Clinical Model Redesign
In order to better care for our cardiac patients, the hospital had to separate out its medical and surgical ICUs. This was a significant challenge as there was not enough space to house both units together. To solve this issue, they turned an 8 bed MICU into a medical CVICU, changed the lower acuity unit to a full intermediate one and outfitted each bed with vent capacity. This allowed them to better manage their current capacity and improve workflows.
Space Planning Innovation
The graph at the beginning of the text shows the movement of cardiac patients from two categories (the blue and yellow sections) to two other categories (the orange and light blue sections). This was done by creating a multidisciplinary task force to optimize the Gibbon Building, which is the main hospital. They worked with external vendors to develop a larger master facility plan that included engaging stakeholders in the organization and providing regular updates to senior leadership. They looked at administrative space and made decisions based on what departments needed to be moved out of the hospital and how to maximize space on the inpatient unit for clinical areas like endoscopy and bronchoscopy.
Discrete Event Simulation Modeling
The hospital used Jensen Partners and Big Bear AI to look at their space strategy and operational feasibility. They looked at how much space was needed, volume, services needed, staffing, and provider coverage. They also used Big Bear AI’s med model product to look at patient routing, staffing levels, procedure rooms, equipment, and supplies. This work allowed them to make informed decisions about their care model and optimize geographic placement. They were able to see a return on investment with external transfers and a decrease in length of stay, ED boarding, ICU boarding, and OR boarding.
Change Management Key Takeaways
Shane Flickinger and Christie Cald, Vice Presidents of Operations at Thomas Jefferson University Hospitals, shared their key learnings and provided key takeaways for other leaders. They discussed how they used a task force model to manage capacity during the pandemic, focusing on 90 day priorities and aligning clinical operations. They also highlighted the importance of clinical documentation and identifying champions within the organization.
