Hartford Business Journal

14 Hartford Business Journal • December 18, 2017 • www.HartfordBusiness.com By Matt Pilon mpilon@HartfordBusiness.com T ucked away in a Newington administrative building, 10 nurses and other staff from Hartford HealthCare are work- ing the phones, coordinating patient transfers to approximately 1,800 inpatient beds across Connecticut. Nearby flatscreens display myriad key metrics across Hartford HealthCare's state- wide network of five (and counting) hospi- tals: the number of occupied and open beds; the number of patients in the emergency room; the number of patients awaiting a transfer; and a live feed of Life Star helipads. The $1 million Hartford HealthCare Logistics Center — known internally as the nerve center or mission-control hub, evok- ing NASA-esque imagery — is the latest effort by the health system to better control the flow of patients to its various hospitals. Hospital officials hope the control center will help them fill more beds and produce more revenue at Hartford HealthCare's growing roster of community hospitals that often have room to spare, while freeing up space at the bustling Hartford Hospital for the most serious illnesses and injuries. "Hartford Hospital was overflowing, par- ticularly in the [intensive care units]," said Dr. Rocco Orlando, the health system's chief medical officer. A busy hospital can mean longer wait times for patients who need a bed, said Elizabeth Ciotti, a registered nurse who is vice president of patient logistics. She runs the logistics center. Better coordination will reduce those wait times, resulting in greater patient satisfac- tion, and will also help produce higher-quali- ty care, Hartford HealthCare officials say. With Hartford Hospital and its sister facilities — MidState Medical Center, Hos- pital of Central Connecticut, Windham Hos- pital and Backus Hospital — now operating on the same electronic medical record sys- tem, more strategic thinking about where to send patients is now possible, when it hadn't been feasible before, Ciotti said. (Hartford HealthCare recently acquired Charlotte Hungerford in Torrington, but it will take a few years to get it on the same medical record system.) "I don't think we could have done it be- cause we couldn't see what was happening at the other facilities," Ciotti said. "Now that we have visibility into all of the beds at all of the hospitals, when we get a call we can ask 'what's the best place for this patient?' It might not be Hartford." If the system wants to transfer a patient to a community hospital instead, it's ultimately the patient's call. Community hospitals are capable of handling a number of serious ill- nesses, and sometimes they may be located much closer to a patient's home, she added. Traditionally, for example, if an elderly patient with heart failure showed up at Windham's emergency room and doctors determined she needed to spend several days stabilizing on a respirator, that patient would likely have been transported to Hart- ford Hospital. Now, doctors might ask the patient if she would like to be admitted to Norwich-based Backus Hospital instead. Multiply that by several dozen or more similar instances a month, and Hartford Hospital is freeing up significant capacity for the sickest patients that can only be treated there (or sent outside the system). The key test, Orlando said, will be mak- ing sure the logistics hub makes triaging decisions carefully. Hartford HealthCare is tracking whether patients at the communi- ty hospitals end up transferred to Hartford anyway, which would defeat the point. That hasn't happened yet, he said. Saying 'no' less Ciotti previously oversaw Yale New Haven Health's logistics center, Y Access, which manages patient transfers at two of Yale's Connecticut hospitals. She has returned to work at Hartford Hospital a decade after starting its original transfer center. She said health systems are increasingly adopting logistics centers, and there are plen- ty of software and vendor options available to do it. However, she said one logistics center overseeing five hospitals is cutting edge. Jeff Flaks, Hartford HealthCare's chief Mission Control Hartford HealthCare's new logistics center aims to fill empty beds, reduce patient wait times Hospital Bed Occupancy Rates Source: Office of Health Care Access William Backus Hospital Hartford Hospital Hospital of Central Connecticut Midstate Medical Center Windham Hospital Statewide 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Bed occupancy rate 2013 2014 2015 2016 Beth Ciotti, head of the Hartford HealthCare Logistics Center, is overseeing the health system's new approach to how it moves patients to and from hospitals. HBJ PHOTOS | STEVE LASCHEVER

• Cover