Hospitals have always been challenged with improving patient flow from emergency rooms, elective admissions to final discharge. Inefficient utilization increases cost by decreasing reimbursements.
Whether it is fee-for-service or managed care, the lack of proper utilization has the same effect. Computer guidance coupled with a command and control center helps hospital administrators to address this challenge.
The command center is abuzz as more than a dozen experts monitor the constant flow of real-time information. When alerts emerge on one of the 32 computer screens, team members jump into action to resolve problems that range from minor obstacles to mission-critical challenges.
This sleek, high-tech room looks like the fabled site NASA uses to keep astronauts safe, but it is located inside Michigan Medicine’s University South Hospital in Ann Arbor.
Seven years in the making, this state-of-the-art facility – officially known as the M2C2: The Michigan Medicine Capacity Operations and Real Time Engagement Center – is improving patient care by leveraging real-time data and predictive analytics to not only identify bottlenecks and other barriers hindering care but also to get ahead of potential problems. Building on the success of similar initiatives at other cutting-edge hospitals, including Johns Hopkins and Yale in the United States and several medical centers outside the US, Michigan’s M2C2 reflects the innovative use of technology to enhance care and reduce costs.
The relationship between doctors, nurses and patients has always been at the heart of medicine and M2C2 is designed to improve outcomes by streamlining the complex behind-the-scenes logistical challenges that have profound impacts on the care they deliver.
In addition to expert caregivers, patients need hospital beds, MRI machines, surgical theaters, and recovery rooms and so much more available as needed so their treatment is a steady flow. The command center is designed to optimize these and other resources so that logistics do not impede care.
Hospitals have, of course, always addressed logistics. But they have typically been handled by separate units that did not have clear and easy channels of communication to seamlessly coordinate their actions. The rise of electronic health records during last decade, which greatly facilitates access to and the sharing of information across a hospital’s sprawling operations, makes it not only possible but necessary to unify these efforts which impact patient experience and outcomes.
Command centers such as Michigan Medicine’s M2C2 bring together a broad range of trained experts, including patient flow coordinators, admission triage coordinators, admission triage associates, clinical expediters, data analysts, management and support staff who monitor and analyze data entered into the electronic health records system to improve capacity decision making. A few examples:
- It is not uncommon for patients to remain in the hospital awaiting a test or lab result. Specially designed software alerts the command center to such instances, allowing staff to address the cause of the delay and, whenever possible, expedite care which allows patients to more quickly receive the care they need and be discharged, freeing up rooms and caregivers for others.
- Traditionally, Mondays and Tuesdays have been slower days for surgeries, with demand building toward the end of the week. The command center deploys advanced analytics that help guide OR schedulers so they can smooth out these scheduling bumps, relieving pressure on surgical teams and facilities.
- Advanced algorithms built into the command center dashboards enable staff to analyze a wide range of data to determine which patients might be vulnerable to deterioration and to get ahead of the situation.
As real-time information appears on the command centers dashboards, the team identifies issues that require further attention and work with various teams — including nursing, physicians, pharmacy, physical and occupational therapy, and radiology, to name a few – to address them.
Michigan’s M2C2 just began operating on Nov. 29 but similar initiatives at other institutions have shown significant benefits in patient care covering the full spectrum of services from admission to discharge. After opening its command center, Johns Hopkins Hospital in Baltimore reported that its critical care team was dispatched 63 minutes sooner to pick up patients via ambulance from outside hospitals and “a 60 percent improvement in the ability to accept patients with complex medical conditions from other hospitals around the region and country.” Patients were assigned to a bed “30 percent faster after a decision was made to admit him or her from the Emergency Department” and transfer delays from the operating room after a procedure was reduced by 70 percent. Hopkins also reported that “twenty-one percent more patients were discharged before noon.”
These are game-changing results. As my colleague Vikas Parekh, M.D., associate chief medical officer for U-M Health and an executive sponsor of the M2C2 project, put it, “If we get the right information at the right time to the right people, that will drive the right outcome for our patients.”
Marschall S. Runge, MD, PhD, is Executive Vice President for Medical Affairs and Dean of the Medical School for the University of Michigan. He serves on the Board of Directors for Eli Lilly and Company.
