Before its new command center came online, Augusta University Health (AU Health) didn’t have a way to track capacity, nursing resources or collaborate on operations.
That left patients and staff frustrated.
“The flow was around people, not processes,” said VP and CNO Laura Brower, MSN, RN. “There were times patients were held in the emergency department for two to three days and would be discharged without being assigned an inpatient bed.”
To solve these challenges, AU Health implemented CareAware Patient Flow®, which manages capacity, and Clairvia®, to manage their workforce.
AU Health worked with the Cerner ITWorks team (the Jaguar Collaborative), and DeviceWorks team to guide and create their centralized command center.
Combined, these changes helped the 632-bed organization save millions of dollars and reduce the number of hours it couldn’t admit patients because of poor interdisciplinary communication, insufficient beds and delayed discharges.
The project began in December 2015, when AU Health implemented CareAware Patient Flow, which integrates information about bed management, environmental services and transport functions.
Soon after, in February 2016, the new centralized command center began operations. The design of the new operational headquarters includes wall-mounted monitors to help staff visualize patient throughput and staffing.
The new centralized command center helps nursing supervisors, bed management and individual units work together to track patients’ needs.
“We can now see where our issues are very clearly,” said Billy Cleveland, capacity manager. “We can see what is coming in and how to deploy resources based on what to expect.”
The implementation of Clairvia in August 2016 further streamlined the process by helping nurse leaders get the right staff to the right patient at the right time.
CareAware Patient Flow and Clairvia, along with the new command center, helped AU Health save $3.37 million from December 2015 to June 2016 from reduced average length of stay, management observation cases, management bedded cases and conversions. Hospital staff can now correctly classify and place patients, ensuring the organization receives proper reimbursement.
The organization used CareAware Patient Flow and Clairvia to save $3.37 million in several ways, including decreasing the time patients stayed in the hospital. The improved communication decreased the time needed to get patients in a bed and ready for discharge. The average inpatient length of stay dropped from 6.11 days (from July to November 2015) to 5.86 days in 2016 (July to November.)
Additionally, from January through July 2016, AU Health spent an average of more than 500 hours “in diversion” each month. This means AU Health could not admit patients, many of whom come from surrounding rural areas in need of specialized care.
After implementation of the command center, CareAware Patient Flow, and Clairvia, AU Health experienced a significant drop in diversion hours. By January 2017, pediatric cases spent two months in a row with zero hours of diversion.
“The central hub helps to see the big pictures and accomplish what you need to do better,” said Cleveland.
Using the data, AU Health staff decided to add 15 new beds to the hospital last year and plans to add 23 new beds in 2017.
In the future AU Health leaders plan to hire registered nurses to staff a new transfer center inside its command center. The transfer center will further streamline movement of patients to AU Health from other hospitals.