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Moving Beyond Reactive Healthcare Operations: Using Real-Time Data to Improve Patient Flow and Capacity · Becker’s Healthcare Digital Health + Health IT

• 0:00
  - Hello, everyone. This is Erica Spicer Mason with
• 0:02
  - Becker's Healthcare. Thank you so much for tuning
• 0:05
  - into the Becker's Healthcare podcast series. Today, we're
• 0:08
  - going to talk about moving beyond reactive healthcare
• 0:11
  - operations
• 0:12
  - and how better visibility, real time data, and
• 0:14
  - predictive tools can improve patient flow, capacity, and
• 0:18
  - operational decision making.
• 0:20
  - So joining me for this conversation, we have
• 0:22
  - Bree Bush, the general manager of CareIntellect
• 0:25
  - at GE Healthcare,
• 0:27
  - and Ashley Shearer, vice president of care coordination
• 0:30
  - and patient flow at the Queen's Medical Center.
• 0:33
  - Ashley, Bree, welcome. Great to have you with
• 0:35
  - us today. Thanks for having us. So glad
• 0:37
  - to have you with us. Let's go ahead
• 0:39
  - and get started with introductions, just learning a
• 0:41
  - little bit more about you both. Brie, maybe
• 0:44
  - you can get us kicked off with those.
• 0:45
  - Tell us a little bit about yourself and
• 0:46
  - the perspective that you're bringing to the conversation.
• 0:49
  - Yeah. Thanks for having us again. I'm Bree
• 0:51
  - Bush. I'm the general manager of our Care
• 0:53
  - Intellect Solutions at GE Healthcare,
• 0:56
  - and I've been dedicating my life's work to
• 0:58
  - helping hospital operations day in and day out,
• 1:01
  - trying to improve better access to care. That's
• 1:03
  - really our mission and our focus.
• 1:05
  - Alright. And Ashley, you wanna tell us a
• 1:07
  - little bit about you? Sure. I'm Ashley. I'm
• 1:09
  - the vice president of care coordination and patient
• 1:12
  - flow, and I lead the team who is,
• 1:15
  - working in our command center day in and
• 1:17
  - day out, trying to find all the barriers
• 1:19
  - and delays that prevent patients from moving through
• 1:22
  - our system
• 1:23
  - safely and effectively and efficiently.
• 1:25
  - Yeah. I mean, effectively, efficiently,
• 1:29
  - it's no easy feat to do that in
• 1:31
  - terms of
• 1:32
  - patient access and working within a complicated health
• 1:35
  - care system.
• 1:36
  - And I know GE Healthcare Summit was built
• 1:38
  - around this idea of moving past reactive operations.
• 1:42
  - So I'm curious when you both look at
• 1:45
  - how health systems are running right now, whether
• 1:47
  - that's from the first person perspective or from
• 1:49
  - what you see, Bree, across the industry,
• 1:52
  - what still seems reactive despite that extensive investment
• 1:56
  - in tech in recent years? And how does
• 1:57
  - it ultimately affect teams?
• 2:00
  - A lot of the work we do is
• 2:01
  - still very reactive. So we can identify now
• 2:04
  - much better than previously,
• 2:07
  - where delays and barriers are. We're not guessing
• 2:10
  - anymore. We know where they are. But we
• 2:12
  - see them in real time and then have
• 2:14
  - to sort of firefight to put those fires
• 2:16
  - out and move patients again through the system.
• 2:19
  - Yeah. And
• 2:21
  - and, Brie, I'm curious how you're seeing this
• 2:23
  - too. You're working with so many organizations
• 2:25
  - day in and day out.
• 2:27
  - It sounds like to Ashley's point,
• 2:30
  - the the challenges and the barriers are visible
• 2:32
  - now, but maybe taking that next step and
• 2:35
  - operationalizing
• 2:35
  - a fix or an intervention can be tough,
• 2:37
  - but curious what you're seeing. Yeah. I feel
• 2:39
  - like when I show up and talk to
• 2:41
  - the teams, they say, is it gonna be
• 2:43
  - a good day or a bad day?
• 2:45
  - How do they know? I think it's in
• 2:47
  - their gut.
• 2:48
  - They have some data, but a lot of
• 2:50
  - it is a feel.
• 2:51
  - It's a feel of a lot of great
• 2:53
  - expertise that they've had over many, many years.
• 2:55
  - And I think that they're not planning for
• 2:57
  - tomorrow yet. They're not planning for two days
• 2:59
  - out, and some of that's very predictable. We
• 3:01
  - can see what's coming. I think the other
• 3:03
  - thing that's been really hard is the interdependencies.
• 3:06
  - I mean, if you look at, I don't
• 3:07
  - know, an average care team might have, I
• 3:09
  - don't know, six, eight, 10 different people touching
• 3:12
  - them and coordinating that care, and it's complicated.
• 3:15
  - And so one bottleneck,
• 3:17
  - you know, with one team who might be
• 3:19
  - short staffed, all of a sudden creates a
• 3:21
  - huge cascade. And I think that's what we
• 3:22
  - really mean about kind of reactive operations. We
• 3:25
  - can't see those patterns. Yeah. So we... And
• 3:27
  - we can't anticipate them. So we don't know
• 3:28
  - how to problem solve for them in that
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  - moment. Mhmm. Absolutely.
• 3:32
  - Appreciate the insights from you both. So, Ashley,
• 3:35
  - at the Queen's Medical Center, I'm curious where
• 3:37
  - better visibility into what's happening across
• 3:40
  - the organization has changed, how your teams work
• 3:43
  - together, how they collaborate or troubleshoot.
• 3:45
  - And what has that made possible that wasn't
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  - made possible before?
• 3:50
  - So previously,
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  - we spent a lot of time, like,
• 3:54
  - to Breeze Point, sort of guessing what was
• 3:55
  - happening and guessing what was going to happen.
• 3:58
  - A lot of departments were doing incredible work,
• 4:00
  - but they were doing them in silos. And
• 4:02
  - so they didn't know that
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  - what
• 4:06
  - they did would impact what the next department
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  - was gonna do. So if somebody's waiting for
• 4:10
  - MRI,
• 4:11
  - but rehab is gonna come into the room,
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  - and then we stall the MRI so that
• 4:15
  - rehab can be there, that really slows down
• 4:17
  - the patient's entire progression of care and can
• 4:19
  - kind of back up the whole day.
• 4:22
  - Mhmm. Being able to pull the curtain back
• 4:24
  - a little bit allowed all of those teams
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  - to see the interdependencies
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  - between each other and
• 4:29
  - kind of move beyond whose turn is it
• 4:31
  - or whose fault is it into, hey, what
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  - are the next steps for all of us
• 4:34
  - to to help this patient get through care?
• 4:37
  - Mhmm. Yeah. And, Brie, how does that compare
• 4:40
  - to what you've seen at organizations who are
• 4:42
  - leveraging this kind of visibility?
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  - Is that... Is it closely aligned with what
• 4:46
  - the Queen's Medical Center is experiencing? Or what
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  - else is that? Absolutely. And I think that
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  - there's... If we look at what does data
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  - do, it brings everyone to the same playing
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  - field. It brings transparency,
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  - and so we're finally singing from the same
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  - sheet of music.
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  - It's very easy in your individual silos, as
• 5:02
  - Ashley said, to be so consumed with just
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  - how you are operating. I think the transparency
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  - allows us to understand questions, understand where the
• 5:10
  - problems are, the true problems, not just, hey.
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  - It looks like this might be happening, but
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  - is that really the underlying root causes or
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  - something else there?
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  - So I really feel like the transparency
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  - has driven that cultural change. Mhmm. And I
• 5:22
  - think as Ashley will attest to, I think
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  - in many of these changes, it takes
• 5:27
  - a village of people. Everyone has to change.
• 5:30
  - Mhmm. I think there's so much... You know,
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  - it's a lot of finger pointing until you
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  - get to that point. And then when you
• 5:35
  - realize, well, oh, we all have to do
• 5:36
  - our part, then all of a sudden you're
• 5:38
  - rolling together. You know? And I think that's
• 5:39
  - a big change for these organizations when they
• 5:41
  - have that visibility.
• 5:43
  - It's such a good point, and I definitely
• 5:45
  - wanna go deeper on the adoption and change
• 5:48
  - management piece here.
• 5:49
  - Before we do, though, just wanna acknowledge that
• 5:53
  - data and predictive tools for patient flow and
• 5:55
  - capacity, they're not new to health care. These
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  - tools have been around for a while.
• 6:00
  - So at this point,
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  - what are you seeing separate organizations that are
• 6:05
  - getting actual value from those tools
• 6:08
  - compared to those who maybe haven't fully realized
• 6:10
  - the benefits?
• 6:12
  - I think it's important to not just use
• 6:14
  - technology as the only solution to a problem.
• 6:16
  - Mhmm. It's a tool, but adding
• 6:19
  - technology on top of a problem doesn't necessarily
• 6:22
  - fix it. So you need those processes and
• 6:24
  - the people to be all kind of wrapped
• 6:26
  - around that technology.
• 6:28
  - You also need the technology to support existing
• 6:31
  - effective workflows.
• 6:32
  - So in any system that has breaking points
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  - or barriers, there are probably a lot of
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  - processes that work just fine Mhmm. And some
• 6:40
  - that don't. It's hard to tell which is
• 6:41
  - which. You got the technology in there, you
• 6:43
  - can kinda see it, but don't shift and
• 6:45
  - adjust those processes that are currently working. And,
• 6:48
  - hopefully, you can have the technology
• 6:50
  - to kind of be nimble and flex for
• 6:53
  - your team so that you can continue doing
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  - the good work you are already doing and
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  - then add and enhance,
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  - with new processes.
• 7:01
  - Yeah.
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  - And I feel like the the concept of
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  - adoption and change management fits in nicely here.
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  - So many organizations are considering that the hard
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  - part when they're introducing something like a command
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  - center or other piece of technology that's meant
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  - to make things more efficient,
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  - operationalize
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  - workflows, but it's certainly hard when you're trying
• 7:21
  - to get all of these different teams on
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  - board. So we'd love to hear from you
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  - both
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  - how you think that leaders should ensure that
• 7:29
  - these enterprise wide operational improvements are becoming a
• 7:33
  - new way of working together rather than something
• 7:36
  - like the flavor of the week, so to
• 7:38
  - speak. You know, how how how can this
• 7:40
  - change really stick?
• 7:41
  - I think the the first thing that's really
• 7:43
  - important is to listen to your frontline staff.
• 7:45
  - They know where all the problems are. Mhmm.
• 7:49
  - I think often
• 7:50
  - we kind of hand them something, and that's
• 7:52
  - where it feels like the flavor of the
• 7:53
  - week. Hey. There's a new process or a
• 7:55
  - new piece of technology that we're gonna require
• 7:58
  - you start using. Mhmm. But if you listen
• 8:00
  - to them and listen to what their problems
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  - are,
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  - and then make sure that the technology
• 8:05
  - that you're gonna propose supports
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  - and
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  - helps make their job easier, better, more effective,
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  - more efficient,
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  - you'll get the buy in from them. And
• 8:15
  - I think for something like this, specifically in
• 8:17
  - health care, really bringing the focus back to
• 8:19
  - patients,
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  - back to access to care,
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  - back to those quality measures. So if you
• 8:24
  - can impact those things, you'll get your frontline
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  - staff who didn't sign up to be a
• 8:29
  - nurse so that they could save a hospital
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  - money or hit KPIs. Like, they wanna do
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  - the right thing for patients. So if you
• 8:34
  - can reframe
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  - your solution around that Mhmm. And have that
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  - be the driving force behind it, I think
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  - you get,
• 8:40
  - more buy in, more enthusiasm
• 8:42
  - for change. Yeah. And did you find that
• 8:44
  - to be the case at the Queen's Medical
• 8:46
  - Center where where, like, the clinical metrics and
• 8:48
  - improvements, is that what resonated with teams? Yeah.
• 8:50
  - For many years, we talked very much about
• 8:52
  - length of stay, and we had, you know,
• 8:54
  - x number of days saved equals x number
• 8:56
  - of dollars. And that was our messaging all
• 8:58
  - the time when we present in town halls
• 9:00
  - to our frontline staff and sort of meaningless
• 9:03
  - to them. But when we started saying, hey.
