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Where the Beds Are
An online system takes the guesswork out of finding space for patients

Not long ago, a hard-to-use, paper-pushing process designed to track patient admissions, transfers and discharges frustrated every nursing shift coordinator. In their quest to locate and assign beds, they didn’t have an at-a-glance view of the open beds at Hopkins Hospital. Nor were they sure of the census count unless they consulted each and every unit. With a shortage of beds and a need to turn them over quickly, a new system was critical to track patient flow and manage the census.

That’s why a team, led by Mary Margaret Jacobs of patient and visitor services, JHMCIS’ Sherrie Szekalski, and Dan Wassilchalk of performance improvement, began to look beyond health care to industries such as video rentals and overnight shipping to explore new ways to improve bed monitoring. “If UPS can track a package across the world at any point in time, we should be able to do the same for a patient in the hospital,” says Wassilchalk.

So, taking a cue from companies like Blockbuster and UPS, Hopkins created a user-friendly, online, real-time bed-tracking program for a large hospital. Called the Electronic Bed Board (EBB), and modeled after a similar concept at Johns Hopkins Bayview, the password-protected program is accessible through any public work station in the Hospital and, eventually, through hand-held devices.

The system was piloted in clinical Neurosciences and has since rolled out to the departments of Medicine and Surgery. It uses color codes to indicate bed status, type of occupancy, pending discharges and transfers, allowing staff to better project and plan patient flow and demand for beds. Most importantly, it increases accuracy and frees up shift coordinators to focus on patient-care activities.

Before EBB, nursing shift coordinators were paged every three minutes on average, Wassilchalk explains. More often than not, those calls referred to a bed assignment. And finding that bed meant communicating with six to 10 different people—increasing the risk of patient misidentification.

“Now,” says Wassilchalk, “whether you’re in the emergency room, the nursing unit, the Hopkins Access Line office or the operating room, you can see any available bed as well as those that are upcoming. It improves patient identification, helps track flow and makes a more accurate census at any time of the day.”

On the Neurosciences and Medicine units where EBB was piloted, measurements taken before and after the launch showed a threefold reduction in unreported discharges and admissions. User satisfaction survey results prove that it is indeed easier to navigate.

In the next phase of development, the team plans to add more system efficiencies. Included will be an automatic notification service based on one used in hotels. Currently on EBB, when a patient is discharged, the bed turns red on the grid identifying the patient’s room. Soon, this will trigger an electronic text message to housekeeping, letting them know the room needs to be cleaned.

Future enhancements may also include touch-screen technology, two-way interfacing between EBB and other online patient-care systems (such as MedBed, Medicine’s reservation system for identifying patients pending admission), and possibly, replacing the omnipresent white boards with flat-panel EBB monitors.

—Lindsay Roylance



Johns Hopkins Medicine

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