An ambulance pulls up to the emergency room with a critically ill child. Paramedics rush the patient inside while two parents follow behind. One parent stays in with their child, while the other heads in an entirely different direction to complete hospital registration with the admission's staff. It is a familiar scene. If you have ever been in this situation, you know this experience all too well.

Now, imagine a hospital where there is a patient flow command center with 24-hour onsite staff from various departments working hand in hand to make the entire process as seamless as possible. Here, transport control specialists are sitting next to hospital admissions, who are sitting next to someone from bed control. In addition, an Access Center RN is available to consult with the team around clinical conditions, transport mode, and appropriate bed placement. So now, within minutes of the first call the coordination of the patient arrival, transfer, and admission is in the system.

Bottom-line, the command center takes multiple communications processes such as patient bed information, emergency room volumes, operating room schedule, weather, local news, and traffic patterns for emergency vehicles or aircraft, and puts them into one room for visualization and rapid decision making.

Managing time matters

That is exactly what has been achieved at Children's Medical Center (CMC) located in Dallas, Texas. They had a vision beginning in March 2008 that was developed and implemented by August of the same year when CMC unveiled its Access Center. Based on an aggressive and accelerated schedule, the design team was able to go from schematic design to construction documents in a matter of months based on the need for transfer process improvements to accommodate the opening of a new campus.

The Access Center at Children's Medical Center Dallas has combined transport control specialists, hospital admissions, bed control and an Access Center RN to increase workflow efficiency.
The Access Center at Children's Medical Center Dallas has combined transport control specialists, hospital admissions, bed control and an Access Center RN to increase workflow efficiency.

While there may be other facilities with similar capabilities, this center is truly one of a kind. It houses staff from four separate departments in one location where under the same roof transport, bed control, admissions, and nursing assist one another with the flow and appropriate distribution of hospital resources individualized to meet each patient's needs. The Access Center is manned 24 hours a day, seven days a week. It also features the latest technology applications including transportation monitoring and communications, satellite tracking for fixed wing aircraft, and video-conferencing with direct links to their other campuses and state emergency agencies. Allowing these teams to work side-by-side optimizes both performance and process flow. For example, if a room has been vacated, three departments will be notified at the same time allowing for an efficient transition of the next patient instead of each individual department waiting for a piece of paper to cross their desk. It also reduces the number of phone calls needed to coordinate an incoming admission.

To illustrate just how big of an impact was felt by combining these services and efforts, the numbers speak for themselves. After the Access Center went live, physician referrals increased by 17 percent, direct admissions were up 62 percent, and denials due to lack of bed space decreased significantly. In a world driven by bottom lines, it is hard to deny numbers like these as they prove that the combined environment concept helps facilitate greater efficiency within today's healthcare environment.

Providing emergency solutions

Secondarily, the Access Center is designed to be a catastrophe/emergency operations center that is split into an outer and inner core. The inner core services the core team, who answers phones and manages logistics in an “authorized personnel only” environment with access control measures. The outer core has secure access enabling only those who need access to real-time information as it relates to patient flow at CMC.

Several of the latest technology trends have been implemented in the Access Center, one of which is sound masking (also known as white noise or pink noise). This is the addition of natural or artificial sound into an environment to cover or reduce unwanted sound. In addition, command center consoles were selected based on their ability to help decrease noise. Because they contain soundproofing materials, these consoles also help to dampen the effect of working in a call center environment. Recent studies show that pink noise is preferred in applications and environments that center around children because the decibel level is lower. Elevated levels cause children to talk over the noise-almost nullifying the need for the masking.

Another technology utilized in the Access Center is called multiple monitoring. Each core has a number of workstations and with this technology each of these stations has the ability, at the push of a button, to project what is displayed on their monitor onto any of the larger wall-mounted LCDs in both the inner and outer core. For example, if there is a conference being held in the outer core and they need to have helicopter traffic information displayed, it can be pulled from one of the Transport Specialist workstations located within the inner core. This conference area can also be connected with the CMC conference center located at the north Dallas campus via direct video link with nothing more than a tap on a touch screen control panel.

Turning today's unique approach into tomorrow's commonplace

While numerous corporate facilities are creating a “command and control” center for their day-to-day operations, this application is not yet commonplace in healthcare facilities. For obvious reasons, it should be. The ability to combine functions of multiple departments is critical in time-saving efforts.

When dealing with an industry that serves patients, you strive to maintain the human element for patients and their families as they enter into your system. However, the initial effort of each group is captured in the function and intent of the Access Center. In those critical first moments of a patient's time in the hospital, no one wants to be tied up in a mountain of paperwork or frustrated due to communication errors and delays. This is why this type of facility should be a must-have on every hospital administrators' list of ways to improve communication, efficiency, and workflow-especially for those that have an extremely high volume of patients.

Every life is precious and every second counts. In a world of life or death decisions, CMC Dallas has showcased an unparalleled commitment to quality and innovation in healthcare. HD

Mitch McKinley is a healthcare communications technology consultant and project manager for Smith Seckman Reid Inc., an engineering and facility consulting firm that specializes in healthcare. Mitch can be reached at 214.765.6564 or Healthcare Design 2010 January;10(1):14-15