November 15, 2023: In this solution showcase, our guest Todd Larson, Consultant at HonorHealth, offers insightful anecdotes based on his mixed experiences in law enforcement and healthcare. His military background encourages an innovative approach to healthcare, specifically in information centralization and operational efficiency. What drove the conception of the Command Center? How has it evolved? Larson nudges us to think about our healthcare models and how we're potentially lagging behind. As we move through various topics, Larson emphasizes the crucial role of technology in healthcare. However, is technology a help or a hindrance? Does it streamline processes or does it add another layer of complexity? The future of healthcare is undeniably digital, but how well are we adapting to this change? Let's explore further in this conversation.
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we had a nurse come back who had been on the ICU in the flight line trauma area at Bagram Air Force Base. And she was here doing about a 20 minute scenario. The sound's going, the human simulator's going, and when the scenario ended, she actually looked at me and said, I forgot where I was for a minute. I thought I was back on the flight line at Bagram
All right, here we are from the Health Care to Health Care conference down here in Phoenix, Arizona, and we're joined by Todd Larson with Honor Health, and we're going to talk a little Command Center. We're going to talk about the new lab as well, and we might talk about some other things. We'll see where it goes.
So, Todd talk a little bit about the Command Center. What was the genesis for it and how has it evolved? Yeah, in basic terms, the genesis was that having a career in law enforcement And after 9 11, I saw a lot of the synergy that occurred with various agencies and law enforcement to try to centralize communications, centralize operations, share information.
And years later when I retired and came into healthcare and running emergency management and security and access control and all of these things that run a similar type of operations in healthcare. I realized healthcare was really behind. So the strategy behind it was to create a business plan of a network operation center where initially that was information, operations safety, security, patient movement, patient ingress, egress, transport all of those types of things would be in there sort of from a safety, security, all hazards approach.
That's really morphed now into... Let's really focus on how we can coordinate and integrate all kinds of care in addition to operations. So that's a real, reader's digest of how we got here. It's interesting. The use cases really present themselves once you start getting that information to flow.
You get the people and the culture sort of organized around it. I'm reminded of that 9 11 story when they talk about... All the signals we had, and we couldn't pick them up. Right. And with a command center, you really can pick up those signals and then design around that. And that's really the goal, that we can make the patient experience improved.
We can improve patient safety, we can improve staff safety, we can improve patient outcomes. But to your point we want to go further than that. We want to be alerted to patient issues, be alerted to patient process needs. before they happen and one of the things we focused on with our operation center is we purposefully moved into a building that gave us room to grow.
So we were only using roughly 40 percent of the building when we moved in and we still have 60 percent of the building to use as your point. You learn process, you course correct or you say, wow we really could integrate this into this model. Whatever that service line could be. So whether it's telemetry or whether it's, remote nursing, whether it's virtual care, whether it's home health, whether it's post surgical, right?
Start thinking about all of those things that you can now do within that operations. Again, I go back to 9 11, thinking about the cultural change that had to happen. But there was an event that sort of created the burning platform and that everyone knew, hey, we have to change. This doesn't.
But in a healthcare organization, You almost have to create that sense of urgency that there's a better way to do this and whatnot. Talk about the cultural change that has to happen. I think that cultural change in the health care setting really is, I would call it ground floor. Your nurses, your techs those people that are on the ground are the ones that, that really are going to push that culture.
So as they start to see how virtual care assistance. Programs helping them, automation, charting all of these various things, the staff are the ones that are going to benefit. And as the staff benefit, that's going to change the culture. That's interesting. So, talk about bringing all the information to a central location.
Was the technology a barrier or did the technology help? I use the example of, EPIC's great on the clinical side, or our EMR is great on the clinical side, but that really doesn't help us too much on the operations side. On the operations side, there are upwards of 20, 30 programs that our operations center personnel are in and out of every day.
So, if you don't use a program, it times out and you're in and out. So, we're still looking for certain technology. What's that black box? Could we have a single sign in for 30 programs? How do we integrate our monitoring, right? Camera monitoring tied versus emergency management. But then you have patient cameras that can be used for virtual care, but they don't really tie to our security cameras.
