Operational command centers are helping health systems coordinate across departments, streamline patient care and reduce length of stay.

Feb 03 2020

A Look Inside AdventHealth’s Massive New Command Center

The Florida network is one of several organizations using new technologies to coordinate across departments, streamline patient care and reduce length of stay.

In 2016, AdventHealth wasn’t just running into a wall, it was running out of room.

“We had reached capacity in our Central Florida facilities,” says Carlos Escobar, vice president of market IT for the Florida-based healthcare network. “We hit what we call a ‘red line’ — a point where we were going to have to turn patients away due to lack of capacity.”

It was not a milestone to celebrate. “At one point, we had to say, ‘We cannot accept any more patients,’” recalls Dr. Sanjay Pattani. “That made us really reflect on how we were doing things.”

Officials realized they needed to rethink their approach to capacity management, and also find a way to improve coordination among eight regional campuses.

Their solution: an operational command center known as Mission Control that unites stakeholders across facilities and departments with patient data from throughout the network.

The 12,000-square-foot, $20 million center opened in August, with Pattani as executive medical director. Already, Pattani and Escobar say, the command center is providing a more seamless patient care experience and reducing the number of patients AdventHealth turns away.

“We have a wealth of data, but previously, that data was isolated to individual campuses,” Escobar says. “We needed to move from data to insights, and then ultimately move from insights to insights at scale.”

That shift is happening at more hospitals, especially large healthcare systems where it’s otherwise nearly impossible to keep track of myriad moving parts, says Tanya Egbert, senior director for research and strategy at KLAS. The resulting command centers rely on a variety of technologies, including video displays, networking equipment and workstations — but Egbert notes that these facilities vary greatly in design and implementation.

“It’s a newer phenomenon,” Egbert says. “Each command center tends to look slightly different, even if they’re using the same underlying vendors. If you’ve seen one command center, you’ve seen one.”

Command Centers Bring Insight, Speed and Safety

AdventHealth brings data and staff from throughout Central Florida into one common space with the intention of making small improvements that shape big changes in operational efficiency and patient care across the network.

With the help of custom-built dashboards, officials have enough visibility into their data to estimate wait times and offer patients the choice of a bed at another AdventHealth facility. “We’re giving our consumers a little bit more choice to minimize delays in care, to make it a better experience for them and to allow for better patient safety,” says Pattani.

Photography By EDWARD LINSMIER

AdventHealth’s Carlos Escobar, Vice President, Market IT (left), and Dr. Sanjay Pattani, Executive Medical Director of Mission Control, a data-driven command center.

The data-driven effort also helps align scheduling for patients who need multiple screenings, such as an ultrasound and a CAT scan, in the same visit. “Ordinarily, the patient would be ­transported for the tests whenever the equipment became available,” Pattani says. “Through the command center, the patient leaves once and gets both tests done at the same time.”

That same notion guides Tampa General Hospital, which also opened its operational command center — an 8,000-square-foot facility dubbed CareComm — in August. Dr. Peter Chang, vice president for care transitions at the hospital, notes that the command center allows caregivers to treat the sickest patients first and then prioritize care delivery to shorten wait times and hospital stays.

“Say five patients need MRIs,” Chang says. “What would normally happen is five different team members would call radiology to get the MRI done. The radiology department would have no real idea of prioritization. Now, the command center team can use predictive analytics and scoring systems to determine which patients are more ill, and which have an actual discharge barrier. They can make one call to radiology and say, ‘Do these MRIs in this order.’”

The Capacity Command Center at Yale New Haven Hospital is much smaller, just 800 square feet in a repurposed room. But by colocating employees in the space and providing them with data from throughout the hospital, the solution yields insights that cascade throughout a patient’s stay, says Dr. Robert Fogerty, medical director for the command center.

“If it takes 45 minutes to clean a bed, the instant that bed starts to be cleaned, you can dispatch the transporter,” he says, adding that the physical proximity to coworkers can be as helpful as the technology itself. “Since the 2000s, we’ve been working to break down silos. What’s different now is, we take frontline employees and put them in the same room. Things that used to be a phone call are no longer a phone call. You can just turn your head and talk to the person next to you.”

