Case Study: 22% Increase In Emergency Medicine Physician Productivity
Central Logic Transfer Center™ Application Transforms the Patient Flow Process at a High-Volume Medical Center*
Emergency physician productivity, market share, and data management at the flagship facility of a regional medical system are enhanced through implementation of an industry-leading transfer center solution
This healthcare facility, located on the east coast, serves diverse communities throughout the region. The facility has grown under community direction from a five-bed general hospital to a comprehensive medical center with approximately 500 beds. A medical staff of several hundred physicians at this center provides three-quarters of the primary care, specialty, and intensive hospital services to nearly two-thirds of the state. The medical facility is owned and operated by a regional healthcare system that consists of well-respected, area hospitals and other medical facilities that offer access to high-quality healthcare. This medical center is one of the largest employers in the area with over 5,000 medical professionals on staff and $1 billion in annual revenue.
In this rapidly expanding, regional healthcare organization, the creation of new service lines and the addition of new operations annually have resulted in handling more inbound and outbound patient transfers. As a result, much of the administrative burden of processing transfers became the responsibility of the hospital emergency staff. The emergency physicians and nurses were spending too much time handling administrative details and not enough time delivering high-quality patient care.
In addition to negatively impacting productivity and customer service, the procedures for handling patient transfers did not include any process for detailed measurement and reporting. The lack of this process made it difficult for management to isolate the exact locations where quality controls, procedural improvements, and better alignment with other departments were most needed. The staff acknowledged that they could efficiently handle greater numbers of patient transfers if an improved system was put in place.
In early 2009, the senior management of the healthcare organization began seriously evaluating the concept of a patient transfer center as a comprehensive solution to these pressing issues. The hospital management team had been monitoring closely the set-up and successes of transfer centers nationwide since 2003.
The hospital president and CEO knew that much preparation was required before the organization could move forward with the establishment of a patient transfer center. The CEO also knew that the challenges needed to be addressed quickly to avoid further impact on patient care quality and employee productivity. In an effort to quickly employ research, a registered nurse and a senior hospital administrator were asked to jointly research patient transfer centers and provide strategic recommendations about the potential of establishing a patient transfer center at this facility. The nurse and the administrator (the Team) were trusted employees, known to be thorough, analytical, and exceptional performers under pressure. The CEO considered these characteristics essential for this project.
After extensive research, the team prepared a business plan to present to hospital leadership. As part of their research, patient transfer center directors at 10 different medical facilities across the country were interviewed to discuss the strategies, protocols, and best practices implemented in their respective operations. The team learned from these discussions that the success of the patient transfer center would depend on the processes and procedures adopted just as much as it would on the physical operations management. After evaluating many best practices, the team moved forward to create process-oriented business plans for their management team.
Because of the scope of patient transfer issues at this medical center, the team focused their research on three main areas:
- What are the best ways to physically handle patient transfers?
- Which members of the staff should manage specific elements of an inbound or outbound transfer?
- What is the ideal ratio of registered nurses to administrative personnel within the patient transfer center? How critical is the need for and frequency of reporting metrics to senior management?
- What role should technology (i.e., hardware, software, and peripherals) play in the day-to-day operations and management of the center?
- How should follow-up with physicians and medical specialists be orchestrated throughout the medical center?
- How should the patient transfer center be aligned with existing bed management and registration systems in the hospital?
- How can the hospital staff deal with unscheduled spikes in patient volume (i.e., sudden increases in unscheduled transfers, such as the need to accommodate critical-care patients immediately following a major catastrophe or natural disaster) more effectively?
Documentation and Data Management
- How can transmission and receipt of confidential patient information be managed, organized, and archived?
- Does the organization need a technology-based system to assist the center in this regard?
- Can the volume of information be reduced to rapidly provide physicians with relevant data?
- Does the medical center require dedicated patient transfer software? If so, can the IT department develop a proprietary application, or should an external provider be identified?
- Should this application be compatible with other applications, including hospital bed management and registration? How long will it take to install this type of software?
- What is a reasonable cost for purchasing and maintaining third-party software?
- Are training and ease of use important considerations?
- How should the organization measure return of investment on these purchases?
After addressing these specific research areas, the team felt they could move forward to create a world-class patient transfer center. The next step was to identify a well-designed, cost-effective, software application that would meet the needs and anticipated growth of the medical center.
During their research, the team was introduced to Central Logic and the company’s flagship solution, Central Logic Transfer Center, a Web-based software application. Transfer Center is designed to streamline the transfer of patients between medical facilities, as well as securely capture and deliver critical transfer information to physicians and hospital administrative personnel.
Central Logic was contacted for additional information, and after an in-depth demonstration of the Transfer Center software, the medical center selected the product to power the patient transfer center. The new operation officially opened in Q4 of 2009.
During the first 10 months following the activation of Central Logic Transfer Center, the medical center saw considerable improvements in the speed and efficiency of the patient flow process within the facility. Much of the progress can be attributed to the capability of Transfer Center to assist with the creation of standardized, structured processes to guide the formal handling of patient transfers. In addition, the new patient transfer center now had the ability to analyze and provide high-quality data to various departments within the hospital. Under the direction of two project leaders, the Transfer Center application them to identify areas for improvement within the transfer pipeline that can improve operational efficiencies.
When describing the performance of the Transfer Center software, the registered nurse remarked that the product was “impressive” and “user-friendly.” The nurse’s patient transfer center uses Transfer Center for its solid data, documentation, and reporting capabilities.
The two patient transfer center managers reported that feedback for the new center from referring providers, doctors, and hospital senior management, has been positive. The hospital attributes this favorable input to efficiency enhancements within the emergency department, including a 22% increase in productivity among its emergency medicine physicians. With the addition of Transfer Center, the patient transfer center staff is now able to provide relevant, concise documentation for each patient, and update records effortlessly in real time with important data.
The senior hospital administrator noticed that the use of Central Logic Transfer Center allowed their patient transfer center to become a comprehensive, information resource that provides flexibility and visibility into the entire transfer process. These benefits add value throughout the organization and translate into better patient care and service across the board.
The new patient transfer center in the hospital is now closely aligned with its management and telemedicine resources. This improvement in efficiency has allowed the medical staff to admit more patients in less time, and provide high-quality medical care and service, especially to critical patients. The patient transfer center team also uses the Transfer Center application to track market share and precisely pinpoint transfer origins to deliver better service and patient care. The patient transfer center team is able to identify medical organizations that do not currently send patients through this organization. This important information enables the management team to determine why this is happening. Without Transfer Center, this information would not be accessible to them.
Because of the installation of Central Logic Transfer Center software, the patient transfer center staff is now able to produce and deliver a wide range of detailed, easy-to-understand reports for all management to use.. The patient transfer center staff appreciates the reporting capabilities of the Transfer Center application and calls these assets, “outstanding.” The installation of Transfer Center in the patient transfer center has allowed medical center management to identify areas for improvement and continues to enhance patient transfer processes.
*The data, quotes and summary detailed here are true and based on a real set of activities and events, however the name of the facility has been removed at request of the medical center.