Entry 4: Visualization improves workflow, referral numbers

St. John Health System sees big improvements after implementing patient flow software.


When someone would call out “code purple” over the loudspeaker at St. John Medical Center in Tulsa, OK, the staff would mobilize. They would meet in an empty room and develop a plan of action, discussing priorities and patient-flow strategies based on the information they had with them. The problem was, by the time they walked out of the room, the plan had already changed.

In a hospital environment, days are constantly in flux, and a successful one is measured by how quickly staff can react to new challenges.

“We thought we were pretty innovative with our ‘code purple’ calls,” says Shelisa Scott-Combs, R.N., BSN, Nursing Director of Patient Logistics Center, St. John Health System. “But really, we were giving ourselves a headache. First, because we were calling nurses away from their floors, and secondly because we were already planning based on old data. What you thought was going to happen isn’t always what happened, because there may be an emergency call, staff illness, issues with a patient, unexpected arrivals, or some other thing. We were just having to be very reactive at every moment – you couldn’t plan anything, you couldn’t anticipate anything. So, it was just rather interesting because we stayed at a code purple state constantly.”

St. John Medical Center, Tulsa, OK

“Code purple” goes off the air
In December  2013, the code-purple calls went silent when St. John adopted TeleTracking’s Capacity Management Suite system for their 550-bed facility. Compared to the old workflow of printed charts and guesstimations, Scott-Combs says the pinpoint-specific data provided by the TeleTracking system allowed St. John to spot inefficiencies and respond to changes before they happened. Suddenly, “code purple” didn’t seem leading-edge any longer.

H1602-St. Johns Health System-Shelisa-Scott-Combs
Shelisa Scott-Combs, R.N., BSN Nursing Director of Patient Logistics Center, St. John Health System

“It’s interesting how you think you know what’s going on, but until you can truly see the data attached to it – and it’s not data that’s subjective – you really are missing a lot of pieces,” Scott-Combs says.

The decision to adopt the full TeleTracking Capacity Management Suite came after success with other TeleTracking products, including BedTracking and TransportTracking – two solutions that track bed turnover and patient transport. With measurable progress in timestamps and operational capacity continuing to reach benchmarks, St. John decided to upgrade for a more complete picture.

But simply adopting new software wasn’t enough. With a change of this magnitude, workflow adjustments and training are unavoidable. Scott-Combs says that the staff was initially hesitant, but with time the “code-purple” era became little more than an unwelcome legend of the past.

“I think it was just a change in how we did business that concerned the staff – that was the biggest thing. The technology itself is pretty intuitive, and so we did have some training classes and things like that. We also had a lot of support from TeleTracking – they were here all the time during the initial adoption,” she says. “But again, most of the stress was a result of workflow changes. The technology itself is easy to use; once you kind of get in there and look at it – play around a little bit – it becomes very self-evident how this thing works.”

Results: St. John Health System incoming transfers from external referral sources

“Skittles” bring colorful progress
In the Patient Logistics Center, there hangs what Scott-Combs affectionately calls the “Skittles board,” a detailed, color-coded display screen that gives her team a comprehensive view of every bed at St. John. The Skittles analogy becomes clear upon seeing TeleTracking’s electronic bedboard – a display of colorful markings, each representing a patient or location. It’s in the Patient Logistics Center that staff has converged, allowing team leaders who were once spread out all over the facility to see changes in real-time.

On the floors, staff and unit managers have their own downscaled electronic board with detailed information on the status of rooms, including the name and schedule of each patient. In the past, communication between departments came through phone calls and running down the hall looking for somebody with answers. Now, wherever pertinent information arises, it can be added to the TeleTracking system, and display screens throughout St. John will instantly refresh.

“Every couple of minutes, the screens update,” Scott-Combs says. “And so, we’re never operating off old information – when I say we can view everything in real time, I mean it.”

TeleTracking’s electronic bedboard
TeleTracking’s electronic bedboard

It’s the real-time information that has allowed St. John to see further growth, especially in their outside referral numbers. Now, when a patient is coming to the ER or needs a bed, an answer is as simple as looking at a monitor. And because workflow kinks are being ironed out, more patients can find space at St. John, which Scott-Combs says presently operates at 98 percent capacity on a regular basis.

“Our transfer numbers have just significantly grown – oh gosh – I’d say our external transfers have grown around 16 percent,” she says. “And each year it just keeps getting better. I may have not have known what TeleTracking was before we worked with them, but I can speak to the results – and they speak for themselves.”