And so if you hear what I'm saying it's how do we synthesize? How do we stitch all of this together? And we're not there yet.
Talk about some of the use cases and some of the outcomes that Honor Health has been able to achieve. Yeah, I would say several. But the really easy ones to understand, straightforward, like...
Immediately recognizable, patient transport. We were having Q level or a patient in need of being transported and I'm talking about within its own facility, right? So patient that needs to go to CT or a patient needs to go for an MRI or a patient that needs to go to some type of imaging or maybe they need to go to it for a test somewhere else or they have a procedure and so you always have these patients that are waiting to be transported within the facility.
That average rate was double digits of numbers of patients that needed transport. By incorporating that into our clinical operation side of the network operations center, we have taken that rate pretty much to zero. Simply by having that air traffic control model, taking the leader out of the facility, putting the leader into the clinical command center.
They're able to monitor and see all of their floors, all of their building, and it took our patient transports to zero in weight. Was there additional staffing or was it a majority just, taking that one? No, it was, it, we've actually been able to do it with less staff, so it, not only that, it's improved our efficiency as well as the patient care and the timeliness.
It's improved our own workforce efficiency.
So I wanna talk about the lab. Yeah. So, the lab is a great opportunity for CDW clients and others to come down and see the advances that are going on in the patient room and around the experience and whatnot. You're involved in the lab. Talk a little bit about the lab.
Yeah. So, the lab evolved because Honor Health's unique position with the Network Operations Center. There are a lot of, I think, healthcare organizations that are looking at these operations centers, but you got to get through committee and budget, and then you have to get to brick and mortar, and I mean construction.
I wrote the business plan in 2018 for the Network Operations Center. So here we are, five years later, our brick and mortar is up and it's running. That's the key with the Innovation Lab and process with CDW. Is that we can work with CDW on the testing of items.
Whatever that technology may be. Could even be tied into innovation. Could be transformation, could be workflow. So we have that lab that sort of, I, we joke and call it the mad scientist room, right? Where, you can get dirty, you can play around with things, you can test things. If they break, but you course correct and you move.
Then from there, once we think we have a good working model, we can take those things from the lab that we work with in partnership with CDW. and others that they may bring in, and we can go to the Network Operations Center, where we can actually launch something, maybe on one floor, on one hospital, but our whole 360 approach allows us to see that live, and in real time, and how it's comparing to other floors, and how it's working within the system.
And then we could maybe launch on one wing, maybe we launch at one hospital, and that Network Operations Center gives the operational innovation. That you don't necessarily get, right? How many times do we buy something out of the box and we implement it at six hospitals, and then the nurses work around the problem, and we don't even know they're working around the problem, and the solution or implementation we bought isn't even being used.
So the network operation center is the key with the Innovation Lab partnership, that you can take that innovation and you can operationalize it, but you can do it safely. And you can do it from sort of an air traffic control model.
if people are going to come down to the lab, I would encourage them to bring their nurses.
Yes. First of all, there's a vision aspect to it of actually seeing it and playing with it and working with it. But also, it's a buy in aspect of, they're going to get to speak into the future that they're going to have to live with. And it's one of those things. really Seems like it's common sense, but hasn't been for the last decade.
And we're starting to see more and more that nurses, clinicians are starting to speak into the technology. I agree. And that's a big focus with our innovation lab and our partnership on this program with CDW is to take two things. Number one, what's their global network of nursing techs, clinicians, physicians, whatever that role and they have a global network of that.
But then internally we have always had programs where. Line level staff. A nurse could submit an idea. And traditionally those ideas, if you think back, Bill, to, your days in running health care, you have this sort of the suggestion box, right? And does it really go anywhere? Is anybody really looking at that?
So that's a big focus of our lab, exactly. Your point is we want line level staff to be submitting ideas. It can come into the governance committee. We look at that idea and we have the right leaders to say, yeah this is a network. This is a great idea. Let's play with it in the lab. Let's try it. Well, then we can reach out to that employee that submitted that idea and say, why don't you come on in and help?
