St. Joseph Hospital Implements ED Orchestration

BY: Erik Davidson CATEGORY: Success Stories

The Opportunity

Located within the Los Angeles metropolitan area, St. Joseph of Orange encounters a high volume of patients with a variety of clinical and social determinants of health (SDoH) needs, including behavioral health and substance-use disorder conditions. Adding to the complexity, like most EDs, patient traffic fluctuates depending on time of day and year. Although some patient flow patterns emerged, the fluctuations were not always predictable, which required the hospital to call in additional clinical staff during particularly busy times and send staff home during unexpectedly slow shifts.

With the large volume of patients and complexity of needs, hospital leaders determined that less critical patients spent longer than required in the ED. These slower “process cycle times,” as the hospital referred to them, contribute to dissatisfaction, both for patients being cared for, those waiting in the reception area, and their families. This dissatisfaction caused some patients to leave the ED without receiving care, which both increased a patient’s health risk and decreased revenue for the hospital.

Identifying causes for delays at the various stages of care was a challenge without live observational studies, which are time-consuming and expensive and can be highly subjective. The hospital recognized that more effective clinical communication would move patients through the ED more efficiently, but it wanted to prevent providers from becoming inundated with too many messages and alerts that could distract and slow them down

Key Details

  • Large Metropolitan Hospital
  • High volume of patients
  • Variety of health needs
  • Unpredicatble traffic fluctuations
  • Staffing complications
  • Slow processing times, long waits
  • Increased patient health risks
  • Decreasing revenues

The Solution

To improve ED oversight and patient throughput, St. Joseph Hospital of Orange implemented TAGNOS ED Orchestration Solution throughout the department and related screening and care areas. The implementation was completed in a month.

Now implemented, the location monitoring and intelligence begins in the ED as soon as the patient enters the hospital. At registration, patients receive a bracelet that includes a radio frequency identification (RFID) tag which is linked to the patient’s identity and their health issues. The bracelet beacons its identification at regular intervals to receivers installed around the emergency department, the radiology and laboratory departments, and other screening and care areas. Physicians, nurses and technicians also wear badges that contain RFID tags. Determining when patients and providers interact and how long they interacted were important measurements the hospital wanted to track as it impacted both efficiency and patient satisfaction.

Along with the interaction and location of patients and providers, St. Joseph Hospital of Orange clinicians can view in real-time how long patients have been waiting and what they are waiting for, such as to see a physician or receive test results. With its AI-powered machine learning capabilities, the TAGNOS ED Orchestration Solution also provides highly accurate measurements of anticipated wait times in each phase of care, as well as total process cycle time. To prevent the patient from waiting too long in any area, the TAGNOS ED Orchestration Solution offers highly targeted alerts to only relevant providers and staff, which minimizes interruptions to others and allows them to focus on patient care. For example, environmental services staff can be alerted of a discharge so a room or bay area can be cleaned and prepared for the next patient and then the charge nurse is alerted when a bed or bay area is ready for the next patient. Formerly, the nurse would need to visually verify or manually message a colleague to determine if there was an available bed, slowing cycle times.

The Results

In only six months since implementing the system, St. Joseph Hospital of Orange reduced the patient’s room-to-discharge time by 55 minutes on average and decreased the number of patients who leave the ED without being seen by a provider by an average of 68 patients per month. Increasing the number of patients receiving needed care earned the hospital an average of $2,500 in reimbursement per non-critical patient for a total of more than $625,000 over six months while reducing the overall length of stay for those patients by 15 minutes. Staffing efficiency also improved in that time, enabling the hospital to save more than $27,000 in labor costs in six months while improving the productivity and efficiency of the clinicians.

55m

Patient Room to
Discharge Time
Reduction

68

LWBS Patients
Average / Month
Reduction

$625K

Six Month
Hospital Earnings
Increase

15m

Overall Patient
Length of Stay
Reduction

$27K

Six Month
Labor Costs
Savings

With TAGNOS’s AI-powered machine learning technology, the savings and clinical quality performance will only improve over time. St. Joseph Hospital of Orange intends to leverage the intelligence to better predict patient volume and clinical staffing needs based on an analysis of its history combined with TAGNOS proprietary algorithms to ensure the right staffing mix for that day or time of year. Although staffing levels have already improved, prediction of patient census and optimal available staffing will ensure patients’ care episodes advance efficiently without needing to send clinicians home due to lack of need.

St. Joseph Hospital of Orange also plans to integrate the location data and analysis with its electronic health record providing even richer data to analyze the impact of process times on safety and clinical outcomes. The hospital also intends to use TAGNOS ED Orchestration Solution’s analytics to determine how delays in inpatient locations such as the heart catheterization lab and operative services affect the ED’s throughput to focus on collaborative solutions to enable the entire hospital to operate more efficiently.

With the TAGNOS ED Orchestration Solution, St. Joseph Hospital of Orange now has complete, real-time visibility over provider workflows and patient traffic. With relevant clinical, non-obtrusive clinical communications and AI-powered analytics, the integrated solution will guide the hospital toward many other such opportunities to further streamline workflows and safely increase patient throughput while optimizing outcomes and satisfaction.

About the Author

Erik Davidson

Putting customers at the heart of TAGNOS

Erik serves TAGNOS as its Chief Customer Officer. He is responsible for keeping customers at the heart of the TAGNOS mission by leading Sales, Marketing, Customer Success, and Product Strategy initiatives. Erik has a breadth of entrepreneurial experience that includes being a founder, employee, advisor, and investor in a variety of new ventures. Complimenting his entrepreneurial experience, he has also been hired to serve in leadership roles at established businesses ranging from managing functional departments to growing the organization as the CEO. Erik is actively involved in his community and serves in part-time public office.  When he isn’t working, he is cherishing time with his loving family, teaching Taekwon-Do, spending time outside, reading, learning, or simply enjoying life.

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