Bedboard Upgrade Gives Hospital Managers` Room a New View

Volume 4 | Issue 19 | Through April 12, 2011
Opportunities to improve capacity management
Bedboard Upgrade Gives Hospital
Managers’ Room a New View
By Tyler Smith
Shortly after 7 a.m. March 22, UCH Hospital Manager Paige
Patterson, RN, sat down in front of a computer monitor in a firstfloor Critical Care Wing conference room. Shortly after logging on,
Patterson beamed widely and gave a thumbs-up sign to several
other people around her.
The hospital’s upgraded electronic “bedboard” was live. For
Patterson and providers throughout UCH, it meant nothing less than
activating the eyes and ears that allow them to keep track of where
their patients are and their status.
But the big moment also culminated a long period of preparation the
hospital believes will help clinical and support staff communicate,
manage capacity, coordinate care and keep patients safe.
Patterson and other hospital managers have long overseen the
hospital’s nerve center on the first floor of the Anschutz Inpatient
Pavilion, from which they coordinate admissions, discharges,
requests for transport, orders to clean rooms and more on a large
monitor. Their main tool since 2005 has been a bedboard application
from TeleTracking Technologies, Inc., headquartered in Pittsburgh.
Last week, the hospital became an “early adopter” of the company’s
new system, TeleTracking XT, Patterson reported. It’s a Web-based
application that providers can pull up from any computer in the
hospital. “Anyone taking care of a patient can use it,” she said.
Wider view. The new application, in fact, offers providers a
“total view of the hospital and how we are managing it hour to
hour,” Patterson noted. The system’s PatientTracking Portal™ is
the electronic equivalent of the white boards units use to post
information – nurse, attending physician, discharge status, fall risk,
transport requests, etc. – about their patients. The Portal provides
all of that information from a single view, anywhere in the hospital.
That’s a boon for patient care, said Information Services System
Analyst Karen Henz, the project manager for the upgrade. “For
Bedboard in hospital managers’ office
has a new look after March 22 upgrade.
example, a nurse at the end of the hall can get on the Portal and
see the white board information on any patient [without having
to go to the nurses’ station].”
Or a physician who wants to follow up on a patient he or she
discharged can find the patient’s nurse or certified nursing
assistant and call directly.
But the hospital didn’t undertake the upgrade solely for clinical
providers, Patterson emphasized. Another important feature
streamlines communication between hospital transporters and
Environmental Services (EVS) staff and the inpatient units.
Both transport and EVS now receive automatic pages as soon
as a patient needs to be moved from a unit or a room needs
to be cleaned. If they are moving a patient from an isolation
room or have to clean a contaminated room, they’ll get advance
notification that extra time will be needed.
“If there are isolation issues, for example,” Patterson explained,
“transporters will know in advance that they’ll need to get a gown
before they enter the room.”
Continued
Volume 4 | Issue 19 | Through April 12, 2011 | Page 2
Discharge help? A seemingly small detail such as that saves time,
and thus contributes to moving patients more efficiently. Patterson
is hopeful that other new system features will help providers move
patients more expeditiously into, out of and around the hospital.
It’s a key need at UCH, which frequently runs at or near capacity.
“Today, units put discharge barriers on white boards in their units,”
she said, “but with [XT] we will now be able to track why they
aren’t getting out on time.” The application includes “discharge
milestones” – completing physicians’ orders and nurses’ education,
arranging transportation or transfer to a skilled nursing facility and
so on – that help providers electronically track a patient’s progress
toward leaving the hospital.
and training that involved Nursing, Information Services, EVS,
Transport, the Access Center and other departments.
The hospital trained 100 “super users,” who in turn helped to instruct
social workers, case managers and patient services coordinators
on each of the inpatient units, Patterson said. Additional rounds of
training in April will reach “ancillary staff” who play important roles
in capacity management, including pharmacists, occupational and
physical therapists, dietitians and chaplains.
Hardware help. But without a technological platform, the training
would have been for naught. Henz served as the point person
linking TeleTracking staff and the more than 1,000 employees in
the hospital who are now using the application. Patterson helped
design and tailor the way XT displays the information to a UCH
audience. Henz worked to make sure the information would display.
That required much effort on the hardware front, Henz said.
She and her team had to set up a new server, which runs all the
applications for the XT system, she explained. IS began running
the new system in parallel to the legacy system about three weeks
before go live.
Hospital Manager Paige Patterson (seated) gives thumbs up as
new Teletracking application goes live. Mark Wolf (left) of EVS
and Chris Sweat of Transport share in the celebration.
