Managing the flow of patients and bed capacity is challenging for any hospital, especially for unscheduled admissions. For Zed Medical Center, a large regional referral center in the South and a member of the University Health System Consortium, the challenge is even greater. As the flagship hospital for a multihospital system with more than 750 licensed beds and a Level 1 trauma center with 50-plus trauma beds, approximately 70% of annual admissions are unscheduled.

The vice-president for Operations has a PhD in Nursing, is a fellow of the Advisory Board Company, and has more than 20 years’ tenure at Zed Medical Center. Three of the ten departments under her purview (Patient Care Coordinator, Bed Control, and Patient Transfers) are directly engaged in managing patient flow and bed capacity. The division is also responsible for system-wide care coordination for patients discharged to skilled nursing facilities, to home health, and to home without planned service delivery. Current operational goals include (1) decreasing the current length of stay by 0.3 days from 5.7 to 5.4 days and (2) “ED to 3″—a slogan incorporating the intention to place patients from the emergency department into a bed within 3 hours of the decision to admit. With the Centers for Medicare & Medicaid Services clarifying penalties for readmissions within 30 days, Zed Medical Center has been preparing to effectively manage readmissions based on CMS guidelines.

The eight staff members assigned to Patient Transfers coordinate with hospitals within the region wanting to transfer patients to Zed Medical Center. They take calls, connect outside transfers with accepting physicians, and arrange transport. The accepting physician determines the patient’s needed level of care, special care needs (e.g., diabetic), and the time frame for transfer. The Patient Transfer Department uses the TransferCenter module of TeleTracking (www.teletracking.com) to manage the transfer and admission of patients. After a patient has been accepted for admission by the admitting physician, Bed Control makes the bed assignment. The staff members of Bed Control assign incoming patients to specific beds once the Patient Placement Facilitators from the Patient Care Coordinator Department identify the nursing unit to which patients should be assigned. This determination is made based on the level of care required, physician preferences in choice of nursing unit, and the scope of care supported by the nursing units. The Bed Control Department uses the Capacity Management Suite of the TeleTracking software. The PreAdmitTracking module keeps track of bed status with an “electronic bedboard,” which provides a graphical user interface through which planned admissions, transfers, and discharges can be annotated. The status of a bed freed by patient discharge for which a cleaning request has been made is also noted (dirty, in progress, or cleaned). The Bed Tracking module uses the medical center’s 130paging network to notify the environmental services staff of a cleaning request and the unit director of the unit that a patient is incoming. The TransportTracking module automatically dispatches patient transport requests via phone or pager.

Given the above scenario, please answer the following question:

1. Describe some of the advantages and disadvantages of this new software. Include the stated organizational goals in your answer.

ANSWER

Advantages and Disadvantages of TeleTracking Software Implementation at Zed Medical Center

Implementing new software solutions, such as the TeleTracking system, at Zed Medical Center offers a range of advantages and disadvantages in line with the organization’s goals of optimizing patient flow, bed capacity management, and care coordination.

Advantages

Enhanced Patient Flow: The TeleTracking software streamlines patient flow by providing real-time information on bed availability, transfers, and discharges. This reduces delays in bed assignment and patient placement, aligning with Zed Medical Center’s goal of admitting patients from the emergency department into a bed within 3 hours.

Improved Care Coordination: The software facilitates coordination among departments involved in patient transfers, admissions, and bed assignments. The Patient Transfer Department can efficiently communicate with referring hospitals, and the Bed Control Department can assign beds based on physician preferences and patient needs, supporting the organization’s system-wide care coordination initiatives.

Reduced Length of Stay: The software’s PreAdmitTracking module allows staff to monitor bed status and cleaning requests, ensuring that beds are promptly cleaned and available for new admissions. This contributes to achieving the goal of reducing the current length of stay by 0.3 days.

Real-time Communication: The TransportTracking module automatically dispatches transport requests via phone or pager, enabling seamless communication between units, environmental services staff, and unit directors. This feature aids in maintaining efficient patient movement and timely bed turnover.

Data-Driven Decision-making: The software provides data analytics and graphical representations through the electronic bedboard, allowing staff to make informed decisions regarding patient placement, transfers, and discharges. This supports Zed Medical Center’s commitment to evidence-based operational improvements.

Disadvantages

Initial Learning Curve: Implementing new software requires training for staff members, and there may be an initial learning curve as they adapt to the new system. This can temporarily impact efficiency as employees familiarize themselves with the software’s features.

Technical Glitches: As with any technology, there is a potential for technical glitches or system downtime that could disrupt operations. Such interruptions could lead to delays in bed assignments, transfers, and communication, affecting patient flow and coordination.

Resource Investment: Implementing and maintaining the TeleTracking software requires an investment in terms of time, financial resources, and staff training. Balancing these investments with the anticipated benefits is essential for achieving positive outcomes.

Resistance to Change: Some staff members might resist the change from traditional processes to software-based solutions. Overcoming resistance and ensuring a smooth transition can be a challenge during the implementation phase.

Integration Challenges: Integrating the software with existing hospital systems and workflows may pose challenges. Ensuring seamless integration is crucial to avoid disruptions and inconsistencies in patient care and bed management.

In conclusion, the implementation of the TeleTracking software at Zed Medical Center offers significant advantages in terms of patient flow optimization, care coordination, and data-driven decision-making. While there are potential disadvantages, careful planning, effective training, and ongoing support can help mitigate these challenges and ensure the successful utilization of the software to achieve the organization’s operational goals.