The implementation of the patient transfer technology freed up nurses who were stuck making these calls and allowed them to get back to their patients. All the nurses wanted to do was take the best care of their patients; this helped reduce some of the stress the nurses were feeling, Marrs reported.

"Motient showed us how implementing Mission Control would broaden WNH's patient transport reach, expedite patient transfers and improve inpatient care," she said. "As soon as our team receives a patient report from an emergency medical services agency, we would assess the acuity of the patient's condition in Mission Control.

"The vendor team then would handle the search for an appropriate bed placement and coordinate with hospital administrators to authorize and confirm transfer and transport," she continued. "If the WNH team requires additional expertise while patients are awaiting transfer, the vendor could quickly connect them with cardiology, neurology, pulmonology and other specialists for immediate telemedicine consultations."

Should the transfer distance be greater than 90 miles and the local EMS agency unable to take the patient because the trip would leave the community without ambulance care, Motient would work with multiple ambulance services and flight companies to identify the fastest, safest method of patient transport, whether it be ground, helicopter or fixed-wing aircraft.

MEETING THE CHALLENGE

"Multiple people on our staff use the technology, this list includes my nurse managers, my house supervisors and some ER staff," Marrs explained. "The process would start with staff filling out the online form describing what type of bed we needed for what type of patient.

"We installed a shortcut on the desktops in the ER so staffers in that unit could start the process if the house supervisor was tied up elsewhere," she added. "It's very user-friendly."

Staff made sure to set up the vendor's platform to start from the desired geographical area and then expand out from that. That way, staff do not keep repeating themselves, which is important if one is handing off making phone calls to another staff member and trying to keep track of what facilities have been called.

If staff cannot find beds, they can check in with the closer facilities six or eight hours later to see if things have changed, which often they do.

"Besides helping with bed placements, the best thing about the technology is the behind-the-scenes support," Marrs said. "A Motient account manager would check in periodically to see if we were having any issues that needed to be addressed. That was very nice. Most of the time there were none."

RESULTS

Implementing Mission Control was like gaining another team member, which was huge, Marrs reported.

"The system performs all the patient transfer-related administrative tasks that our physicians and RNs previously did," she said. "Now, we can quickly coordinate transfer and transport across greater distances, giving patients more and better options for care.

"We also found the acuity questions helpful," she continued. "There were times we wanted to include more information; in those cases, the clinical staff would just go into the chat box and add that information there."

William Newton Hospital has had 248 missions since Motient was onboarded in November 2020. In the beginning, staff used the service phone calls before official onboarding in the web portal in January 2021.

Data show the hospital's top uses are for patient transfers involving:

1. Respiratory

2. Dialysis

3. GI and septic

"Average acuity is about 11, typically ALS and critical care patients," Marrs said. "We have a six-bed ICU. At one point, we had 18 dialysis patients during the height of COVID. That was tough. We have a dialysis center on the northeast corner of our campus, but they wouldn't take dialysis patients if they had COVID.

"Now, we're working on trying to set up an agreement with them so we can take better care of our patients," she added.

ADVICE FOR OTHERS

"I talk all the time about this technology and the problems it solves," Marrs noted. "When you receive a phone call asking if we have a bed available and you can recognize it was a small facility, we will ask if they were aware of this technology and share it with them.

"We've lived through calling on our own and know what it's like," she concluded. "When there's help out there, why not use it? I would tell them not to hesitate."

Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication.