Humber River Hospital sits in Toronto, Ontario, Canada.
Humber River Hospital sits in Toronto, Ontario, Canada.

Humber River Hospital (HRH) in Canada said it could relieve the shortage of beds by launching the “Command Center” in 2017. Functioning like an air traffic control tower, the command center in HRH was the world’s second after Johns Hopkins in the U.S.

Relocating to Toronto, Ontario, HRH newly opened with 656 beds in 2015. The hospital became popular with more visiting patients, and the number of patients waiting in the emergency room (ER) for more than a day started to go up. Some of them even stayed in the ambulance because they could not enter the hospital. HRH received a report that it could be short of 40 to 50 beds by 2021.

To tackle the overcrowding, HRH decided to take on a new challenge. It did not seek a conventional way of securing physical space through construction. Instead, the hospital partnered with GE Healthcare to set up the command center.

HRH installed the command center after one year of preparation. The 4,500 square-foot center has 15 to 20 employees who monitor 35 screens on a single wall. The monitors alert the status of waiting patients in the ER and hospitalized patients in real-time. After the command center launch, the number of patients waiting in the ER went from 30 to almost zero.

Humber River Hospital introduced the Command Center, which acts like an air traffic control center, in 2017. (Credit: Peter Bak, chief information officer of HRH)
Humber River Hospital introduced the Command Center, which acts like an air traffic control center, in 2017. (Credit: Peter Bak, chief information officer of HRH)

Peter Bak, chief information officer of HRH, explained how the command center changed the hospital operation at the Korea Healthcare Congress (KHC) 2020, an online conference organized by the Korean Hospital Association on Thursday.

According to Bak, the hospital completed setting up the first-generation command center in 2017 with 33 screens displaying various analysis results. “It analyzes patient movements, treatment flows, and ER status, and tell us what is going wrong,” he said. “It uses machine learning to predict the next 48-hour scenario, including the planned amount of transfer work and the number of staff required.”

The first-generation command center has been focusing on raising hospital capacity for three years, Bak went on to say. He said the command center brought the effect of securing 35 additional beds without building extra infrastructure or hiring more staff.

“This is because efficient hospital operation smoothened the flow of patient movements. It helped us save $11.5 million annually,” Bak said.

The new system also relieved the stress of medical staff so that they could concentrate on patient care.

Humber River Hospital’s command center has 15 to 20 workers who check on patients' status in real-time. (Credit: Peter Bak, chief information officer of HRH)
Humber River Hospital’s command center has 15 to 20 workers who check on patients' status in real-time. (Credit: Peter Bak, chief information officer of HRH)

In 2019, HRH upgraded the command center to a second-generation one to focus on quality improvement. By benchmarking the U.K. National Health Service, HRH created “Humber Early Warning Score” to monitor patients' vital signs up and close. The hospital also collaborated with Welch Allyn, a medical device company, to reflect the Humber Early Warning Scores in the vital sign monitors.

HRH has renewed the command center as a third version this year to slash unnecessary consults and ER revisits. The hospital is now building a system to monitor at-home patients. This helped the hospital respond to Covid-19, too, Bak said.

To brace for the post-Covid-19 era, Ontario asked patients with light symptoms to seek home care from primary physicians instead of visiting the ER. HRH also discontinued non-essential services due to concerns about lower capacity, but Bak said it was not a good decision.

“During the second outbreak of Covid-19, we continued services in other fields and optimized capacity for Covid-19 patients,” he said.

To do so, HRH had to discharge post-operative patients and monitor them after they went home. Bak said he looked through all of the many home monitoring products on the market but found several disadvantages. However, HRH is trying to cover the shortcomings through the third-generation command center, he added.

“If we can use robotic technologies to communicate with patients, guide medication, and even check vital signs, we will have a powerful means of response. We are going in this direction, and this may be realized next year,” Bak said.

According to Bak, the command center played a key role in operating the hospital successfully because it improved capacity, reduced costs, and enhanced patient safety.

“It helped us respond to Covid-19 and made remote patient care possible in the post-Covid-19 era,” he said.

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