Do you want to be on a subcommittee and help get this going? So I think you bring a great point, which is involve those that are doing the work in the future of their care. When someone walks into the lab, what are they going to see? I mean, it's not just a conference room like this. There's other aspects.
, our lab is really built upon three phases. The first phase is sort of that mad scientist room. And I mean that seriously. A concrete floor, large room white walls. You're gonna come in, you can wheel things in, wheel things out. You can play with things. If you wanted to bring in a bed to test some type of sensing technology, you could.
If you want to bring in something different, you could. The second phase that they would see would be our sim lab. We have a sim lab for our nursing education. And then we have another sim lab for our military partnership program. So between the two simulation centers, you could actually fully mock up your simulation in a medical patient room.
And then the third phase of that is we have presentation space, high technology that's being built out, where we can really do these presentations both locally and globally from that room. And then the final step is the Network Operations Center to integrate it. So somebody could really come and see that stitching process all the way through.
you started with Honor Health at the Military Partnership. Yes. Which is now the Military and First Responder Partnership. We got a chance to go through that tour. It really is amazing. I'd love for you to share a little bit about that. Yeah, Honor Health is the only community hospital that brings in military personnel.
So very quickly. I want you to think if you're an Army medic and you're in the reserves, you were 18 years old. You went to basic training, you got your training. You spent maybe a year in your training for your job, and now you're in the reserves. So you're back out in the private sector, you're in the reserves.
You go to a drill one weekend a month, two weeks, a year. You might be doing physical exams, like flight physicals if you're in the Air Force, or you might be doing medical exams. You might be the medic working the PT test, right, for that weekend. And then, now you're 21, 22, you're 3 4 years into your military reserve career, and they call you to go to Afghanistan, or they call you to go to, some other location globally to do medicine of injured military people in the field, in the dirt, and you really haven't touched a live patient in A long time, other than maybe a physical fitness test.
Because you're a college student, or you're working in another industry. So the military partnership will bring in primarily reservists to focus on getting them hands on training in the trauma center. Hands on training in the emergency room. They actually touch patients. work with them, they work with the nurse preceptor, and they provide patient care.
In addition, we do simulation training. We do training with various simulators, both audio video AR type training, as well as inpatient with our high fidelity human simulator. So on the flip side, we do the same thing with our local law enforcement. You think about things like tourniquet wound packing, your active shooter trauma events, how can we train our first responders to do that same type of medicine that really the military forged for many years.
It was amazing. You say, simulations. Those simulations are these very sophisticated dolls. Mannequins or whatever. I remember the ones that we used to have to do CPR at in high school and those kind of things. This is way beyond that. I mean, you have essentially the ability to have breathing.
You have the ability to have a voice through as well. So the simulations are fairly real. And we walked into a tent where there was All the sounds of a battle going on around us while we're doing that. So we're really trying to make those simulations. But those aren't the only simulations you're doing.
I've been in discussions. They were talking about how they would set up out in the desert They would take those mannequins and essentially... Set up for first responders and whatnot, and they create these scenarios all over the place , that trains these people in real world situations.
It's really fascinating. Yeah. Yeah. And I what we strive for is the most realistic training we can do, and sometimes that's , in a medical patient room, sometimes that's in a military tent, as you said. We have a full military tent mockup. We have a helicopter mockup. But really the key is to set the realistic version of training.
So, as you said, the high fidelity human simulators can bleed. You can see TBI, you can read their pupils. They, you can crike them for an airway. You can do io directly into the bone for infu, whatever you need to infuse. You can give birth, you can give birth with the birthing mannequins, but the sound and the tent and the smell and everything that we have in there.
The greatest example I can give you is we had a nurse come back who had been on the ICU in the flight line trauma area at Bagram Air Force Base. And she was here doing a scenario, and it was about a 20 minute scenario. The sound's going, the human simulator's going, everything's going. And when the scenario ended, she actually looked at me and made a comment and said, I forgot where I was for a minute.
I thought I was back on the flight line at Bagram. And that's the setting we want to create for them. That's amazing. Todd, I want to thank 📍 you for your time. Thank you. Thank you, Bill. Appreciate it.