How Johns Hopkins uses a command center to address capacity issues

In today's complex healthcare system, hospitals continuously strive to enhance operations through a number of tools.

One tool used by The Johns Hopkins Hospital in Baltimore is the Judy Reitz Capacity Command Center, which launched in February 2016. Designed and built with GE Healthcare Partners, the NASA-inspired command center is comprised of hospital workers from various departments who analyze capacity through real-time and predictive analytics.

"It's a very cool tool, but it's just a tool serving a larger purpose," James Scheulen, chief administrative officer of emergency medicine and capacity management at Johns Hopkins, said at the Becker's Hospital Review 8th Annual Meeting on April 19 in Chicago. "It's unique not only in that Johns Hopkins has the command center, but it also helps the hospital actively manage the minute-by-minute capacity issues of the institution. We're looking at the demand, we're looking at the supply" and making decisions accordingly.

The command center uses a systems engineering approach, which includes device modeling and system simulation, as well as platform product baseline comparison, among other principles. Mr. Scheulen said other industries, such as aerospace, use a similar method.

"Clinicians will tell me these other industries don't take care of patients ... But all other industries also have to think about quality and safety as well as being efficient. So the conclusion is we should be learning from how they do operations," he said.

In the command center, about 20 hospital workers join forces with the goal of using gathered information to avert or resolve instances of crowding, reduce patient wait time, coordinate services and reduce risk. Through this work, Johns Hopkins is able to address not only a string of individual processes, but also a collection of systems, according to Mr. Scheulen.

Overall, Mr. Scheulen suggested hospitals balance three factors to enhance operations — the time patients spend in a bed, the number of beds and patient volume. He said hospitals must also consider operational variability.

"As you increase capacity, that's the time variability can most impact your operations. That's why in a factory, when robots do tasks, you can have high utilization. Hospitals are very different — cycle time isn't measured in seconds, and variability is significant," Mr. Scheulen said.

Bree Theobald, vice president of GE Healthcare Camden Group, said these are the exact factors officials considered when creating the command center at Johns Hopkins.

"We wanted to re-engineer the system to be more efficient and use the command center to take us to the next level," she added. "We also wanted to shift our tipping point, by reducing variation, which allows us to feel less full at higher occupancies."

She added the command center is helping Johns Hopkins reach an overarching goal: to expand productivity while ensuring care is administered to the "right patient, [in the] right place and at the right time."


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