Since 2010, team members at The University of Tennessee Medical Center have been on a mission to identify and eliminate wasteful processes while reducing and reprioritizing redundant full-time equivalent (FTE) hours. After nearly a decade of work focused on improving efficiency, leaders at the Knoxville, Tennessee-based medical center took their efforts a step further by implementing CareAware Capacity Management® solutions. Collectively, the solutions provide team members with situational awareness to identify and address patient flow bottlenecks by pairing enterprise dashboards with automated bed management.
"When this project began, we built on our existing partnership with Cerner to ensure we implemented the model approach. This required both parties equally to contribute thoughts and ideas," said Devin Fladd, process engineering manager.
The implementation included CareAware Patient Flow™, CareAware Care View™, CareAware Transfer CenterSM and Command Center Dashboard.
Leaders set the go-live date for Dec. 1, 2020 - and they didn't know this would be the same day The University of Tennessee Medical Center would experience a COVID-19 surge.
"CareAware Capacity Management allowed us to decentralize physically and still maintain a coordinated digital presence," Fladd said. "CareAware CareView and CareAware Patient Flow enabled us to use and see COVID attributes, so not only did the floor clinicians look at their CareView board and know which patients were positive and which were pending, but radiology, environmental services (EVS), patient transport and other team members knew patients' status, in the moment."
Having near real-time information helped teams at The University of Tennessee Medical Center make critical patient flow decisions at any time of day, to maintain bed availability for their community. "Sometimes we were working on flow, making literally hour-by-hour decisions for ICU patients until 11 p.m. or midnight, because we have the domino effect if this ICU patient goes to this acute care bed, so the next patient can go to the ICU bed," said Lindsey Jennings, director, operations center.
After redesigning and automating patient throughput processes in Capacity Management, The University of Tennessee Medical Center logistics center experienced a 51% reduction of hours worked.1 This included a drop from 116 to 56 hours per day.
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.
"It took some time to perfect but optimizing the proximity build with our knowledge leader enabled us to achieve the results we have experienced," said Fladd.
The University of Tennessee Medical Center staff, through process redesign and new technology, were able to reallocate hours to more appropriate areas by reducing redundancies.
"Prior to implementation, transport and EVS were dispatched from manual lists. A phone call was required to request transport, and often that phone line was busy. Capacity Management created a self-service model that reduces waste on requesting services," said Fladd.
"CareAware Patient Flow is the best solution to address our needs. It helped us realize more than half the time and manual effort we previously spent on patient flow wasn't necessary. Now we can shift some of those hours to higher-value work."
In addition to addressing patient flow, The University of Tennessee Medical Center was able to leverage CareAware Transfer Center to help coordinate admission requests from other venues of care. Previously, they documented denials on a paper and now CareAware Transfer Center allows them to capture data that couldn't be captured in the past.
"We went from paper to electronic, which has helped us manage our reporting process much easier. Now everyone can work cases in the same way," said Fladd.
Overall, Command Center Dashboard and Real-Time-Health System are helping to improve processes.
"We are starting to evolve. We have adopted technology and designed our processes around it," said Fladd. "This is part of our culture and the expectation for senior leadership team."
1Comparing 116 FTE hours per day from Jan. 1, 2020 to Dec. 1, 2020 to 56 FTE hours per day from Dec. l, 2020 to present