Friday, March 16, 2012

Assessing occupancy at the MGH: Meet the MGH Capacity Committee


MORNING MEETING: The MGH Capacity Committee at work.


Every weekday at 10 am, representatives from several departments within the MGH gather in the Admitting Conference Room. This multidisciplinary team reviews the morning’s capacity report for the MGH’s 947 beds, assesses overall occupancy, looks at current bed requests and planned admissions and discharges for the day. The team also proactively reviews the planned admissions for the next several days to predict the demand for beds in the near term.

As needed, the MGH Capacity Committee reports its findings to senior leadership and team members also share the report with staff members, outlining any notable trends or expected surges in capacity on each unit and what strategies will be implemented.

“Before we only came together in times of crisis,” said Nancy Connery, director of Admitting and Registration Services, who leads the committee. “Now, because we meet every day, we have a shared understanding of capacity and people work better together to find solutions. We’ve developed a group shorthand that enables quicker interventions.”

Most days, the morning meeting is sufficient, but on days when the Emergency Department’s (ED) or Operating Room’s (OR) patient volume spikes, the Capacity Committee is called together as often as needed – oftentimes hourly – to address the surge. Earlier this year, when faced with unprecedented volume on two separate occasions, the committee met up to five times a day, Connery said. “We were able to work collaboratively and creatively to manage both the capacity surge and keep our colleagues on all units up-to-date on the latest plans.”

Peter Dunn, MD, executive medical director of the OR, said the creation of the committee was an essential step in helping the MGH collectively manage resources and patient flow. “In addition to addressing the issues of the day, the committee is now working toward establishing processes for predicting the future, which will help us to continue to grow with a fixed capacity. This will enhance efficiency, throughput, and ultimately the quality of care for our patients,” Dunn said.

As part of its charge, the Capacity Committee also helps administer Code Help, the state-mandated policy to move all admitted patients out of the ED within a 30-minute period once its maximum occupancy is reached or exceeded.

“The fact that a group of senior leaders from Admitting, the Emergency Department, Patient Care Services, Case Management, Medicine and Perioperative Services comes together each day is comforting and encouraging,” said Bob Seger, executive director of Emergency Services and Emergency Preparedness. “We work as a team to develop countermeasures in the morning that hopefully avoid ED overcrowding – and the need to activate Code Help – in the afternoon and evening.”

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