#13 - Transfers Tile

Andy Day: Hello and welcome. This is Andy Day from the Command Center team, And today we're here to talk to you about the Transfers Tile.

Right now we're on Tile Viewer, which is our landing page. And you can see that there's nine different Tiles or apps that are available to pick from, depending on the individual configuration they'll be different. But we're here to talk about Transfers today. So I'll click on the middle one and dive into the Tile. Before I look at the individual patients that are trying to transfer, I just want to orient to the Tiles navigation.

In the upper left, you always see the name of the Tile. As you move across to the upper right, you see the IR Info button. That's where the Legend lives. You can always see the definition of any flag or icon that's used in the Tile here. You don't need to have a cheat sheet or an education guide or whatever. It's available within the Tile itself, always kept up to date. And then as you move to the right of that, the little gear Settings button is where an individual user can change the way the Tile appears for them to fit their preferences. So they, for example, can change the sort order. The default is usually elapsed time, how long the patient's been queuing, but you can also sort by bed type.

You can control the scrolling behavior of the Tile, and you can have it not scroll, or you can have it scroll like the Hertz board at the airport. And then you can, most interestingly, apply filters depending on your role to take a subsection of these that are most interesting to you. And as a user you can save that as your default, if you'd like. So next time you log in it comes back to just that way.

In the bottom left corner of the Tile with the little flickering bars there, that's the Freshness Indicator. That tells us when the data was last pushed to the Tile. We typically have that data being pushed to Tile every 30 seconds, so it's very near real time and kept up to date, and that way we know. Now of course, the data today is mock data, because this is a demo, but it's very representative of what you'd see in the real world when you use the Tile.

So now let's look at individual patients that are trying to get a bed, or get into the system. The section on the left there where it says ‘Internal Transfers’ you can see that there's 20 of them, the number at the top there. And each of these rows is a patient. So if I look at the first one, you see if that patient's been waiting for one day and 16 hours trying to get in, and they're waiting for a tele med surge bed. Now, you see the patient's name and then the patient's MRN. You can right click on that and copy paste it into the lookup bar in your EMR to get to that patient fast without having to hunt through a bunch of patient's names trying to find them. You can see that that patient is in an inpatient bed in Facility 1, and they're trying to get to Facility 8.

As you move to the right, you then see where it says 'Pending MD Accept'. This is the workflow state of the transfer, and they go through a series of workflow states, and you can see where they are in the process. The one below that's awaiting dispatch, for example.

The one below that's transporting. The little red 4 there, that waiting dispatch, that says that there's 4 beds that appear to match the bed need of that patient, based on what we know about that patient right now. And you can see here that 3 of them have green buckets. That means the beds are clean and available and ready, and have been for some time. And that's why that red bed is lit up, indicating that there are beds meeting that patient's need apparently.

And of course, that final decision is made by the bed management team that assigned the beds based upon hospitals, protocols, and procedures, as well as their clinical judgment, but this at least indicates that based on what we know, there are options that appear to be available.

Below that, you see the Transporting one. There's a little ambulance next to that. That says that patient's in transit and they are coming in an ambulance. It could also be a fixed wing aircraft or helicopter, depending on again, the mode of transport. That category was again, Internal Transfers. To the right, you see External Transfers, patients trying to come from an outside facility. And then below that, Direct Admits, patients that are in, typically, a hospital clinic where the physicians decide this patient needs to be an inpatient right now, and they have a discussion with the attending and put them on the direct admit list So as an individual user, I might have a different use case. I might want to only look at a subset of these patients.

So let's say for example, I am an intensivist. I want to go up to the gear button and apply a filter to look at just those patients that have a level of care of ICU. So I can say, just show me those patients that are interesting to me. I hit 'apply' and that'll filter down the list of patients to just these 2. You can see 1 out of 21 and 1 out of 20 that are trying to get into ICU. And I can save that as my default view for this page so it's set up the way I like it. Let's say I'm a bed manager and I'm trying to assign beds. So I'm going to clear that filter and say, "I want to look at a workflow state where the next step in the process is 'assign bed' " and select that and hit apply. And this will show me just those patients that are far enough in the workflow that they're ready to have a bed assigned and don't have one yet, and you can see what is going on there. But one last thing I want to show you is, you go to the ‘i’ button.

We're going to look at one of the symbols here, which is the top one there, which is a reroute opportunity. This flag will show up if there's a patient that's trying to come into the hospital, and based upon where their home zip code is, there's another facility that's closer to that patient's home that offers the service or bed type that matches that patient's needs. This can be very helpful in trying to steer patients to where there's a location that might be more convenient to them, but offers the services they need and might not be as crowded or might be more available in the moment.

Now, of course, the bed manager makes that final call based on their clinical judgment, but oftentimes there's a tendency to just always send everybody to the main campus. And this can be very helpful in rerouting patients to places that can offer that service that are more convenient.

Thank you for your time.