READ MORE: Discover how analytics tools help healthcare providers predict staffing needs and reduce costs.

Organizations Benefit from a Combination of Tools and Human Intuition

Typically, hospitals work with their electronic medical record (EMR) provider to develop dashboards to bring together information that healthcare facilities are already gathering. Then, that data is transmitted in real time — or nearly real time — to digital displays in the command center.

By building out command centers that combine a variety of technologies in strategic ways, healthcare systems can provide a holistic view of their data.

Carlos Escobar, Vice President of Market IT, AdventHealth
We needed to move from data to insights, and then ­ultimately move from insights to insights at scale.”

Carlos Escobar Vice President of Market IT, AdventHealth

Often, a command center will incorporate touch-screen displays to allow staff to access and zoom in on specific metrics. While most data come from existing hospital systems, some command centers incorporate weather or traffic data to help guide decisions about transportation operations and staffing levels.

AdventHealth’s command center ­features a wall of 60 Planar VM55LX-M 55-inch LCDs, nearly two dozen HP workstations and other tools such as virtual machine servers and digital signage media players.

The command center at Yale New Haven Hospital includes Crestron Electronics touch screens and speakers, 14 Samsung 4K monitors ranging in size from 55 inches to 75 inches (two of the interactive displays have whiteboard and touch-screen capabilities), Cisco network switches and a Polycom RealPresence Group Series 500 videoconferencing system.

Tampa General’s solution is run through a PC controller made by Jupiter Systems and features a “Wall of Analytics” made up of 38 Planar displays for maximum reach.

“We’re capturing this information from the Epic EMR and then feeding the video displays,” says Brian Hammond, CTO for Tampa General. “You have to be careful because you don’t want to put extra loads on those production systems. It would affect performance for the actual operations of the hospital.”

It was a group effort, Hammond notes. “Our IT integration team custom-developed APIs for the application engine that pulls that information and ships it to various systems.”

Many of the applications feeding command centers rely on artificial intelligence and machine learning, but much of the data analysis and decision-making is done by human workers, who are empowered by the technology to see their facility’s big picture in a way never before possible.

“It does feel like this is not just technology,” says Egbert, of KLAS. “It really is this combination of having great software, great technology, great analytics — combined with having people working together in close proximity who can look at that and make decisions based on the data that’s being presented to them.”

Care Improvements Make Centers a Worthy Investment

Over just the first few months of ­operations, the command center at Tampa General saved the hospital $10 million and reduced the average patient length of stay by more than half a day. By streamlining patient care, says Chang, the hospital effectively created the capacity of 25 additional hospital beds. That equals cost savings, quicker discharges and more people receiving treatment.

“When they’re here, the key thing that’s on patients’ minds is, when are they leaving?” Hammond says. “The cost of an additional 25 beds would be millions of dollars. But we’re utilizing technology to improve efficiency and gain that benefit.”

20 million

The annual number of unnecessary patient days at hospitals — capacity that could be used to provide care for an additional 3 to 5 million people

Source: Patient Flow Quarterly, Spring/Summer 2019

At Yale New Haven Hospital, command center staff uncovered a simple source of startling inefficiency when they noticed that one patient’s room still hadn’t been cleaned nearly three hours after discharge. It turned out that glitch in the system incorrectly designated the patient’s room as a “flu room,” requiring staff to wait three hours to clean it and then take special precautions — even though that patient didn’t actually have the flu.

Hospital officials fixed the glitch, resulting in substantial cost and time savings. “This happened because two people were talking over coffee,” Fogerty says.

Before implementing its command center, AdventHealth’s Central Florida facilities had to turn away around 17 patients per month due to lack of capacity. Since Mission Control went into action, that number has been reduced to two per month.

That helps ensure the people in need of specialty care can get it, regardless of time or medical circumstance. “We’re the only quaternary care system in Central Florida,” Escobar says. “This is helping us keep our patients in the ­community.”

Photography By EDWARD LINSMIER