• 9:05
  - If if we don't decrease our length of
• 9:06
  - stay, this is how many patients we deny
• 9:09
  - transfer into higher level of care. This is
• 9:11
  - how many patients are in the emergency department
• 9:13
  - right now waiting for a bed upstairs in
• 9:15
  - a hallway bed. Mhmm. And that really did
• 9:17
  - shifting the focus around it being a purely
• 9:20
  - financial decision,
• 9:21
  - into access and patient care really did help
• 9:23
  - get everybody on board. Yeah. I might add,
• 9:26
  - I think it has to be top down
• 9:27
  - and bottom up. Because if the top is
• 9:30
  - not aligned, like, these solutions are transformations. Right?
• 9:33
  - So you need the IT team, the clinical
• 9:36
  - team, the operations team in lockstep. Mhmm. The
• 9:39
  - vision has to be very clear and simple
• 9:41
  - because you have to be able to communicate
• 9:42
  - access to care. It's a very simple mission
• 9:44
  - for people to get behind.
• 9:46
  - I think the leadership's job is to set
• 9:48
  - that vision
• 9:50
  - and break down the barriers and the silos
• 9:51
  - where they come up, but then you gotta
• 9:53
  - go grassroots because the reality of how the
• 9:56
  - work is done and to make anyone's lives
• 9:58
  - easier, which that's all why we're adapting AI,
• 10:00
  - that's all why we're doing this stuff is
• 10:02
  - to make people's lives easier so they can
• 10:03
  - better serve the patient. It has to be
• 10:05
  - at that grassroots level. I think where I've
• 10:08
  - seen organizations go really slow is when leadership
• 10:11
  - loses focus quickly. The transformation takes time, and
• 10:14
  - it takes resilience and focus.
• 10:17
  - And when that leadership team begins to shift,
• 10:21
  - everyone underneath starts... You know, the foundation just
• 10:23
  - gets really wobbly. So I think it's both
• 10:25
  - top down and bottom up to see these
• 10:27
  - organizations make the change. I think it's also
• 10:30
  - the relentless focus.
• 10:31
  - Yeah.
• 10:32
  - It's such an interesting concept, relentless focus in
• 10:35
  - this day and age where change is happening
• 10:38
  - constantly.
• 10:39
  - Technology is evolving and developing so rapidly.
• 10:42
  - You know, can you think of an example
• 10:44
  - or even just the best practice you've witnessed
• 10:45
  - to help leadership teams stay focused? It sounds
• 10:48
  - like such a rudimentary
• 10:50
  - concept, but I I think it's important for
• 10:52
  - listeners to hear. I mean, from my perspective,
• 10:55
  - change is constant in this world. Yes. We
• 10:57
  - all agree to that. The focus, though, is
• 10:59
  - on the outcome that we're trying to achieve.
• 11:01
  - So I think how we get
• 11:03
  - somewhere will... Might look different. But I think
• 11:05
  - if we're focused on access,
• 11:07
  - then it's really clear we're gonna keep trying
• 11:09
  - more and more strategies. We're going to adapt.
• 11:12
  - We're going to learn.
• 11:13
  - That relentless focus, I think, on the why
• 11:16
  - needs to say, how you get there? Well,
• 11:17
  - you have to learn. You're gonna try some
• 11:19
  - things. Things aren't gonna work. You're going to
• 11:21
  - adapt. I think you have to prepare the
• 11:23
  - team for this is how we learn and
• 11:25
  - get better together. And I think health care
• 11:27
  - is kinda set up for that. It's a
• 11:28
  - scientific Yeah. You know,
• 11:30
  - field, and I think they're used to looking
• 11:32
  - for evidence, trying things, and looking for the
• 11:35
  - evidence of what's gonna work.
• 11:37
  - It's great perspective, and it's very aligned with
• 11:39
  - what you had mentioned about the frontline, having
• 11:41
  - that why behind transformation is essential.
• 11:44
  - Just add really quickly. I think Please. So
• 11:47
  - kind of a day to day thing around
• 11:49
  - that is put in a governance structure the
• 11:51
  - way you would for any other project you
• 11:53
  - are working on. So take flow seriously like
• 11:55
  - you would quality,
• 11:57
  - like you would any other kind of measure.
• 11:59
  - And put in
• 12:01
  - leadership, put in
• 12:03
  - frequent meetings, put in expectations, hold people accountable.
• 12:07
  - So while you do all those kind of
• 12:08
  - iterations of trying new things, you do have,
• 12:11
  - like, a solid foundation and an expectation that
• 12:13
  - you're reporting this back out.
