Entry 3: Simplifying workflows to improve patient transfers

There was a time when Penn State Milton S. Hershey Medical Center, located in Hershey, PA, had difficulty accepting new patients, especially those coming from referrals. When Director of Patient Logistics at Hershey, Heather Boyle, recalls the issue, she is frank and to the point.

“The referring hospitals were unhappy with how difficult it was to get patients into Penn State Hershey,” she says. “The process was very decentralized, and even though calls were coming in to one number, the person taking those calls had to coordinate the acceptance of a patient through many places.”

During our conversation, Boyle went on to detail the old process, which sounded arduous and time consuming. In short, a nurse had to make several calls before being able to give a simple ‘yes’ to another organization about Hershey’s ability to accept a patient. And worse yet, because so many individuals were involved in the process, the inability to get the correct person on the phone sometimes resulted in the patient being turned down, even though a bed was open and available.

After calling in consultants to examine their workflow, data revealed what clinicians at referring organizations already knew – the Hershey Medical Center admissions process could use some improvements to meet the high standards of the teaching hospital. Beds were too often left empty, and patients were stuck waiting unnecessarily. Hershey was simply not operating at maximum capacity, and consultants believed a simple workflow change could solve the problem and improve efficiency.

Armed with numbers and specific recommendations from the consulting firm, funding came through to establish a Patient Logistics Department and a new Transfer Center to handle referral admissions.

Hershey Medical Center Campus
Bringing in the right software

Powering this new center is the appropriately named TransferCenter software from TeleTracking, which Boyle says was selected in part because of Hershey’s relationship with the company, which dates back to pre-2008. Further, the workflow changes promised by the software met the recommendations of the consulting firm by allowing for a streamlined, simpler admission process, thanks to patient flow monitoring capabilities.

Whereas the original process was decentralized and involved the person on the phone contacting several others to complete a successful admission, the new TransferCenter system is cleaner, in part simply because the R.N. who actually receives the transfer request is able to coordinate everything from their computer screen through the TeleTracking system. Without even leaving the line, the nurse can bring an attending physician into a call for some basic questions, assign a bed, and coordinate all necessary transportation.

“It’s all done through one central person, and they can do everything really quickly,” says Boyle, detailing features of the TransferCenter software that allow the user to view a patient’s admission order and track details such as what time it came through, which bed is for which patient, and how each patient has moved through the health system as they’ve received care.

Despite a necessary period to habituate staff and familiarize clinicians with the new workflow, Boyle, who says her job is to monitor the hospital’s capacity and workflow procedures, says the Transfer Center and the Patient Logistics Department met their goal of increasing referral rates “very, very quickly.” After only a few months, the hospital was able to improve its number of transfers from an average of 11 per day to almost 13.

Heather Boyle, Director of Patient Logistics, Penn State Milton S. Hershey Medical Center

“We were able to increase the number of transfers from outside the hospital per day within the first six months,” she says. “Just by nature of having the centralization and the software to visualize what we’re doing, we increased the number of transfers right away.”

Still moving forward

Sitting now just shy of three years after the initial launch of the Patient Logisitics Department and the adoption of the TransferCenter solution, Boyle says Hershey has sustained all of its initial growth and operates at full capacity. While she admits they haven’t grown their number of transfers further, that’s only because “there’s simply not a lot of room to increase further. We’ve sustained our improved referral rates without adding any beds.”

Future business studies are currently being drafted to implement TeleTracking’s Orchestrate application to improve operating room workflow, and RTLS technology to better monitor equipment and the movement of patients. Boyle says she hopes to implement these solutions to allow more patients to receive timely care.

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