Article

Hospital Command Centers (HCCs) have been a much-discussed topic in recent years. Their data-driven coordination promises better patient care, reduced workload for doctors and nurses, and superior capacity management. In other words: benefits aplenty. However, can a concept that originated in the United States (and specifically in the large healthcare systems) benefit Belgian hospitals? IQVIA Health Command Center offers a positive response, both in terms of results and feasibility. IQVIA's new solution is being developed in cooperation with Belgian hospitals in order to achieve significant gains in bed and staffing capacity.

Hospital Command Centers are on the rise

In 2016, Johns Hopkins Hospital in Baltimore opened its ultramodern Capacity Command Center. More than 20 specialized employees have a wall of dashboards and advanced technology at their disposal to monitor, control and optimize the flow and volume of patients, as well as their safety and experience.

The rise of Hospital Command Centers has been unstoppable since 2016. HCCs signify a logical evolution, as hospitals have increasingly digitized their data. Centralizing, analyzing and utilizing this data in combination with new technologies such as predictive analytics is the natural next step.

Hospital Command Centers are also the solution to the traditional dichotomy – and persistent operational obstacle – within hospitals: the different departments are interdependent yet structured as organizational silos. The new abundance of data and smart technologies can provide this long-sought integration.

In addition, the demand to improve outcomes and increase efficiency is becoming more and more compelling. Hospital budgets and staff availability have been under pressure for years. The available resources, both financial and human, are set to decrease rather than increase.

Staff retention in particular is becoming an enormous challenge. Workload plays an important role in this issue, both in terms of burnout prevention and the appeal of the nursing profession. For instance, after six months of COVID-19, almost a quarter of Flemish care staff considered quitting their job. 55 percent felt exhausted, 42 percent experienced sleep deprivation, and 35 percent could not relax properly.

HCCs provide an answer for these challenges. The results of Hospital Command Centers have been remarkably strong right from the start. According to research firm KLAS, HCCs lead to "improved efficiency, increased revenue, and enhanced patient safety and satisfaction." Hospitals with HCCs have also shared their results. For example, in the 18 months following the opening of its Capacity Command Center, Johns Hopkins saw an 8% increase in occupancy while reducing the waiting time in the emergency room by 35% and the waiting time after surgery by 70%.

Hospital Command Centers are therefore not a defensive intervention to achieve an objective. The aim is not to reduce, but to improve. However, optimizing flow and capacity can realize measurable improvements in patient care and experience, in workload, and in efficiency parameters.

What’s in a name

A Belgian hospital director who sees the Johns Hopkins Capacity Command Center, and the resources, staff and investments it requires, will quickly conclude that such an HCC is a financial and logistical impossibility in Belgium. Of course, the name Command Center immediately evokes connotations of a large room full of high-tech equipment and specialists. But, at the end of the day, it is all about the power of real-time, integrated information and predictive analytics to take quick and informed action. These functions can definitely be tailored to Belgian hospitals and budgets.

Using real-time data and AI-driven predictions to achieve smart agility doesn't necessarily involve a Mission Control room like NASA’s. It can also be achieved with a number of fixed and mobile screens across different departments.

What’s more, an HCC can be implemented and structured in phases, adapted to the needs of a hospital. An HCC doesn’t have to offer everything it theoretically can from the very start. In our current Belgian context, for example, it makes the most sense to focus on optimizing bed and staff capacity first. After all, optimal capacity management has a direct impact on the operation of the entire hospital and even on the quality of care. COVID-19 has illustrated this point disproportionately, but meaningfully this past year.

Hospital Command Centers tailored to the Belgian reality

In Europe, Belgian hospitals were not among the first adopters of Hospital Command Centers. While Dutch institutions did start to implement them, their Belgian colleagues had a more cautious attitude. This gap is now quickly being bridged. In 2021, the first Belgian HCC will be put into operation.

It is not surprising that Belgian hospitals are starting to implement HCCs. The efficient management of staff and bed capacity is a major challenge. High workloads, the great variability in bed capacity and patient pathways, and the availability of medical-technical equipment at peak times are examples of complex issues for which hospitals must find smart, cost-effective and flexible solutions.

The existence of hospital networks in Belgium is an additional factor. No matter how imperfect their organization and funding often still are, the networks are here to stay. As a result, the optimization of the cooperation between partner hospitals will remain a priority. This is exactly where HCC can play an important role.

Fortunately, most Belgian hospitals already have the basic element required for a Hospital Command Center, i.e. electronic data. An HCC adds a threefold functionality to this data: the integration and usage of data in real time, and the use of predictive analytics to make that data actionable.