• 12:15
  - At Queen's, we actually made it one of
• 12:17
  - our board our board goals, and that really
• 12:19
  - helped center everyone around it and keep our
• 12:21
  - leadership team engaged on that. Yeah. That's hitting
• 12:24
  - all the marks. You're keeping leadership focused and
• 12:26
  - engaged. The frontline teams are held accountable.
• 12:29
  - It's been great hearing both of your perspectives
• 12:32
  - throughout this conversation.
• 12:33
  - If listeners remember just one thing from what
• 12:36
  - we've talked about today, what do you think
• 12:38
  - it should be?
• 12:40
  - I think we talk a lot, especially with,
• 12:42
  - like, health care tech,
• 12:43
  - about how change is hard. And some of
• 12:45
  - your questions were about adoption and how that
• 12:47
  - can be challenging. And I just wanna put
• 12:48
  - out there that change
• 12:50
  - by nature is neutral. It's not hard and
• 12:53
  - it's not easy. Resistance to change, and so
• 12:56
  - it's really hard and makes change,
• 12:58
  - something that can feel painful in an organization.
• 13:01
  - And so I would just hope that listeners
• 13:03
  - have a little bit of openness and curiosity
• 13:05
  - around what could be different in their system,
• 13:07
  - in their process, with their team.
• 13:09
  - And being open to that change will help
• 13:11
  - it be a lot less painful, a lot
• 13:13
  - less hard.
• 13:14
  - That is
• 13:15
  - profound. That change is not inherently hard, but
• 13:19
  - it's the resistance that you meet it with.
• 13:21
  - Wow.
• 13:22
  - Fantastic. Brie, I... I'm sorry you have to
• 13:24
  - follow that up, but Love it. Oh my
• 13:26
  - goodness.
• 13:28
  - I'm a little bit more literal in my
• 13:30
  - engineering days.
• 13:31
  - I think my thing that I would listen
• 13:33
  - is your relentless pursuit to get better, I
• 13:36
  - think, is key. I think in health care
• 13:39
  - in general,
• 13:40
  - it's
• 13:41
  - slow sometimes,
• 13:43
  - but you need the tenacity
• 13:44
  - to keep on driving forward.
• 13:47
  - I also think there's a wave
• 13:48
  - coming for us or we're in it now
• 13:51
  - where there is a real opportunity to transform
• 13:53
  - how we really do the work. I think
• 13:55
  - that's gonna require
• 13:56
  - investments
• 13:57
  - beyond what we do today in our EMRs
• 13:59
  - and some of our staffing systems
• 14:02
  - because there's still so many silos. And I
• 14:04
  - think until we can connect to those pieces,
• 14:07
  - connect to what's happening on the resources side,
• 14:09
  - connect what's happening on the patient side, connect
• 14:11
  - what's happening on our staffing side, I don't
• 14:14
  - think we can get... What we aspire to
• 14:15
  - do is seamless care. What does seamless care
• 14:19
  - really look like? And I think I think
• 14:21
  - you have to have be willing to take
• 14:23
  - big and bold decisions,
• 14:24
  - and you need to be able
• 14:27
  - to create that change catalyst in your organization
• 14:30
  - and the why to to drive it forward.
• 14:32
  - So those are things I would be be
• 14:33
  - with. Well, it's incredibly dynamic work what both
• 14:36
  - of you have undertaken and and gone through
• 14:39
  - with with your transformation at the... At Queen's
• 14:41
  - and what you're seeing, Brie, in... Across the
• 14:43
  - industry. So I just wanna thank you both
• 14:45
  - for the time and the insights you share
• 14:47
  - with our listeners today.
• 14:49
  - You know, it feels really relevant talking about
• 14:52
  - this at our eleventh annual,
• 14:54
  - IT and revenue cycle conference. And I just
• 14:56
  - wanna thank you both for making the time
• 14:58
  - while you're here on-site. Thank you so much.
• 15:00
  - Thanks for having us. Thanks, Erica. And we'd
• 15:02
  - also like to thank our sponsor for today's
• 15:04
  - episode, GE Healthcare.
• 15:06
  - Listeners, be sure to tune into more podcasts
• 15:08
  - from Becker's Healthcare by visiting our podcast page
• 15:11
  - at beckershospitalreview.com.