Monday, June 18, 2007

Massachusetts General Hospital steers patients to the right beds with bed management dashboard

By Lucy Caldwell-Stair

Like most hospitals, Massachusetts General Hospital (MGH) in Boston is chronically short of beds. To get maximum use of its 900-plus beds, MGH has just implemented the CBED (coordinated bed efficiency dashboard) program. Medical staff in the emergency department and admitting office use the bed assignment system to electronically locate in-patient beds that are available or will be soon.

Says Keith Jennings, corporate manager, IS management and planning, "There ought to be a patient in every bed. CBED is like a manufacturing process for being efficient within safety limits," he said.

The bed management software comes from Premise Development Corp. in Farmington, Conn., and was developed at Yale New Haven Medical School.

"It was kind of a co-development project with Premise to customize the system because our admitting folks use one system and our emergency department uses another," said Jennings.

Manual bed management is time consuming. The clinical hand-off of the patient is a "face to face transfer of care" that takes 15 to 20 minutes. The old way was for ER staff to repeatedly "pick up the phone and ask, 'Is the bed ready? Is the bed ready?'" said Jennings.

Now a floor nurse uses a telephone to tell CBED through interactive voice response that the room is ready or about to be ready. The optimal bed -- one with the specific equipment needed and special features -- is quickly found, and the hand-off can start sooner.

Implementation of the dashboard took about 18 months, and began with nine months of procedure studies and interface enhancement. To be of value in the ER, all 900 or so beds had to be online and thousands of nurses had to be trained.

"It was a fairly rapid installation, and in November 2006 we started the rollout that went for six to eight weeks," said Jennings.