SHM Converge Scientific Abstract ePoster Gallery-Integrated Capacity Management: A Streamlined Process for Facilitating Transfers Between Hospitals in an Academic Health System

Integrated Capacity Management: A Streamlined Process for Facilitating Transfers Between Hospitals in an Academic Health System

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This project addressed emergency department (ED) boarding in a three-hospital academic health system, where uneven boarding burden and limited transfer coordination were contributing to delays and dissatisfaction. Because boarding is linked to worse outcomes and lower patient, family, and staff satisfaction, the team sought to improve flow by integrating capacity management across all three hospitals into one centralized department.<br /><br />Previously, inter-hospital transfers were difficult to scale because the process was siloed, lacked transparency, and involved multiple handoffs. The new approach introduced an EHR-based workflow that lets ED physicians identify eligible and agreeable patients for transfer. A centralized, 24/7 capacity management system then handles streamlined bed assignment across sites, reducing administrative steps and handoffs.<br /><br />After implementation, transfers increased substantially, from 89 in the three months before the intervention to 195 in the three months after. At the same time, the two higher-volume hospitals saw median boarding times decrease by 1.7 and 1.2 hours, respectively. The receiving hospital did not experience increased boarding. Although 686 additional patients were eligible and agreeable for transfer, they could not be moved because of receiving-site capacity constraints.<br /><br />Overall, the integrated capacity system appears to have improved transfer volume between hospitals and reduced ED boarding. The team plans to expand this centralized model to additional service lines beyond hospital medicine.

Asset Subtitle

Victor Cotton

Meta Tag

Author List Amanda Albrecht, Amanda Whartenby, Anne Krajewski, Joshua Davis, Joyce Kim, Michael Rehr, Neil Crimins, Neil Fishman, Nicholas D. Benson, Regina Cunningham, Robin Wood, Susan Chonko, Victor Cotton, Vincent Collins, William Schweickert

Category Innovations

Concept Emergency Department Boarding

Concept Patient Transfer

Concept Transfer volume

Concept Capacity Management

Concept Bed Assignment

Distinguished Non-Finalist

Presenter Organization University of Pennsylvania

Presenting Author Victor Cotton

Track Quality Improvement

Keywords

emergency department boarding

capacity management

inter-hospital transfers

centralized workflow

bed assignment

EHR-based workflow

patient flow

hospital medicine

transfer coordination

boarding reduction

Emergency Department Boarding

Patient Transfer

Transfer volume

Capacity Management

Bed Assignment