Earlier this month, hospital executives from around the country gathered in Boston to discuss how Operational Command Centers are improving access— and generating revenue— by streamlining patient care delivery. Melanie Morris, senior director, Carilion Clinic Transfer & Communications Center (CTaC) was one of the speakers, sharing her transfer center development and implementation journey. Melanie’s work was also recently featured in a peer-reviewed article in Nursing Administration Quarterly.
Melanie took the time to share some of her insights:
Q. The Carilion Clinic Transfer & Communications Center has been recognized for its best practices. Please explain the process you and your team went through in designing your center that has made it so successful.
A. It was only a few years ago that Carilion decided it needed to reevaluate how transfers came into the system—quite simply there were too many competing priorities contributing to system inefficiencies.
The main goal—now, as well as during planning and implementation—is helping ensure patients get the right care, at the right time, in the right place. The initial decision was made to move the transfer center under the emergency services wing of the hospital—bringing an EMS mind set to the planning process, including establishing clear protocols and consistent processes.
Building out the work flows were just the first step. Next, the physical space had to be designed and staffing determined—the team decided that it simplified things to put EMS dispatch and transfer center nurses in the same room. The team also needed dispatchers to get the discharges out and the new patients in a bed—so processes were established that allowed for better prioritization and a more natural progression through the system. In fact, the successful processes established at the control center have been integrated into emergency operations and disaster management logistical planning at the local and regional level.
Q. This was a big change for everyone involved. What did you do to engage employees?
A. The physical space facilitates a highly collaborative work environment to state-of-the-art technology that includes an electronic throughput and software system that provides real-time capacity updates.
The team also worked closely with everyone on training and making sure they were comfortable and compliant with the software systems. A strong synergy was established in the department with both the EMS and nursing staffs feeling like they were part of the bigger picture and that the entire health system was operating as a cohesive unit.
Q. Please describe how this engagement led to concrete results.
A. With the new system that was simplified and centralized, people knew what to expect and how to facilitate things so that the right patients were sent to the right facility—whether it was Carilion’s main facility or one of the six community sites. The result was a 40% increase in transfer admissions to the secondary campus.
Other results include positive feedback from physicians who love having a nurse facilitating every transfer, as well as the data that’s now available to them. And with all of this data, bed assignments can be better prioritized to make sure patients get to where they need to be. The overarching goal is to make things as seamless and full service as possible. When someone gets off a transfer call, there shouldn’t be any unanswered questions. At the end of the day it’s about helping providers so they can help their patients.
Q. What are your next steps – what is on the horizon to further enhance your operating model?
A. We are consistently looking for ways to further refine the transfer center processes and make things even better for patients. Recently, we added a clinical transporter dispatcher and an EVS (environmental services) dispatcher to the transfer center. We are also working on integrating the hospital interpreters into TeleTracking’s ServiceTracking™ application. Finally we’re looking at how to better utilize and integrate case management/social work, and establish greater integration with emergency disaster procedures.
To download a copy of the Carilion Clinic Case Study, click here.
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