The state of hospitals and health system readiness for future disasters remains uncertain even following a pandemic. Healthcare facilities that have pulled through COVID-19 and their own localized disasters, natural or otherwise, with crisis plans in place still had major challenges due to “capacity blindness.” Capacity blindness can be overcome with centralized capacity management technology that gives healthcare organizations a real-time view from all angles of an unfolding crisis, including how it will impact their operations, staffing, and ability to deliver patient care. This blog looks at:
One of the biggest vulnerabilities exposed by the COVID-19 pandemic was the near total lack of visibility into patient capacity thresholds and constraints across facilities. The level of that visibility often was the difference between an organization experiencing deep and lingering impacts –or- being able to manage effectively while navigating through the most significant public health crisis in the nation’s history. Additionally, healthcare facilities that had or adopted an operational platform to streamline efficiencies in the years prior to the pandemic based on such approaches as High-Reliability Organization (HRO) principles were far better prepared for disasters.
However, not having an advanced across-the-board view of capacity left many healthcare institutions making “blind” decisions about where to place the influx of COVID-19 patients -- whether that be within their own facilities or outside their networks. It also hampered their ability to quickly redeploy resources, such as equipment and care teams, as well as effectively coordinate and communicate with government disaster response and health agencies needing real-time pandemic-related data to plan next steps.
Before healthcare organizations put to bed their final pandemic post-mortem impact analysis reports --- especially their “lessons-learned” revised disaster preparedness plans -- their most urgent priority should be how to solve and remediate their capacity blindness problem. A key first step should be analyzing the inadequacies and deficiencies of their current methods, processes, and approach to capacity visibility so they can create a better system for capacity management and become truly disaster-ready organizations to effectively navigate future public health or other disaster-related crises. Following this, organizations need to identify technology options that can ensure that capacity blindness never again becomes an issue for effectively handling disaster-related surges in patient volumes.
One institution that was better prepared than most to manage through the COVID-19 public health crisis was University Medical Center of El Paso, Texas (UMC of El Paso), largely because years prior, the hospital trauma center had incorporated and deployed a centralized Operational Command Center powered by TeleTracking’s Capacity Management Suite® solution. This capacity management technology gave UMC of EL Paso a clear line of sight into patient flow throughout their facility, from the ED to admissions –to- internal placement changes to discharge. The new efficiencies and outcomes that UMC of El Paso achieved transformed their patient throughput processes and enabled the hospital to maximize internal operational readiness to meet future patient treatment and care challenges. As a result, the capacity management technology transformed patient throughput processes at UMC of El Paso. It also became the foundation for mobilizing through a crisis the hospital would first experience in August 2019 and the cornerstone for their disaster preparedness operational planning going forward.
The COVID-19 pandemic wasn’t the first crisis that UMC of El Paso had experienced. Less than two years before the pandemic began, a mass casualty shooting event in August 2019 at a local Walmart produced a fast influx of trauma patients into the hospital, including patients transferred from other hospitals. Fortunately, UMC of El Paso’s senior leadership team had a well-developed disaster readiness program and infrastructure, which included an Emergency Preparedness Committee their Director of Safety oversaw. The hospital regularly conducted training exercises for several crisis scenarios with other local hospitals, law enforcement officials, and universities, and fortunately had conducted one specifically for an active shooter scenario just five months before the August incident.
The integration of a Hospital Incident Command Center, which was an extension of their Operational Command Center powered by TeleTracking’s Capacity Management Suite® solution, was integral to the effectiveness of UMC of El Paso’s disaster readiness program. The technology’s data analytics capabilities, coupled with simulated drills, helped the hospital understand what changes needed to be made to their policies for addressing active threats. They’ve also learned the best ways to activate and use their emergency management system, identified resources needed vs. those actually available during an active threat, determined training and emergency management needs, and provided senior leadership with input on active threat training/planning needs.
In fact, the Capacity Management Suite driven integrated Operational/Hospital Incident Command Center, which formed the core of a web-based Emergency Operations Command Center Network, optimized UMC of El Paso’s disaster preparedness and simulation drills program and enabled the hospital to run normally during the active shooting crisis.
UMC of El Paso avoided diversion of patients and EMS/ambulance traffic to other hospitals and were able to triage all incoming patients in their ED. Additional care team resources, who voluntarily reported to assist with the crisis, were efficiently deployed and moved throughout the hospital as needed. These included phlebotomists teaming with the blood bank to keep up with high blood transfusion demand for critically injured patients, and Environmental Services team members efficiently turning over beds and preparing rooms for the next injured patient. For UMC of El Paso, the benefits of physically co-locating the Hospital Incident Command Center with the Operational Command Center powered by Capacity Management Suite enabled enhanced real-time efficiencies for the two to work in tandem, feeding information to each other regarding bed availability and status, pending and confirmed discharges, and dispatched EVS and transportation as needed throughout the crisis.
When the shooting crisis began, one administrator on duty at UMC of El Paso said that TeleTracking’s Capacity Management technology “was an excellent tool for communication and enabling us to identify projected discharges and moving shooting victim patients into beds. The technology also guided us in directing the charge nurses where to go and keeping everyone up to date on what was going on with the event and where they were needed.”
Next came the COVID-19 pandemic for UMC of El Paso. In the early months of the outbreak, the team there knew they were ready for just about anything. Custom reports utilizing TeleTracking’s SynapseIQ® Enterprise analytics solution were created for leadership to track the volume of patients and those testing positive or negative for COVID-19 in real-time, and read-only views were shared with pharmacy, respiratory, and food service for increased visibility—and to maintain staff safety. The technology also enabled the trauma center’s engineering department to expand the number of negative pressure rooms by placing exhaust fans in windows for infected patients. Post-pandemic analyses are still being formulated by UMC of El Paso, but having experience already with TeleTracking’s solutions made a significant difference in establishing patient capacity needs for tackling a larger scale disaster.
While the COVID-19 pandemic was a category of disaster that no hospital or health system had experienced in more than a century, healthcare institutions have been through numerous local “smaller scale” crises over the decades that nonetheless had major impacts on operational and patient care operations and forced them to develop formalized disaster preparedness and exercise drill planning programs. Yet, even as healthcare facilities started adopting these programs to help them navigate through various crises – whether they were weather-related, man-made violent incidents, or other health-related outbreaks – their effectiveness and outcomes were often based on hampered decision making due to limited visibility into their patient capacity and flow.
Today, the availability of robust, purpose-built capacity management solutions, that enable hospitals and health systems to have an “always-on” 24/7 view of their patient movement and flow across their facilities in virtual centralized command center operational hubs, radically changes the game for disaster readiness. The benefits of centralized capacity management technology during a disaster include:
The next disaster facing the healthcare community unfortunately may just be around the corner, affecting facilities across the country and/or around the world like the COVID-19 pandemic, or just impacting a specific geographic area. Expectations that facilities will have optimized bed management, patient flow, and placement processes in place that support faster, more informed decision making as a crisis unfolds based on learnings from previous disasters and the implementation of well-honed disaster simulation exercises will be high. Unfortunately, without centralized capacity management and patient flow monitoring technology driving these learnings and updated disaster readiness programs, having confidence in managing best outcomes from the next disaster will still be guesswork for healthcare providers.
Combined with Capacity Management Suite technology, key considerations healthcare facilities should always have top of mind for successfully navigating through a disaster should include: