Presenters & Topics

  • Roger Resar, MD

    Senior IHI Fellow
    Assistant Professor, Mayo Clinic Medical School

    The Practicality of 95% Reliability in Patient Flow Process Design

    Bio:

    Roger K. Resar, MD, Senior Fellow, Institute for Healthcare Improvement, has contributed to the development and national spread of key safety and improvement strategies such as medication reconciliation, use of the Trigger Tool methodology to measure adverse events, the development of “bundle science,” avoidable ED visits, flow improvement and the use of reliability concepts in health care. Dr. Resar serves as part time faculty for the Institute for Healthcare Improvement, Assistant Professor of Medicine at Mayo Clinic Medical School, and practicing clinician in Urgent Care.

    Topic:

    The Practicality of 95% Reliability in Patient Flow Process Design

    The implementation and sustainability of a process requires understanding the importance of simplicity. World-class performance does not require perfection, but rather good process design linked to measurable outcomes by known science. A few key observations can quickly determine if the patient flow process being designed has the potential to be successfully implemented and sustained over time. Improvement teams armed with these skills can quickly learn the sequenced steps to reliable process design. These include the importance of understanding linkage opportunity, moving away from vigilance and hard work, attention to articulating standard work, using a simple two step methodology in design, along with rapid cycles and easy data collection.

     

    Following this presentation, attendees will:

    • Understand key reasons why current process design frequently fails to be reliable
    • Learn how to judge a patient flow process for traits of reliability
    • Learn a methodology to achieve 95% reliability in process design

  • Susan Dentzer

    Sr. Adviser, Robert Wood Johnson
    Former Editor-in-Chief, Health Affairs

    Crosswinds of Change: Are You Ready for Affordable Care?

    Bio:

    Susan Dentzer is Senior Policy Adviser at the Robert Wood Johnson Foundation, the nation’s largest philanthropy focused on health and health care in the United States. In this role, she works closely with foundation leaders to carry out the organizational mission of improving the health and health care of all Americans. One of the nation’s most respected health and health policy thought leaders and journalists, she is also an on-air analyst on health issues on the PBS NewsHour. From 2008 to April 2013, she was the editor-in-chief of Health Affairs, the nation’s leading peer-reviewed journal of health policy, and led the transformation of that journal from a bimonthly academic publication into a highly topical publication and web site with more than 120 million page views annually. From 1998 to 2008, she led the PBS NewsHour’s health unit as on-air health correspondent, and was the recipient of numerous honors and awards. Dentzer is an elected member of the Institute of Medicine and the Council on Foreign Relations. 

    Topic:

    Crosswinds of Change: Are You Ready for Affordable Care?

    Buffeted about by crosswinds of change, hospitals face an uncertain environment in the years ahead. On the payment side, reimbursement under Medicare and Medicaid will be constrained by the ACA and federal and state budget pressures. Delivery and payment reforms are pushing health care out of the inpatient setting–and payers are growing reluctant to pay more for outpatient care provided by hospitals than for similar care provided by others. Construction costs for inpatient facilities now average $1 million per bed, and at least some regulators are growing concerned about a hospital building boom. At the same time, proposed legislation on nurse minimum staffing levels could drive up hospital operating costs. All told, many hospitals and health systems are likely to face pressure to reduce costs further and to use existing their capacity as efficiently as possible, rather than undertaking new construction. 

    This presentation will summarize these trends, as well as what some hospitals and health systems are doing to optimize their patient flow as a strategy for cutting costs and gaining efficiencies. Attendees will (1) be able to identify hospital utilization, pricing and reimbursement trends; (2) understand and identify countervailing cost pressures, such as proposed minimum staffing level requirements; and (3) understand strategies for optimizing patient flow as a means of avoiding new construction, gaining operational efficiencies, and, in at least some cases, expanding volume.

  • Kirk B. Jensen, MD, MBA, FACEP

    Patient Flow Faculty, IHI
    CMO, Best Practices Inc.

    Winning Physician Buy-In

    Bio:

    Dr. Kirk B. Jensen has spent over 20 years in Emergency Medicine management and clinical care.  Board-certified in Emergency Medicine, he has been medical director for several emergency departments and is Chief Medical Officer for BestPractices, Inc.

    Dr. Jensen is a faculty member for the Institute for Healthcare Improvement (IHI) focusing on quality improvement, patient satisfaction, and patient flow. He chaired two IHI communities: “Improving Flow Through the Acute Care Setting” and “Operational and Clinical Improvement in the Emergency Department”. Currently he is a leader of the innovative IHI seminars Cracking the Code to Hospital-wide Patient Flow and Perfecting Emergency Department Operations.

    Dr. Jensen is co-author of two books, Leadership for Smooth Patient Flow (2007 ACHE Hamilton Award winner) and Hardwiring Flow. In addition, Dr. Jensen served on the expert panel and site examination team of Urgent Matters, a Robert Wood Johnson Foundation Initiative focusing on helping hospitals eliminate ED crowding and congestion as well as preserving the health care safety net.

    Topic:

    Winning Physician Buy-In

    Changes in hospital operations are periodically necessitated when physicians, executive leadership and staff aren’t aligned in providing quality and service to patients. The $1 Million question is: HOW do you get physicians on-board, inspiring and motivating them to buy-in? This session will walk through the process of winning physician engagement through examining key-drivers, execution tactics, optimal activities, and ultimate goals.

    Participants in this session will learn to win physician buy-in by discussing:

    • Key drivers for physicians (patient care, financials/incentives, reduction in risk/complaints, expectations of consumer/licensing boards)
    • Execution tactics (training and coaching, transparency and metrics, rewards and recognition, emotional persuasion)
    • Optimal activities (evidence-based clinical practices, peer comparison and benchmarking, regular feedback)
    • Ultimate goals (decrease variability, move the bell-shaped curve, shape culture) 

  • Christy Dempsey, RN, MSN, MBA, CNOR, CENP

    Chief Nursing Officer, SVP
    Press Ganey Associates Inc.

    Smoothing Flow in the Continuum of Care to Achieve Success Under Payment Reforms

    Bio:

    Christy Dempsey is the Chief Nursing Officer for Press Ganey Associates, Inc.  Christy is a registered nurse with over 28 years of healthcare experience in nursing, perioperative and emergency services management, medical practice, supply chain and materials management, and physician/hospital collaboration. As the Chief Nursing Officer, Christy is responsible for enhancing the clinical relationships between Press Ganey Associates and our healthcare partners to transform the patient experience.  As the former leader for the clinical and operational consulting division, she helped Press Ganey clients fully embrace the clinical components of the patient experience by redefining and redesigning the way patients flow and care is delivered in our client organizations.

    Christy regularly speaks and publishes nationally and internationally on patient experience, patient flow, physician/hospital collaboration, and balancing cost and quality. She also serves as faculty for the Missouri State University Dept. of Nursing.  Christy has master’s degrees in both business and nursing and is certified in both perioperative nursing and executive nursing practice.

    Topic:

    Smoothing Flow in the Continuum of Care to Achieve Success Under Payment Reforms

    Patient flow through the complex hospital environment has always been a challenge.  Success under payment reform is an even bigger challenge.  The key to successful patient flow under payment reform is understanding and leveraging the full continuum of care.  Hospital executives and providers will not be successful focusing solely on hospital or ambulatory care.  Patient flow must now be viewed from a patient centered perspective, across the continuum of care – from the medical practice, through the hospital, and beyond to skilled or long term care and home care.  Only if we focus on the continuum will we truly be successful in optimizing patient flow.  During this session, we will discuss ways in which organizations leverage data and best practice solutions to be successful in this new healthcare paradigm.

    After attending this session, participants will be able to:

    • Discuss how healthcare continues to change in an era of reforms
    • Identify ways to leverage data across the continuum of care to identify opportunities for improvement in flow and care
    • Apply best practice solutions that address both patient flow smoothing and success under payment reform

  • Lisa Romano, RN, MSN

    Chief Clinical Officer
    Skylight Healthcare System

    Patient Engagement: The Missing Piece to the Discharge Puzzle

    Bio:

    Lisa Romano, RN, MSN, joined Skylight Healthcare in 2013 as Chief Clinical Officer. In this role, she guides clinical product development efforts and works closely with clients to ensure effective patient engagement and care.

    Previously, Romano was CNO and Senior Vice President at TeleTracking Technologies where she worked with clients to achieve positive patient flow outcomes, maximize software functionality, and ensure culture change. Prior to joining TeleTracking, Romano worked at Lehigh Valley Hospital and Health Network from 1988 to 2007. During her tenure she served as nursing supervisor, transfer center coordinator and eventually became Administrator of Patient Logistics and Patient Access/Registration. While at Lehigh, she was responsible for patient placement, patient transfer, quality and patient satisfaction initiatives.

    Topic:

    Patient Engagement: The Missing Piece to the Discharge Puzzle

    This session will demonstrate the power of patient engagement in effective discharge planning. Patients can be empowered with the knowledge and resources necessary to manage their condition upon discharge. Continuous and consistent communication, with prompt intervention for requested care-needs translates into significant, measureable improvements in the patient experience, outcomes, and readmission rates. Vital communication points will be highlighted in this presentation, along with workflow processes that allow the patient and family to conveniently participate.

    Special attention will be given to interface opportunities between the electronic medical record and interactive patient care technology and how hospitals can create a seamless flow of discharge information to the patient using their in-room television screen. When patients are notified of pending discharge plans, they can more easily involve their family in home care needs and also arrange transportation early on the day of discharge. Discharges completed earlier in the day allow for quicker room turnover and prompt assignment of new admissions.

    Knowledge is power. Patient Engagement is life-saving. 

  • Marilyn Rudolph, RN, BSN, MBA

    Vice President
    VHA IMPERATIV Advisory Services Operations

    Are There Consequences When Perioperative Patient Flow Isn’t Flowing? You Bet There Are!

    Bio:

    Marilyn Rudolph RN, BSN, MBA, is the vice president for VHA IMPERATIV Advisory Services Operations. She has more than 20 years of clinical background in critical care, emergency and perioperative nursing, and also has extensive experience in nursing leadership, healthcare quality, patient safety, perioperative and patient throughput, and performance improvement.

    She has supported and led numerous healthcare organizations in clinical and operational improvement work throughout her career, and has also shared her experience and expertise via numerous speaking engagements, publications and media interviews. Marilyn has been appointed to committee, advisory and board positions to support the advancement of healthcare quality, safety and performance improvement. 

    She most recently served as senior clinical consultant with the Geisinger Health System, and prior to her role at Geisinger, was vice president of performance improvement for VHA Pennsylvania. In addition to her current role with VHA, Marilyn also serves as faculty for the Institute for Healthcare Improvement and the Institute for Healthcare Optimization both located in Boston, MA, and is a faculty member for the Hospital & Healthsystem Association of Pennsylvania Trustee Quality Curriculum.

    Marilyn is a graduate of Sewickley Valley Hospital School of Nursing (RN), Slippery Rock University (BSN), and Point Park University (MBA).

    Topic:

    Are There Consequences When Perioperative Patient Flow Isn’t Flowing? You Bet There Are!

    Participants will gain insights into the effects of variability on patient throughput, the consequences of inefficient perioperative patient flow, and compelling reasons to work toward improving timely and efficient patient preparation for surgical procedures.

    Session Objectives:

    • Discuss the effects of variability on patient flow
    • Identify system-wide clinical, financial, and operational reasons to improve perioperative flow
    • Describe key considerations for improving OR start times and timely and efficient patient preparation  for surgical procedures

  • Sam Mossallam, MD, FAAEM

    Associate Chief Medical Officer
    Henry Ford Health System

    Internal Physician Advisory Services: Streamline Patient Placement, Optimize Resources, and Maximize DRG Collection

    Bio:

    Sam Mossallam, MD is dual board certified in emergency medicine and internal medicine. He has extensive experience in observation medicine, setting up the first observation unit as chief resident at CCHS in 1999 and then moving to Henry Ford Hospital (HFH) for further work.

    In addition, Dr. Mossallam oversees the utilization review for HFH and worked with a team to develop and implement the Internal Physician Advisory Services model at HFH. Significant gains have been made to the appropriateness of patient placements and status, authorization capture rates, and improved back end processes. Dr. Mossallam has lectured regionally, nationally and internationally on many topics.

    Topic:

    Internal Physician Advisory Services: Streamline Patient Placement, Optimize Resources, and Maximize DRG Collection

    This presentation focuses on the need for hospital to implement an Internal Physician Advisory Service, real time and before a patient is placed in the hospital to ensure the most accurate patient status (inpatient, observation or bedded outpatient). This ensures appropriate utilization of resources, enhances authorization capture rates, and improves back end appeals processes.

    Hospitals need Internal Physician Advisory Services because it is a CMS condition of participation to have a secondary physician review for cases that do not meet inpatient criteria. Hospitals are either outsourcing and paying top dollar, or insourcing and providing better compliance and a more sophisticated UR process. 

    Indeed, with the new “2-midnight” rule being implemented by CMS this issue is of prime importance for hospitals. Getting the correct patient status from the get-go will ensure that hospitals are maximizing their DRG collection rate, minimizing the number of code 44 cases, and help direct outpatient cases in into a cohorted location such as an observation unit. 

    This process impacts the entire hospital from the inpatient units to the PACU to the observation unit. Additionally International Physician Advisory Services has a huge implication for the ED to ensure compliance with appropriate statusing, and minimizing boarding times. 

    Following this presentation, participants will:

    • Know how to implement an Internal Physician Advisory Service model
    • Appreciate the pros and cons of an internal model vs. national use
    • Take-home tactics to embed such a model into an existing UR model

  • Deborah Kaczynski, MS

    Senior Administrative Director, UPMC
    IHI Patient Flow Faculty

    WORKSHOP: Real-Time Demand Capacity Management in Your Facility (Pre-registration Required)

    Bio:

    Deborah Kaczynski is a Sr. Administrative Director at UPMC Mercy—part of the University of Pittsburgh Medical Center Health System in Pittsburgh, PA. She has administrative oversight of Pharmacy Services, Care Management, Environmental Services, Food and Nutrition, Capacity Management and Organizational Excellence. Kaczynski has been involved in quality and operational improvement, specializing in capacity management for the past eight years, both in day-to-day hospital operations and in a consultative role. She helps support UPMC’s patient flow initiatives and is faculty for IHI’s Learning and Innovation Community on Improving Flow Through Acute Care Settings. She has assisted several large health systems in their patient flow work, including Kaiser Permanente, VA, Christianna, and Johns Hopkins.

    Kaczynski co-authored an article on patient flow which appeared in the May 2011 issue of The Joint Commission Journal on Quality and Patient Safety entitled “Timeliness and Efficiency: Using Real-Time Demand Capacity Management to Improve Hospital-wide Patient Flow”.

    Topic:

    WORKSHOP: Real-Time Demand Capacity Management in Your Facility (Pre-registration Required)

    This workshop will briefly review the basic concepts of managing capacity using the Real-Time Demand Capacity Management model.  After the review, participants will actively engage in exercises based upon the four principles of RTDC to assist them in implementation of this model in their own facility. This workshop will be highly interactive and involve participants bringing data from their own hospitals to receive immediate feedback and perspectives.

    Objectives:

    • Demonstrate knowledge of the four principles of Real-Time Demand Capacity
    • Actively participate in exercises to demonstrate knowledge of predicting demand, predicting capacity, creating plans and evaluating plans. 
    • Develop three “next steps” necessary to implement RTDC in your facility 

    Space is in this workshop is limited to 30 people (with attendance restricted to 2 people per organization). The workshop costs an additional $50. The workshop takes place from 1:30-3:30PM on Wednesday, May 14.

    Please note the workshop takes place DURING the Session C Breakout presentations. Those breakout presentations will be recorded and made available online after the Summit. The workshop will NOT be available after the Summit.

  • David Yu, MD, MBA; Beth Cumbie, MSN, RN; Dusty Chavez, BSN, RN, BC

    Medical Director, Director of Nursing Operations, Director Patient Placement and Transfer Center
    Presbyterian Healthcare

    Aligning Multidisciplinary Forces to Streamline Flow in an Integrated Healthcare System

    Bio:

    David Yu, MD, MBA is the Medical Director of Adult Inpatient Medicine Services at Presbyterian Healthcare. He graduated from Washington University in St Louis, and received his medical degree from University of Illinois, Chicago, College of Medicine. Dr. Yu trained in Internal Medicine Residency at Northwestern University, McGaw Medical Center, Evanston Hospital, and is board certified in Internal Medicine, and in Hospice and Palliative Medicine. Dr. Yu is actively involved in Society of Hospital Medicine, and has served on several SHM national committees. Dr. Yu has gained national recognition for his work on the Unit Base Model with Multidisciplinary Rounding incorporating Lean Six Sigma concepts.  

     

    Beth Cumbie, MSN, RN, began her career at Presbyterian Healthcare as a licensed practical nurse then worked as a staff RN and manager of progressive care units. As Director of Patient Care Services at Presbyterian Kaseman Hospital Beth had oversight for inpatient, emergency services, sub-acute and rehabilitation as well as a multiple ancillary and clinical ancillary departments. As Director of Nursing Operations Beth implemented a daily leadership huddle focused on throughput and patient care processes. Beth serves as a board member for the New Mexico Organization of Nurse Leaders. Beth led the Robert Wood Johnson Transforming Care at the Bedside (TCAB) initiative for Presbyterian.

     

    Dusty Chavez, BSN, RN, BC, serves as the Director of the patient placement and transfer center. She has oversight of three metropolitan hospitals and coordinates services and throughput efforts.  The transfer center is a key access point for rural New Mexico hospitals, clinics and providers. In the two years since opening the patient placement and transfer center the average emergency wait time for an inpatient bed has declined by over 50%. Discharges by non-licensed personnel increased by 30% keeping licensed care givers at the bedside. Alignment and gains in efficiency allowed for acceptance of transfers into the metro facilities to increase to 400 per month.  The direct admission process has decreased the traffic into the ED effectively decompressed non-urgent visits by direct placement into an inpatient bed.

    Topic:

    Aligning Multidisciplinary Forces to Streamline Flow in an Integrated Healthcare System

    The Presbyterian Hospital, a tertiary 453 bed hospital in Albuquerque, NM, was plagued with patient flow issues that severely impacted hospital operations. The aLOS for the hospitalist services (Adult Inpatient Medicine Service-AIMS) was over five days, and LWBS rates in the ED were over 10%. The hospital ED was on frequent bypass, and patient transfers from regional hospitals were severely hindered.  Decreasing outmigration, increasing timely patient acceptance and the need for an uninhibited patient flow system were driving factors for change.  

    Seeking to improve this situation, the AIMS group started on a Lean Six Sigma Project to look at patient flow issues. The result was an innovative Unit Base Model with Multidisciplinary Rounding. Finding success, the initial project spread. The aLOS decreased from 5.06 days in 2009 down to 4.15 YTD Sept. 2013. LWBS in the ED dropped from over 10% in 2009, to below 2.5% YTD Sept. 2013. Additionally, the hospitalist group was able to hire more physicians to reduce rounding census. Presbyterian’s patient flow has been significantly improved with no ED bypass in the last two years.

    The unit-based model created bed capacity, which led to the creation of a robust bed management system that serves three metropolitan hospitals and five rural regional facilities. Presbyterian Care Connection works with local providers, clinics, and nonaffiliated healthcare centers to provide tertiary care within communities across the entire state. To become a reliable patient access center, Presbyterian aligned physicians, nursing, transport, and environmental services (EVS) processes. The collaboration of multiple departments increased incoming referrals and created a system that insures bed availability. This has resulted in more than 1,800 additional transfers in just one year. The combined focus and accountability has resulted in a culture of alignment centered on patient need beginning in the ED, on the units and throughout the state.

    After this presentation, participants will be able to:

    • Improve hospital flow, aLOS, ED flow, through Lean Unit Base Model with Multidisciplinary Rounding
    • Develop basic understanding of Lean Six Sigma Concepts regarding quality through process standardization
    • Discuss how highly organized bed management processes enhance patient flow, decompress PACU and ED and increase the ability for patient admissions.
    • Understand how multidisciplinary roles contribute toward patient acceptance, flow, and placement.
    • Learn how working algorithms and service line agreement within a Hospitalist Model support patient acceptance and care delivery.

  • Kathryn Maddox, MSN, RN

    SME Capacity Management
    Sidra Medical and Research Center, Doha, Qatar

    Implementing Patient Flow Initiatives in the Middle East: Lessons in Patient-Centered Care

    Bio:

    Kathy Maddox has been a registered nurse for 34 years, obtaining her Master’s Degree at George Mason University in Fairfax, Virginia. Twenty-two years of her nursing career was spent at the Medstar Washington Hospital Center where her duties included that of both a Patient Flow Coordinator and Director of Patient Access.  She was actively involved with the development of the Patient Flow Department at this facility.  Upon the retirement of her husband, they relocated closer to family in Phoenix, Arizona where she was employed at the Maricopa Medical Center as a Patient Flow Administrator.  It was at the Maricopa Medical Center where she was instrumental in implementing an electronic bed board. In expanding her horizons, Kathy took a position in the specialty field of patient flow in Doha, Qatar to aid in the opening of a new Women’s and Children’s hospital. 

    Topic:

    Implementing Patient Flow Initiatives in the Middle East: Lessons in Patient-Centered Care

    The Islamic belief is a part of the political, social, economic, and legal structure within the Middle East. As such, hospital patient flow in these countries must also encompass the understanding of this religious arena. Particular consideration must be paid to implementing patient-centered care within this cultural framework in order for hospitals to operate and be successful.

    Hospitals in the Middle East can have occupancy rates approaching 100%, just like their counterparts in the United States. Indeed, successful patient flow initiatives are global objectives, not just regional. This presentation will acquaint attendees with the patient flow challenges and accomplishments in opening an innovative Women’s and Children’s Hospital in Doha, Qatar. These challenges and accomplishments reflect cultural, economic and demographic platforms. Additionally, this presentation will include valuable information for any hospital looking to jump start patient flow initiatives or open a brand new facility (fully-loaded with patient flow best practices).

    After this presentation, participants will:

    • Take-home steps to effectively implement patient flow initiatives in their hospitals
    • Understand how to approach throughput initiatives from a patient-centered perspective
    • Appreciate global patient flow challenges and opportunities
    • Learn unique details about Middle Eastern healthcare   

  • Mark Berchtold, RN, MHA and Sarah Basile, MHA

    Clinical Director, Emergency Department; Planning and Development Mgmt. Associate
    Carolinas HealthCare System

    Streamlining Patient Hand-Off From the Emergency Department to Inpatient Floors

    Bio:

    Mark Berchtold, BSN, MHA, is the Clinical Director of Emergency Nursing Services at Carolinas Healthcare System. Having worked in front line and leadership roles in all areas of the hospital, he has a strong foundation and knowledge of hospital flow, throughput and efficiency.  Recently, at the 2013 CHS system wide Quality Day of Sharing, he presented, alongside Ms. Basile, a project to improve patient flow from the emergency department to inpatient nursing units.  This new nursing hand off process broke down traditional silos, utilized the electronic medical record, and increased the communication and trust amongst care providers.

    Sarah Basile, MHA is a Planning and Development Associate at Carolinas HealthCare System in Charlotte, North Carolina. After earning her Master’s degree in Health Care Administration and Policy, Sarah completed a one-year Administrative Residency at Carolinas Medical Center where she worked in hospital operations under senior leadership. She received a System-wide Quality and Service Award for her contributions in improving inpatient flow from the Emergency Department alongside her colleague, Mr. Berchtold.

    Topic:

    Streamlining Patient Hand-Off From the Emergency Department to Inpatient Floors

    By yearend 2012, ED Admit LOS for the Carolinas Medical Center ED was hovering around 283 minutes, a 43 minute lag against the 240 minute Leading Practice benchmark. Significant efforts have been made since to streamline areas such as registration, triage, and physician performance. However, never before had the ED focused on nursing functions as an opportunity to see tangible differences in patient movement. A charge was therefore made to challenge traditional nursing logistics when admitting patient and identify feasible enhancements to “nursing workflow” after an ED patient was assigned a clean and ready inpatient bed. This is a sub-segment of the overall ED Admit LOS metric, and any time savings would be anticipated to have a downstream positive effect.

    Utilizing LEAN methodology, we brought together a multidisciplinary team to brainstorm the main delays in admitting a patient from the ED. We developed an enhanced patient hand-off process. After a beta test, positive results led to an implementation house-wide on Q1 2013. Year to date through June 2013, data shows that we have shaved off 12.63 minutes per patient admitted, equating to a 17.83% improvement from baseline. Such clinical efficiency has had a downstream positive effect on other ED operational metrics such as: Left without Being Seen (LWBS) percentages, ED costs, ED/IP revenues, and patient satisfaction. Other positive results include improved nurse-nurse communication, trust, and patient safety. 

    After this presentation, participants will:

    • Learn how RN collaboration and communication can break down traditional silos to enhance the quality of patient care
    • Learn how innovation can be a catalyst to process improvement
    • Learn how to challenge traditional nursing logistics and change patient hand-offs for the better

  • Tom Kurtz, MHS, PA-C, EMT-P, CHEP

    Senior Director of Clinical Operations for Emergency Medicine
    Aria Health

    Expecting the Unexpected: Preparation for and Management of Emergent Transfers and Crises

    Bio:

    Tom Kurtz recently joined the team at the Aria Health System where he oversees three emergency departments. Prior to joining Aria, Tom worked for Temple University Hospital. Tom was an original member of Temple Transport Team (T3), the health system’s critical care transport team. In 2005 he was appointed as Administrative Director of Operations for T3, and later became the Associate Hospital Director of Emergency Services, Logistics, and Specialty Care Transport. He oversaw the Emergency Department (ED) and Transfer Center of Temple University Hospital in addition to T3.

    Kurtz’s expertise includes ED related practices and the flow of patients into and out of that department. Kurtz has years of experience helping facilitate the transfer and transport of patients in need of a higher level of care, and has developed detailed algorithms and check-lists related to making this process as seamless and safe as possible. Kurtz specializes in ensuring risks are minimized during the transfer process, and that high quality care is delivered during air or ground transport; a key component being efficient patient flow processes.

    Topic:

    Expecting the Unexpected: Preparation for and Management of Emergent Transfers and Crises

    Hospitals across the country, particularly tertiary care centers in urban environments, must be prepared to receive transfers of critically ill and/or injured patients requiring higher levels of care, as well as victims of disaster directly presenting for emergency care.  From environmental catastrophes to terrorist attacks, emergency departments (EDs) and trauma centers often are faced with multiple patients presenting in a short amount of time, often with life-threatening injuries requiring emergent interventions.  At times, these situations are exacerbated by the fact that some of the patients include first responders themselves, such as police officers involved in shootings and fire fighters who fall victim to fires they are called upon to battle. 

    This presentation will provide an explanation of the necessary components to prepare for and manage emergent transfers and crises of all types, thus assisting hospitals with “expecting the unexpected.”  It has been well documented and proven that having protocols and pathways proactively established and tested leads to a more effective and efficient response when disaster strikes, and assists with maintaining operations and patient flow for not only the patients and victims involved, but for the usual volume of patients seeking services.

    The three areas to be highlighted include (1) activation, notification, and tracking pathways to ensure critically ill and/or injured patients are transferred/transported directly to definitive care, (2) an emergency preparedness initiative to respond to natural and man-made disasters (profiling the hospital incident command system), and (3) a protocol to address high profile incidents, including line-of-duty injuries and deaths.

    Objectives include the following:

    • Provide an overview of emergent transfers and crises that impact hospital EDs and transfer centers
    • Provide evidence of the importance of emergency preparedness and planning initiatives and its relation to maintaining operations and patient flow within an ED
    • Provide the necessary components of pathways and protocols designed to prepare for and manage emergent transfers, natural and man-made disasters, and high profile (line-of-duty) incidents

  • Julieta Ducasa, RN

    Transfer Center Nurse Manager
    Baptist Health South Florida

    The Value and Evolution of a Transfer Center / Access Center

    Bio:

    Julieta Ducasa has worn many hats within the nursing profession since completing her Bachelor of Nursing Degree at Barry University. While teaching nursing at a local college she was recruited to work at the Transfer Center at Baptist Health South Florida. Having been involved in transfer center operations for more than five years, Julieta is now the Nurse Manager for the center.

    Topic:

    The Value and Evolution of a Transfer Center / Access Center

    The national expectation for the healthcare industry today is to increase value and quality of service while decreasing costs. To successfully meet this challenge, one must think outside the box. Five years ago The Transfer Center was created at Baptist Health South Florida with the intention of creating a centralized area that could render services to physicians and bedside staff by facilitating the movement of patients from one facility to another. As the years passed it became evident by the data collected that The Transfer Center was immensely valuable to the organization. The vision today is to incorporate other services using technology in order to meet the needs of the community while adapting to the impending changes that are already modifying the way healthcare functions under the provisions of the Affordable Care Act.

    Beyond coordinating the movement of patients, The Transfer Center, is now one of the pivotal components in projects that incorporate the use of technology. We have been able to develop and foster relationships with other departments in order to provide excellent quality of service to our customers. We have established a unique relationship with the tele-ICU, specialty service coordination, Emergency Preparedness, Emergency Departments and several transportation companies. The Transfer Center has proven to be a facilitator in the communication and documentation needed in order to incorporate services through technology. We are in the pilot stage of increasing the value of the Transfer Center by increasing quality of patient care and reducing operating costs.  

    After this presentation, participants will:

    • Discover the initial value of transfer centers
    • Learn how to think outside the box and expand the role (and value) of established transfer centers
    • Appreciate the expanding role of transfer centers in the future of healthcare

  • David Spoor, BSN, MHA, RN

    Director of Nursing
    Sturdy Memorial Hospital

    Solving Patient Throughput and Satisfaction Problems in a Mid-Sized Community Hospital

    Bio:

    David Spoor, is a seasoned nursing leader who feels his years of clinical practice and operations oversight have allowed him to look at patient flow differently and incorporate evolving quality management initiatives to solve the puzzle.

     Working in all areas of nursing as a Director including periop, ICU, ED, Med-surg and long term care, David has a unique set of skills to assess and enhance patient flow. He has strong relationship-building capabilities and prides himself on his ability to mentor and develop staff while achieving overall departmental goals.  Particularly adept at supporting and guiding new nurse managers as they cope with managing using fewer resources while expecting them to achieve the same outcomes.  Has worked with many interdisciplinary teams to achieve desired outcomes. 

    Topic:

    Solving Patient Throughput and Satisfaction Problems in a Mid-Sized Community Hospital

    This presentation will review the initial diagnosis of a patient throughput struggle and the 2 year journey to enhance patient throughout in a mid-sized community hospital. It will illustrate the ability for community hospitals to decrease the time from Decision to admit to assignment of a bed from 54 minutes to 13 minutes or a reduction of 76%.  It will review the use of the lean tool A-4 and the involvement of staff as key to the success. It was this staff that then assisted in changing a culture from a push the admission to a pull the admission up from the ED 

    In addition this presentation will demonstrate the importance of patient flow in our Press Ganey Surveys. In reviewing Press Ganey Results for the question “Speed of Admission” shows a mean of 85.9. We have fluctuated between a low of 81 in November 2011 to a high of 88.3 in August of 2012 which is an increase of 7.3 points. On average in FY 2012 our mean score was 85.6 with a 92% percentile ranking. For FY 2013 this mean score has continued to rise to 86.9 with a 93% percentile ranking thus maintaining and slightly improving patient satisfaction in this area. 

    Lastly this presentation  will show an overall decrease in ED time from Decision to Admit to Admit to the floor from 133 minutes to a new low of 97 minutes or a reduction of 36 minutes or 27% in two years. 


    After this presentation, participants will be able to:

    • Identify best practices to streamline patient flow and increase patient satisfaction
    • Use lean and six sigma tools to identify solutions to solve the patient flow puzzle
    • Identify strategies to challenge and change the culture from one of pushing admissions up to one of pulling admissions up

  • Barry Dennis, RN

    CEO and Co-Founder
    Navilife Health Solutions

    Creating Individuality in Multiple Hospital Markets with Single Source Operations (Strategic Transfer Center Design)

    Bio:

    Barry Dennis is a co-founder of Navilife Health Solutions, a service based company providing consultation and turn-key solutions to the complex patient navigation challenges encountered at every level of the healthcare delivery system. His business model evolved from a core transfer center concept into an all-encompassing patient navigation model designed to provide easy access to healthcare services in support of its clients’ needs, to mitigate the complexity of increasing healthcare cost while enhancing revenue potential.

    Prior to founding NHS he served as the Administrative Director of HCA’s TriStar Transfer Center where he developed and implemented a transfer center strategy serving five distinct markets across three states serving twenty-five different hospitals, each with its own identity and unique functionality. Under his leadership each of these distinct centers provided significant strategic value by improving patient retention across health systems while increasing market share and eliminating variability to access.               

    His career began 30+ years ago as a Registered Nurse, and transitioned into various leadership roles including, ICU Manager, Chief Nursing Officer, Assistant Administrator, and Director of Case Management in rural, suburban, and urban acute care hospital settings.

    Topic:

    Creating Individuality in Multiple Hospital Markets with Single Source Operations (Strategic Transfer Center Design)

    Taking a Transfer Center idea from concept to operations can be very labor intensive and complex due to existing market dynamics related to pre-existing processes and political/cultural history.  Couple this with multiple hospitals within a single market or even multiple markets, the task becomes almost overwhelming and tends to drive the implementation process in the direction of a standardized model.  The easy solution is to force hospitals and health systems into utilizing a generic transfer center name with standardized protocols. These are designed to promote efficiency in transfer center operations rather than allowing them to create a Transfer Center identity consistent with their historical branding and processes. 

    Hospitals and health systems spend millions of dollars each year to maintain and protect brand identity with unique processes and protocols to which their medical staff and referral sources have embraced. The last thing they want from a Transfer Center operator is to de-brand and change protocols that create disruption with their medical staffs.

    Multiple transfer center operations can be operationalized effectively and functionally while maintaining and protecting brand identity for the markets served while maximizing Transfer Center productivity without creating work pods unique to support each market. With the right telephony, transfer center software, and employees this arduous task can be accomplished; thus allowing markets served the opportunity to create and maintain a unique identity that includes specific protocols and invoke a sense of ownership by the hospitals and health systems . The objective of every Transfer Center is to make the hospitals and health systems they serve successful. Therefore, the more sense of ownership the hospital or health system has with the Transfer Center the more successful everyone becomes.                    

    After this presentation, participants will:

    • Understand the role of the Transfer Center in protecting brand awareness for the health systems served.
    • Realize the importance of maintaining consistency in processes unique to each market.
    • Know how to leverage technology to exceed customer expectations while maintaining operational efficiency in the Transfer Center.

  • Panel Discussion

    Ann Keane, RN, MSN, MA, NEA-BC, CCRN; Joanne Fletcher, RN, MSN, Ed.D
    Catherine Morris, RN, MS, CCM, CMAC; Laura Ostrowsky, RN, CCM, MUP

    Patient Flow: “It Takes a Village” (Case Management’s Role in Care Transitions, On-Time Discharge, Readmission Reduction)

    Bio:

    Catherine Morris, RN, MS, CCM, CMAC has with over thirty years of healthcare experience spanning multiple aspects of the continuum. Her emphasis for the last fifteen years has been on health care financial management focusing on disease and case management in the insurance environment then moving into the acute care setting. Currently her concentration is on quality and efficiency issues, denial management and revenue cycle improvement. She is an established speaker on various topics at both local and national conferences. CMSA named her the National Case Manager of the Year for 2009.  She is currently the Director of Care Management at St Joseph’s Hospital. 

    Laura Ostrowsky RN, CCM, MUP is currently the Director of Case Management at Memorial Sloan-Kettering Cancer Center (MSKCC) and the 2012 CMSA Case Manager of the Year.  She holds a Masters degree in Health Planning and Policy from Hunter College, has been a CMSA member since 2005 and is currently serving on the Board of Directors of the NYC Chapter.  She has had articles published in CMSA Today, Professional Case Management and Case in Point Magazine.  Laura has over 30 years of health care experience, including time as a staff nurse, QA Coordinator, Director of UR and QA, followed by directorships in CM at New York Presbyterian and currently Memorial Sloan-Kettering Cancer Center.  She also spent 3 years in information services at the NYP Presbyterian Network overseeing the selection, acquisition and implementation of an integrated hospital information application for UR, QA, Credentialing and Risk Management at 5 network hospitals.

    Joanne Fletcher, RN, MSN, Ed.D received her Associates Degree and Master’s Degree in Nursing with a focus on health promotion from Wesley College, Dover, DE.  She received her Doctorate Degree at Wilmington University in Organization Leadership with her dissertation focus on hospital readmissions.  She has 30 years of experience in a hospital setting.  Her professional experience has been in the Emergency and Care Management Departments in staff and leadership positions.  She has been in her current role as Director of Bayhealth Medical Center’s Care Management Department in Dover, DE for the past 12 years.

    Ann Keane, RN, MSN, MA, NEA-BC, CCRN completed her undergraduate nursing education at Misericordia University in Pennsylvania.  Her graduate degrees in nursing and education are from Seton Hall University, in South Orange, NJ.  She is currently pursuing her PhD in Management with a specialization in leadership and organizational change from Walden University.  Ann is board certified as an advanced nurse executive, a fellow in the American College of Healthcare Executives, and a Wharton Nurse Executive Fellow.  In her current role, Ann serves as the Director of Patient Care Services at Kent General Hospital for Bayhealth Medical Center, in Dover, Delaware.

    Topic:

    Patient Flow: “It Takes a Village” (Case Management’s Role in Care Transitions, On-Time Discharge, Readmission Reduction)

    Optimal patient flow cannot be achieved by any one department or division alone; it must be a team effort. Case Management is key in coordination of services and monitoring progress to improve LOS, appropriately utilize resources, manage and meet on-time discharge, and reduce readmissions. These tasks are daunting because they involve connecting players from across hospital disciplines and administrative teams. To be successful, leaders need to cooperate and communicate. Optimizing patient care takes a village – the healthcare village.

    Panelists will discuss successful procedures to prevent readmissions, tactics to enhance team communication, essential partnerships to streamline care transitions, efficient utilization management principles, and take questions on ways to leverage case management principles and personnel to enhance patient flow.

  • Mike Harrington, MPT, MBA and Jess Andringa, RN, BSN, MHA

    Patient Flow Consultants
    Central Logic

    Capacity Management and Process Engineering: Stop Solving the Wrong Problems

    Bio:

    Michael Harrington, MPT, MBA: During his 20 years in tertiary and quaternary hospital operations Mike Harrington has been a clinician, an administrator, and a change agent. He has led departments including the ED, patient placement, and patient transportation. Mike is a process and data junkie. His resume includes certifications in Six Sigma and Lean. When not chasing numbers, he’s chasing after his 3 kids and dog.

    _________

    Jessica Andringa, RN, BSN, MHA: Jess brings years of experience in emergency and family practice nursing, transfer center leadership, and risk management to her true nursing niche at Central Logic as a Patient Flow Consultant. Jessica is passionate about optimizing the global healthcare experience for patients and caregivers alike, and knows that enhancing throughput is an optimal starting point. Years in bed placement, transfer coordination, and healthcare administration have provided Jessica the knowledge to assist clients in achieving their quality and financial goals by optimizing throughput. Jessica resides in Fort Collins, Colorado with her family and three dogs. 

    Topic:

    Capacity Management and Process Engineering: Stop Solving the Wrong Problems

    Hospitals are never stagnant; patients, processes, and staff are in constant flux. To remain sustainable, hospitals must learn to accurately forecast future demand and capacity amid the constant change. Mike Harrington and Jess Andringa will describe how to mitigate the impact of variation, constraints, and waste through processes and technology. Participants in this session will learn to recognize barriers that impede patient throughput and also how to overcome them. 

    Following this presentation, attendees will be able to:

    • Describe the influencing factors (constraints, variations & waste) that currently impact patient flow
    • Explain the impact of these factors on the throughput of patients within your facility
    • Articulate steps to mitigate these negative influences at your place of work