Suddenly, there it was: an empty bed—one of the most precious commodities in patient care.
It’s not something that Nathalie Farley had expected to find on a recent morning at Catherine Booth Hospital, a member-facility of CIUSSS West-Central Montreal. But the bed was indeed available, due to the late discharge of a patient the previous day.
As a Coordinator who helps manage admissions to Catherine Booth, Ms. Farley had to act quickly. After all, every hour a bed sits empty is an hour that could have been better spent helping a patient (often someone elderly) through rehabilitation and, ideally, a return to self‑sufficiency.
So Ms. Farley contacted a colleague in the CIUSSS’s Command Centre, the new digital hub that, among other activities, helps streamline the movement of patients and clients back to their own homes or from one CIUSSS facility to another.
Specifically, Ms. Farley got in touch with Suzette Chung, who oversees discharge planning at the JGH. The query: Did the JGH have a patient whose treatment had ended and who met the criteria for transfer to Catherine Booth? If so, could that person’s discharge from the JGH be hurried along?
Ms. Chung’s answer on both counts was Yes. “By consulting the updated rehab patient list in the Command Centre, I was able to identify someone who could be transferred on such short notice—the kind of patient Nathalie was looking for,” Ms. Chung recalls.
“Then, the discharge planning nurse, who was assigned to the JGH unit where the patient was located, ensured that the patient was informed and that everything was coordinated for the transfer.
“In the end, the whole process of getting the patient out of the JGH and into Catherine Booth took only 3½ hours. It’s something that could never have happened so quickly without the Command Centre. And now, it’s become part of our regular routine.”
Launched late last year and developed with substantial financial support from the JGH Foundation, the Command Centre is also known as C4, because its activities enable the hospital and the CIUSSS to be better able to Care, Communicate, Collaborate and Create.
The primary focus for Ms. Chung and Ms. Farley—and for their many team-mates, including the CIUSSS’s NSA lead, Mary Lattas—is the discharge process, as it applies to patients who are known as NSAs (niveau soins alternatif).
The term refers to those who have finished their hospital treatment and, as they await placement, they continue to occupy an acute-care bed longer than necessary. Often, these patients are waiting to be sent home or transferred to another facility, such as a rehabilitation hospital or a long-term care centre.
Not only is it inconvenient and irritating for patients to be kept waiting, it postpones the follow‑up care they may need to receive elsewhere.
In 2020, it was not uncommon for there to be more than 60 NSA patients at the JGH at any given time. Then the Command Centre shifted into high gear: During the first 3½ months of 2021, the number plunged as low as the 20s and is now generally in the low to mid-30s.
Another significant benefit of the Centre is the way it brings together key personnel for frequent meetings, and ensuring they are within easy reach of one another if circumstances change abruptly.
This has made it possible, for example, for Ms. Farley and for Home Care Coordinator Habiba Boutaleb to determine more precisely whether a patient can be discharged from his or her acute-care hospital bed, in order to receive services at home or to be seen as an out-patient.
“We’re very much like a rowing team,” says Ms. Lattas. “We all have to row in the same direction and our technique is very important if we want to go faster.
“It’s the Command Centre that keep us from slowing down or, even worse, spinning in a circle. It helps us to be really aware of where we’re going and how we intend to get there.”
