Title of Poster or Presentation

Interdisciplinary Collaboration to Improve Patient-Centered Care During The Era of the CoVID 19 Pandemic

Presenter Information

Veronica PalustraFollow

Submission Type

Poster

Degree Type

Masters

Discipline

Sciences

Department

Law

Access Type

Open Access

Abstract or Description

Background:

According to the National Strategy for the COVID-19(CoV19) Response and Pandemic Preparedness:

President Biden issued Executive Order Ensuring a Data-Driven Response to COVID-19 and Future High Consequence Public Health Threats directing steps to enhance collection, production sharing, and analysis of, and collaboration with respect to, data to support an equitable COVID-19 response and recovery. Metrics and metric-driven public health guidance will be essential to controlling the pandemic[1].

A health system, located in the San Francisco Bay area, headquarters to Google, LinkedIn, Intuit and NASA Ames Research Center, experienced the domino effect of CoV19 in the disruption of emotional, spiritual, physical, economic well-being. According to Kaufman Hall, California hospitals can expect long-term changes to financial stability and care delivery[2]. CoV19 patient surges impacted hospital capacity, enabling leadership to strategically collaborate across disciplines and implement a capacity management center[3](CMC), new staffing models[4] and alternate care units[5] to optimize patient flow to ensure safe, high quality, patient-centered care for CoV19 patients.

The CMC, based on NASA’s command center[6] opened July 2020 using analytics integrated in Epic dashboards[7] to provide movement in bed planning, environmental services, transport, and capacity management. EPIC’s CoV19 Metric Specifications for Community Collaboration tracked the spread of the virus and monitored testing and screening[8]. “CMCs’ can influence positive outcomes in efficiency, revenue, and patient satisfaction but require willingness to disrupt the hospital model and a trusted partner to deliver AI”[9].

Interdisciplinary processes based on Lean methods[10]to maintain flow revealed enterprise operations on dashboards. The CMC team included the assistant hospital manager/supervisor, patient flow coordinator, case management, staffing and infection prevention team and collaborated daily with executive leadership, clinical directors and managers, frontline staff, physicians, and all service lines in the enterprise.

Pre-covid Surge Capacity Policies and Procedures were customized to CoV19 patient surge units for the intensive care, progressive care, telemetry and medical beds. The Secondary campus(SC) provided additional beds for admitted non-CoV19 patients.

Methods:

Observational methods were used to report data in median minutes from the patient’s arrival to ED departure; arrival to admit order; admit order to ED departure from January 2020 to January 2021[11]. The EPIC CoV19 capacity dashboard provided CoV19 daily census.

Results:

CoV19 census in January 2020 increased from 0 to 66 patients in 2021.

The highest census reported in December 2020 was 77.

ENTERPRISE ADMIT ORDER TO ED DEPARTURE: 5% DECREASE

MC ADMIT ORDERS TO ED DEPARTURE: 6% DECREASE

MC ARRIVAL TO ED DEPARTURE: 2% DECREASE

SECONDARY CAMPUS ARRIVAL TO ADMIT ORDER 1%

In November 2020, the hospital was recognized with ‘A’ Grade in Leapfrog Hospital Safety Program:[12] Hospital's Score: 120.00 Best Hospital's Score: 120.00

Conclusions:

Interdisciplinary collaboration during CoV19 resulted in positive outcomes in capacity and timely access to care despite the increased CoV19 census. Future implications should include EPIC clinical outcomes dashboards to study health care disparities in patients by race/ ethnicity[13].

[1] Accessed on March 13, 2013 at https://www.whitehouse.gov/wp-content/uploads/2021/01/National-Strategy-for-the-COVID-19-Response-and-Pandemic-Preparedness.pdf

[2] Accessed on February 21, 2021 at https://www.calhospital.org/news-releases-media-statements. Emerson-Shea, J. (2020). “Independent Report Finds CA Hospital Losses from COVID-19 Could Lead to Long Term Changes, Service Reductions”.

[3] Reference accessed at https://galaxy.epic.com/?#Home. Take Command of Your Hospital With a Capacity Command Center-2.pdf

[4] Accessed at https://www.calhospital.org/coronavirus

[5] Reference accessed at https://www.calhospital.org/cha-news-article/oshpd-provides-support-temporary-covid-19-space-hospital-campuses

[6] Reference accessed at https://www.gao.gov/assets/gao-20-146.pdf

[7] Reference accessed at https://datahandbook.epic.com/Reports/Details/4070984

[8] Reference Accessed at: https://galaxy.epic.com/?#Browse/page=1!68!50!3706532&from=Galaxy-Redirec.

[9] Reference accessed on February 21, 2021

https://www.gehealthcare.com/article/ground-control-to-major-growth-in-hospital-command-centers

[10] Accessed on February 21, 2021 at http://www.ihi.org/resources/Pages/IHIWhitePapers/GoingLeaninHealthCare.aspx

[11] Reference accessed on March 9, 2021 at https://www.elcaminohealth.org/about-us/leadership/board-directors

[12] Reference accessed February 21, 2021 at https://www.elcaminohealth.org/newsroom/el-camino-health-nationally-recognized-with-a-grade-in-leapfrog-hospital-safety-program

[13] Accessed on March13, 2021 at https://health.gov/healthypeople/about/healthy-people-2030-framework.

