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Health First Rand Case Study


Using the Power of Data to Drive Efficiency at Health First.


Hospital care today makes up a significant portion of healthcare spending—around $750 billion annually. And while providing care is still the top priority, facilities are facing an array of pressures, including:

• A shift to bundled payments, which means providing better care at lower cost

• The rising costs of pharmaceuticals, supplies, medical technology and personnel

• Operational issues related to capacity management, especially emergency department overcrowding, diverting inbound ambulances and private providers sending elective admissions to other facilities

• An aging population, the growing prevalence of chronic diseases and expanded coverage with less generous reimbursements

The bottom line is that to thrive in this new environment, hospitals will need to operate more efficiently, while maintaining or improving the quality of care and patient outcomes. That’s what Health First, in Brevard County, FL achieved by using Lean thinking enabled by information technology support from TeleTracking.


  • The only not-for-profit, fully-integrated health system in central Florida
  • More than 8,000 employees distributed across four hospitals, a medical group, a health plan and a number of outpatient services
  • A combined total of over 900 beds across the four hospitals
  • The central flagship institution is Health First’s Holmes Regional Medical Center, a multispecialty hospital with 550 beds and a Level II Trauma Center. It also has three smaller community hospitals: Cape Canaveral, Palm Bay and Viera.
  • Holmes accepts transfers not only from in-system community hospitals but also from external facilities.
  • The payer mix is 60 percent public insurance (Medicare and Medicaid), with the remainder coming from private insurance.


  • Financial problems
  • Low-quality scores
  • Low patient satisfaction ratings

Under the guidance of president and chief executive officer Steven Johnson and chief operations officer James Stuart Mitchell, Health First charted a new course utilizing a three-pronged strategy that matched up with these three key challenges.

Both Johnson and Mitchell had come from health systems that had used Lean process improvement methodology and had seen firsthand the impact on overall efficiency. Their first action was hiring Bill Griffith, an expert in Lean and Six Sigma, as Health First’s executive director of operational excellence.

Griffith quickly identified patient flow processes as a key opportunity for improvement. Individual hospitals within the Health First system operated as separate units, often transferring patients outside the system. Within each of the four hospitals, nurses had to manually find and assign beds and were not always motivated to take new patients. Busy times, such as shift changes, resulted in bottlenecks—and prolonged wait times for inpatient beds for patients admitted from the emergency department. And when there was a lack of clean beds and delays in patient flow, Health First sometimes lost transfers to external hospitals outside its system, negatively impacting financials.

It was also difficult to pinpoint inefficiencies because operational performance data was not attainable and most metrics had to be pulled manually.

Learn more about the Key Success Factors that drove Key Patient Flow Outcomes for Health First. 


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Centralized Patient Logistics Center: A Nurse's Perspective

Health First: Patient Flow Podcast

Listen Time | 8:50

Lisa Maples, Director of Centralized Patient Logistics at Health First joins us on this episode of the Patient Flow Podcast to discuss how patient flow technology, best practices and process improvement plays a critical role in improving hospital operations.  

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More information about this resource

Hospital Command Center, Enterprise Analytics, Client Success
Media Type
Client Success
Clinician, Executive, Operations

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