BURLINGTON, ONT. – Joseph Brant Hospital has created a computerized, clinical dashboard that informs executives, physicians and staff about patient volume and trends in the emergency department and inpatient floors. The system – which refreshes itself every 10 minutes – has been up and running since the spring of 2018 and has become an important tool for keeping managers informed about potential logjams and where to focus their attention.
“The system gives us a quick snapshot, so that people can switch into high-gear, if needed,” said Dr. Joe Cherian, chief of the emergency department. He explained that the computerized tool provides the realtime information that staff can use to make fast decisions about reducing waits in the ED or moving them into beds faster.
Thanks to the colour-coded bars and lines – green, yellow and red – managers can quickly determine if there is a problem that needs special attention. “By looking at the graphs, I can see how many people are registering, how many are waiting, and whether we’ll get caught up or if we should call another physician,” said Dr. Cherian.
The computerized system can be accessed by managers and staff across the hospital, and was built by a small team in just six months. They used software from Information Builders, and met regularly with various members of the ED, medical staff and executives to find out which metrics were most needed. The vendor also lent support to the project.
Dr. Cherian noted that the ED is like the canary in the coal mine – if there is a backlog of patients there, it probably indicates problems in other areas of the hospital, like patients in need of discharge on the floors.
The system tracks patient flow on various hospital floors, and shows managers where to place resources, such as nursing staff, or how to move patients to free up needed beds.
“This gives us a tool to quantify what we have to do,” commented Julie DePaul, director of health information services. She noted that there are management huddles three times a week, where decisions can be made about solving patient flow problems. The business intelligence system has been a boon, as it provides hard data about volume in various areas of the hospital.
But the system has also been useful on a day-to-day basis, as it constantly alerts staff about trouble-spots and trends that should be watched.
In the ER, the system notes how many patients are registered; how many have been waiting more than 24 hours; how many have been admitted but are waiting for a bed; and how many haven’t been admitted.
The bars on the display turn red when a particular metric needs attention. The system also shows how many patients are in triage, how many are waiting to be seen, and the number being seen.
On the medical floors, similar metrics are available. Authorized staff can also drill down further, to see the types of patients in various beds, length-of-stay, what’s needed before discharge and other information. To protect privacy, however, the names of the patients do not appear.
By accessing this kind of data, staff can determine whether various tests and services can be speeded up to move patients into a different part of the hospital or to facilitate discharge.
So far, the tool has been used by management and physicians, but Joseph Brant is encouraging all staff members to view it, especially front-line care-givers.
“We want everyone to look at it, to play with it, and to come up with ideas,” said DePaul. She observed that already, staff members who have used the system have asked that many new features be added. They’ve also used the data to suggest ways of improving processes at the hospital.
In the near future, the team plans to add financial data and metrics to the system. In this way, management will be able to analyze costs on a real-time basis. It’s expected to be a valuable tool to compare projected or expected financial performance with the actual experience.
There is a good deal of discussion about new features and metrics to include, giving it even more usefulness. “It’s a living document,” said DePaul. “There is a lot more to come.”
See the original article, in Canadian Healthcare Technology (Page 20)
Burlington, ON 
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