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Interdisciplinary Collaboration to Improve Patient-Centered Care During The Era of the CoVID 19 Pandemic

Background:

According to the National Strategy for the COVID-19(CoV19) Response and Pandemic Preparedness:

President Biden issued Executive Order Ensuring a Data-Driven Response to COVID-19 and Future High Consequence Public Health Threats directing steps to enhance collection, production sharing, and analysis of, and collaboration with respect to, data to support an equitable COVID-19 response and recovery. Metrics and metric-driven public health guidance will be essential to controlling the pandemic[1].

A health system, located in the San Francisco Bay area, headquarters to Google, LinkedIn, Intuit and NASA Ames Research Center, experienced the domino effect of CoV19 in the disruption of emotional, spiritual, physical, economic well-being. According to Kaufman Hall, California hospitals can expect long-term changes to financial stability and care delivery[2]. CoV19 patient surges impacted hospital capacity, enabling leadership to strategically collaborate across disciplines and implement a capacity management center[3](CMC), new staffing models[4] and alternate care units[5] to optimize patient flow to ensure safe, high quality, patient-centered care for CoV19 patients.

The CMC, based on NASA’s command center[6] opened July 2020 using analytics integrated in Epic dashboards[7] to provide movement in bed planning, environmental services, transport, and capacity management. EPIC’s CoV19 Metric Specifications for Community Collaboration tracked the spread of the virus and monitored testing and screening[8]. “CMCs’ can influence positive outcomes in efficiency, revenue, and patient satisfaction but require willingness to disrupt the hospital model and a trusted partner to deliver AI”[9].

Interdisciplinary processes based on Lean methods[10]to maintain flow revealed enterprise operations on dashboards. The CMC team included the assistant hospital manager/supervisor, patient flow coordinator, case management, staffing and infection prevention team and collaborated daily with executive leadership, clinical directors and managers, frontline staff, physicians, and all service lines in the enterprise.

Pre-covid Surge Capacity Policies and Procedures were customized to CoV19 patient surge units for the intensive care, progressive care, telemetry and medical beds. The Secondary campus(SC) provided additional beds for admitted non-CoV19 patients.

Methods:

Observational methods were used to report data in median minutes from the patient’s arrival to ED departure; arrival to admit order; admit order to ED departure from January 2020 to January 2021[11]. The EPIC CoV19 capacity dashboard provided CoV19 daily census.

Results:

CoV19 census in January 2020 increased from 0 to 66 patients in 2021.

The highest census reported in December 2020 was 77.

ENTERPRISE ADMIT ORDER TO ED DEPARTURE: 5% DECREASE

MC ADMIT ORDERS TO ED DEPARTURE: 6% DECREASE

MC ARRIVAL TO ED DEPARTURE: 2% DECREASE

SECONDARY CAMPUS ARRIVAL TO ADMIT ORDER 1%

In November 2020, the hospital was recognized with ‘A’ Grade in Leapfrog Hospital Safety Program:[12] Hospital's Score: 120.00 Best Hospital's Score: 120.00

Conclusions:

Interdisciplinary collaboration during CoV19 resulted in positive outcomes in capacity and timely access to care despite the increased CoV19 census. Future implications should include EPIC clinical outcomes dashboards to study health care disparities in patients by race/ ethnicity[13].

[1] Accessed on March 13, 2013 at https://www.whitehouse.gov/wp-content/uploads/2021/01/National-Strategy-for-the-COVID-19-Response-and-Pandemic-Preparedness.pdf

[2] Accessed on February 21, 2021 at https://www.calhospital.org/news-releases-media-statements. Emerson-Shea, J. (2020). “Independent Report Finds CA Hospital Losses from COVID-19 Could Lead to Long Term Changes, Service Reductions”.

[3] Reference accessed at https://galaxy.epic.com/?#Home. Take Command of Your Hospital With a Capacity Command Center-2.pdf

[4] Accessed at https://www.calhospital.org/coronavirus

[5] Reference accessed at https://www.calhospital.org/cha-news-article/oshpd-provides-support-temporary-covid-19-space-hospital-campuses

[6] Reference accessed at https://www.gao.gov/assets/gao-20-146.pdf

[7] Reference accessed at https://datahandbook.epic.com/Reports/Details/4070984

[8] Reference Accessed at: https://galaxy.epic.com/?#Browse/page=1!68!50!3706532&from=Galaxy-Redirec.

[9] Reference accessed on February 21, 2021

https://www.gehealthcare.com/article/ground-control-to-major-growth-in-hospital-command-centers

[10] Accessed on February 21, 2021 at http://www.ihi.org/resources/Pages/IHIWhitePapers/GoingLeaninHealthCare.aspx

[11] Reference accessed on March 9, 2021 at https://www.elcaminohealth.org/about-us/leadership/board-directors

[12] Reference accessed February 21, 2021 at https://www.elcaminohealth.org/newsroom/el-camino-health-nationally-recognized-with-a-grade-in-leapfrog-hospital-safety-program

[13] Accessed on March13, 2021 at https://health.gov/healthypeople/about/healthy-people-2030-framework.