Rising From Patient Transfer Center to Multifaceted Driver of Organizational Success

  Based in Newport News, VA, Riverside Health System is a nonprofit organization serving a large portion of eastern Virginia. The system consists of Riverside Regional Medical Center and five other acute care hospitals, along with more than 300 physician practices, four cancer centers, three surgery centers, nine skilled nursing facilities, home care services, and a number of other establishments. Linking all of these entities and extending the health system’s services to many outside organizations is the aptly named Riverside Connected Care Center. One phone call to the center sets in motion a well-orchestrated array of services, focused on coordinating all logistics for admission to Riverside Health System facilities. Over the years, the center has added many other services that deliver value to patients, providers, and Riverside Health System as a whole. Challenges and Opportunities Setting the stage for growth and success With the launch of a patient transfer center several years ago, Riverside’s leadership recognized the need to adopt new protocols, processes and technologies — especially with the anticipated surge in call and patient volumes, as well as expansion of the Connected Care Center’s service lines. As is the case in medical centers nationwide, budgetary restraints precluded large-scale hiring commensurate with the additional workload. Consequently, the transfer center needed to adopt new, more efficient protocols and processes, carried out by a team of high-caliber professionals. On the technology side, one of the biggest gaps was the lack of advanced reporting capabilities — and reports are critical for larger health systems like Riverside, says Melody Livengood, MSN, RN, Riverside Health System Director Connected Care Center. Data from these reports, she explains, provide decision-makers with vital financial metrics, including the impacts of patients transferring into and out of the system. “Preventing leakage is huge for health systems right now, especially for a highly diversified organization like ours. From a patient perspective, it’s also important to ensure continuity of care across all settings…for patients to feel like everyone knows them.” Early on, Riverside tried to reconfigure its existing clinical decision-support software for transfer center operations. But it required too much free-text data entry, and this was a major barrier to timely, efficient reporting, according to Livengood. “It simply didn’t meet the needs of a busy transfer center.” The Response and the Rewards Overall growth of 342% in 10 years Riverside Health System embarked on a transformation of its patient transfer center, encompassing operations, staffing and IT infrastructure. More than 10 years later, the results of this ambitious multifaceted initiative speak volumes:

• Over a seven-year time span, transfer center staff handled a 106% increase in inbound and outbound calls.
• Over the same time period, the transfer center arranged 300% more patient transports.
• The transfer center achieved 342% growth in overall dispositions in 10 years; this includes fulfillment of bed requests, ED evaluations, and consults.

Equally impressive is how much responsibility has been delegated to the Riverside Connected Care Center over the years. The center’s core message has long been: “We find the doctor. We find the bed. We find the ride.” Its scope has steadily expanded and now includes more than two dozen services, from patient transports and bed placements to patient monitoring, post-acute discharge calls, and much more. Riverside Health System has become a shining star in the world of patient transfer centers. “We are known nationwide for our transfer center processes and have been visited by many health systems over the years, so others can learn what we do, how we do it, and the impact it’s had on the regions we serve,” says Livengood. “Our doors are always open to other health systems.” The Story Behind the Success Skilled people and carefully formulated processes At the heart of this success is a dedicated and skilled group of people, supported by carefully formulated processes and leading-edge technology. Nothing is left to chance. For example, all staff are cross-trained to handle the broad range of calls coming into the center, ensuring timely and efficient responses. Securing physician buy-in has been another cornerstone in the center’s success. “In the beginning, it was a very hard sell,” admits Livengood. “But then the physicians started asking for changes, which we were able to accommodate. Today we are regularly given compliments, and many physicians refer to us as ‘my transfer center.’” Neurosurgeon Dean B. Kostov, MD, is one of those enthusiastic fans. “I usually refer to the transfer center as ‘the magic workers.’ It’s a one-stop shop where a medical professional will listen to what you need, facilitate consultations, arrange the transfer, and help us do the right thing for the patient.” Technological Support Enabling prompt responses and informed decisions Technology has played a pivotal role in the transformation and the ongoing smooth functioning of the Connected Care Center’s transfer center operations, according to Livengood and her team. They rave specifically about the Central Logic Transfer Center® technology in place — how it supports the fast, efficient coordination of services and informed decision-making at multiple levels. To illustrate, Livengood describes a recent day when two heart attack patients and one stroke patient presented at the same time in the health system’s emergency rooms. “Simultaneously, we had three nurses working on behalf of all of those patients. We had medical services coordinators launching helicopters. And we had the bed management nurse sitting right there with them finding critical care beds for those patients. Everything happened very quickly. If you go back and look at our documentation, it paints a very clear, time-stamped picture of exactly what happened.” From these detailed records, the Connected Care Center team captures a treasure trove of valuable information. “We hold monthly meetings where we look at how we can make improvements,” says Nurse Manager Connie Brooks, RN, BSN. “This is very important not only to our financial well-being, but from a patient safety perspective.” Besides supporting patient retention and quality of care, intelligence generated by the system helps with recruiting, according to Livengood. “For example, if one of our rural hospitals starts to see an influx of neurology patients, we can provide the data to justify recruiting providers in that area.” Lastly, Livengood contends that the Connected Care Center’s growth can be traced in large part to the high-quality information available to the health system’s leadership team. “It clearly shows where there’s opportunity,” she says.  “Without the reports we can generate with Central Logic, it would be difficult to understand what’s coming into or going out of our facilities.” Executive Summary More than 10 years ago, the leadership at Riverside Health System sought a way to transfer patients more efficiently and with greater predictability. This objective unquestionably fulfilled, the Riverside Connected Care Center has steadily become a strategic player in the organization’s growth, driving overall success. Supported by Central Logic Transfer Center®, Riverside has documented many key outcomes, including: Outcomes for Riverside Health System

• 106% increase in inbound and outbound transfer center calls over seven-year time span
• 300% more patient transports arranged over the same time period
• 342% growth in overall transfer center dispositions in 10 years
• Faster, more efficient coordination of services with limited resources
• Reduced leakage of patients and revenues to other health systems
• Visibility to vital metrics that reveal new opportunities for growth and operational efficiency
• Intelligence that drives informed and timely provider recruiting

Outcomes for patients and physicians

• Enhanced continuity of care for patients across all settings
• Clear, time-stamped documentation of events, enabling staff to improve patient safety
• One convenient point of contact for more than two dozen services
• Praise from physicians, who refer to the transfer center as their “one-stop shop”

Thanks to these outcomes, and many others, health systems across the country view Riverside’s transfer center as a model to emulate.