“They’ll be able to see that 50 percent of the discharge process
has been handled,” Patterson explained. The information, in turn,
will help the hospital analyze discharge barriers, from delays in
setting up home health care to waiting for tests to getting patients’
families started on finding a transfer facility.
The system should also let managers and units predict patient
movement better. A “ready-to-move timer” displays approximately
how long it will be before a patient will be ready for admission
either from within or outside the hospital.
“When we have a bed request, but a patient needs tests before
being admitted, we’ll see that,” Patterson said. “If a hospital
manager gets four requests for a bed at the same, he or she can
project which patient will be ready soonest.”
It may have appeared at first glance last Tuesday that XT went live
with the flip of a switch, but that was hardly the case. Patterson’s
delighted reaction capped months of behind-the-scenes work
“We ran XT as if it were live,” Henz said, “to see if it were picking
up admissions, discharges and transfers and transport orders.”
Interviewed the day before go-live, she said all the information
was coming across in the new system. The database is in a server
“cluster” that ensures that if the database goes down, another
server automatically kicks in to keep patient information flowing.
Final checks. Two hours prior to the 7 a.m. switch, IS made
telephone line changes, removed users’ access to the old system
and checked the new system bed for bed to make sure all the
patients showed up in XT in the beds they were supposed to be in.
As a “fail-safe,” Henz added, IS was ready to take the entire system
down for an hour and restart the applications on the old one.
“This was not a typical upgrade,” noted Henz, who has been
working steadily on it since last November. “We had to replace
hardware, install a new application, provide staff training and work
closely with the largest department [Nursing] in the hospital.”
But the change was necessary, she emphasized. “We wouldn’t be
going through it if we didn’t have a need for beds at the hospital.
We’re all about improving capacity management. We don’t want
patients to have to wait for beds. Whatever help we can provide
with patient throughput will be to their and to our benefit.”
Continued
Volume 4 | Issue 19 | Through April 12, 2011 | Page 3
Learning Curves Ahead,
but XT Upgrade Road
Reasonably Smooth
who had attended three-hour training sessions, also
offered help. Each unit also had notebooks with tip sheets
available, Henz said.
By 3 p.m. the command center had handled about 50 calls,
Patterson estimated. Most involved “process issues,” she
said. The majority had been resolved, including one that
initially made users believe they couldn’t see patients in
procedural areas, like the Cath Lab, in the system.
“They’re fairly minor and expected on an upgrade like this
one,” Patterson said as she headed to the Neuro ICU to
help a nurse create a shortcut to the application.
Karen Henz (background right), IS project manager
for the TeleTracking XT upgrade, handles a phone
call in command center March 22.
The hospital’s preparations for the March 22 launch of
TeleTracking XT, its upgraded electronic bedboard system,
appeared to pay off.
Back in the Command Center, Alice Pekarek, RN – a
longtime hospital manager who moved last year to the
Epic team as inpatient nurse champion – said the volume
of calls “was a little heavier than expected. But there are
no huge issues. We’re mostly helping people get used to
the new look.”
The phones in the command center in the Critical Care
Wing began ringing shortly after the system went live
around 7 a.m., but a half-dozen people were ready to
answer and offer help, including IS project manager Karen
Henz; representatives from EVS, Transport and Nursing;
and TeleTracking application specialists Carolyn Brady and
Gretchen DeAngello.
Brady said she and DeAngello would be on hand from 7 a.m.
to 5 p.m.; another company specialist would come in at 10
a.m. and stay until 8 p.m. to offer additional coverage.
Henz said she’d had “a few anxious moments” after
she arrived at the hospital about 5:30 that morning. She
checked phone lines and made sure patient information
was transferring from the legacy system to the new one.
She was clearly relieved when XT fired up and showed
patients waiting to be discharged and admitted, both from
the Emergency Department and from outside the hospital.
“We’ve been working in a test environment for so long,” she
said. “To see our own patients flow through…It’s dynamic.”
In short order, representatives from both UCH and
TeleTracking began rounding the units, answering
questions and providing support. “Super users,”
Paige Patterson (left) helps Neuro ICU nurse
Frank Newsome, RN, with an XT question.
In an email early in the morning of the 24th, Patterson said
most “follow-up concerns” from go-live had been “resolved,”
as had all EVS and Transport issues. The remainder of the
work, she added, involved putting in place and testing new
work processes to take advantage of XT’s new functions.
She seemed satisfied with the progress of the launch.
“The enthusiasm from the staff has been fantastic,”
she wrote in an email. “Everyone is eager to learn
and play with the new system. It’s exciting to watch.”
TS
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