1. Today, operational data remains largely compartmentalized within departments or functions. This is a significant drawback, as a hospital is a dynamic, complex and connected entity. An HCC creates the compete operational overview that has so far been lacking.
2. Right now, data is rarely used in real time, e.g. to manage capacity. An HCC, however, does do this, allowing hospitals to make informed plans, to manage accurately and to respond in an agile manner.
3. These decisions are also more well-founded thanks to the predictions, simulations and suggestions enabled by the new data science and AI techniques.

IQVIA Health Command Center

IQVIA Health Command Center is the first HCC solution developed for and in collaboration with Belgian hospitals. This specifically Belgian solution is necessary because the requirements are equally specifically Belgian. This includes issues such as the importance of single rooms, the link between the type of room and supplemental physician’s fees, low staffing standards and the funding context.

Yet the goal of IQVIA Health Command Center is no less ambitious than that of Johns Hopkins: IQVIA Health Command Center aims to offer Belgian hospitals a state-of-the-art platform to optimally organize and coordinate capacities and resources using the most up-to-date data science technology. Optimizing quality of care, maintaining a healthy workload and reducing avoidable waste are its overarching principles.

The IQVIA Health Command Center will first and foremost focus on capacity management. As such, the module provides a hospital or network with insights into its planned and actual needs in terms of patient flows, bed capacity and staffing.

• Real-time information on the current and expected required capacity (of both beds and staff) in order to better utilize the available resources.
• Early detection of expected bottlenecks (in capacity, operating process, etc.) to minimize the number of ad hoc interventions.
• Provision of supporting information to improve key operating processes (e.g. status of bed cleaning, etc.).
• Optimization of OR planning to avoid variability in occupancy and workload.

Users of IQVIA Health Command Center can count on a (near) real-time connection with their important source systems, innovative data science technology (predictive analytics, decision support, etc.), and a step-by-step build-up to fully integrated digital management of capacities and resources.

This step-by-step implementation illustrates the adaptation of the module to the Belgian reality. Because a physical HCC with specialized staff is not financially or organizationally feasible for most Belgian hospitals, IQVIA Health Command Center also allows for hybrid forms. The module can be used as a wall of analytics, but also as a platform with individual access for physicians, head nurses, admission planning, etc. In addition, hospitals can configure centralized or decentralized control, or a combination of the two.

However, the basic principle behind all these formats remains the same: data must be action driven. Screens, alerts, predictions and suggestions prompt the users to take action. First and foremost, IQVIA Health Command Center is an action driven operational engine.

What specific benefits can IQVIA Health Command Center offer hospitals? Three examples illustrate the value of the comprehensive overview, the real-time management and the predictive analytics the module offers:

1. Bed capacity optimization
How many beds are currently occupied? How many will become available today? How many beds should have become available but are still occupied (and why)? In which department does a bed become available, at which time and can the cleaning service get to work? IQVIA Health Command Center answers these questions and more, giving hospitals an accurate insight into current and planned occupancy. Studies indicate that capacity gains of 5 to 10% can be achieved.

2. Reducing workload
Today, most hospital departments have a high variability in the number of patients per nurse. These peaks and troughs increase the workload and create operational challenges such as a large number of temp staff and overtime hours. The IQVIA Health Command Center screens provide up-to-date and predictive insights into how many nurses and care staff are needed and should be scheduled, from today to a week from now. This allows head nurses to proactively adjust their staffing needs to the demand for care and thus reduce the workload. This will lead to higher quality of care, a better work/life balance for the nursing staff, improved employee satisfaction, and lower absenteeism. In addition, the number of temp staff and overtime hours can be reduced by as much as 40-70%.

3. Coordinated OR planning
IQVIA Health Command Center enables coordination of OR planning and bed capacity. OR planning is usually completed by surgeons, without understanding the impact on the departments. IQVIA Health Command Center integrates the data from the various services and uses retrospective analysis to identify optimization opportunities. This will enable a 5 to 10% improvement in bed capacity.

The digital transition continued

As it stands, Hospital Command Centers are not just ‘pie in the sky’ for Belgian hospitals. If adapted to local realities, they offer a solution to important challenges in terms of staff and bed capacity. The unattainable examples from abroad need not to intimidate but could inspire. The challenges are there and so are the fundamental requirements, just like HCC solutions developed specifically for Belgian hospitals.

Contact for the Flemish region: Kris.Oosterlinck@iqvia.com, Dullaers.Eveline@iqvia.com, Piet.Follet@iqvia.com, or for the Walloon region: Stephane.Djellouadji@iqvia.com for more information.