November 16, 2022

Command Center opened to address capacity issues across health system

A new Command Center addressing capacity issues across the entire Vanderbilt Health system opened in August. The Command Center defines “capacity” as limits on Vanderbilt Health’s ability to serve patients seeking health care services.

Throughout the first few weeks, the group, which comprises operational and clinical leaders from both the hospitals and clinics, met daily to establish priorities, align similar workstreams, assign resources, and establish metrics for success. The Command Center team now meets twice a week—once as a core team and again two days later to report out on progress to senior leadership.

“The work of the Capacity Command Center is addressing one of the biggest challenges facing our health system—our ability to care for the vast number of patients who seek out Vanderbilt Health’s services,” said Deputy CEO and Chief Health System Officer Wright Pinson, MBA, MD. “Every week, the team delivers new successes, which, taken together, are making strides in improving our system’s challenges with capacity.”

The mission of the team is clear: with a clear focus on maintaining patient safety, the Command Center identifies and eliminates constraints on capacity. The team works toward this mission by:

  • Creating both general and real-time awareness of capacity challenges across the health system
  • Helping workstreams challenged with this work by prioritizing, focusing, and removing barriers for them
  • Developing key metrics and dashboards that help display capacity status, as well as pinpoint critical tactics or emergent issues

Capacity challenges can be linked to multiple factors, including:

  • The level of disease activity in the areas served by Vanderbilt Health
  • Lengths of stay for patients in the hospitals
  • Staffing levels in clinics and hospitals
  • Continued growth and strength of Vanderbilt brand, which increases demand for facilities and services
  • Patients seeking health care services where their needs may not be best met (e.g., patients with minor illnesses going to the emergency department instead of a walk-in clinic)

Because the causes of capacity issues are so complex, the Command Center is overseeing several workstreams designed to address specific aspects of the issue. These workstreams include:

  • Helping ensure beds do not unnecessarily remain in “idle” state
  • Optimizing space and services available in Vanderbilt Health’s regional hospitals
  • Connecting patients in need with appropriate behavioral health services
  • Fine-tuning processes for patients transitioning to other facilities, such as skilled nursing or long-term care, after their hospital stays (Transition Management Office)
  • Creating additional capacity for emergent situations, such as exploring use of double occupancy rooms
  • Improving workflows among services for ED patients
  • Creating and communicating dashboards for capacity metrics
  • Enhancing use of the Transfer Center
  • Directing certain patients after an ED visit to the appropriate clinic for follow-up

These workstreams bring together efforts that, in many cases, were already in progress before the establishment of the Command Center. The benefit to managing them through a centralizing structure, as opposed to discrete paths, is the access to resources and decision-making offered by the Command Center model. The Command Center also provides Vanderbilt leadership critical visibility into the progress of this work.

Given the complexity of these efforts, it should take some time to make significant momentum on the goals of each workstream. Yet despite this reality, some of the workstreams have demonstrated substantial progress. For example, the development of the metrics dashboards is nearing completion. Likewise, improved processes are now in place for triaging and assisting patients presenting with behavioral health issues in EDs within the health system.