A moving experience
Date: April 1, 2012
Planning the patient move to The Johns Hopkins Hospital's Sheikh Zayed Tower and Charlotte R. Bloomberg Children’s Center was orchestrated over a two-year period to leave nothing to chance.
Provisions for infection control, moving unstable patients, transporting controlled medications and relocating emergency room patients are just a few of the many considerations that had to be fine-tuned.
Given the move’s complexity and dependence on interdisciplinary cooperation, it was tricky at first to imagine how it would come together, says Dawn Luzetsky, assistant director of nursing in the Children’s Center, who led the patient move work group’s transport team task force.
Luzetsky says she and her team realized there was only one way to devise a safe and efficient plan for moving patients: “We all had to come together and follow the same process. Each unit was a cog in the wheel and if a cog loosened up or somebody didn’t do their job, the wheel, would fall off.”
Working with outside consultants specializing in transition management, administrators, clinicians and support staff across The Johns Hopkins Hospital mapped out an exhaustive plan based on projected patient population, countless spread sheets and checklists. With patients scheduled to be moved from their units every 10 to 12 minutes, team members held two mock patient moves and calculated the time moving between older and new buildings using various connecting passages, in addition to writing a move manual and creating a “patient move game” made available on Hopkins’ intranet site.
Central to the plan were nurse managers, lead coordinators and charge nurses in each unit, who assembled with others into three teams for sending, transporting and receiving patients. During the move, respiratory therapists accompanied the transport team, depending on a patient’s acuity.
Following step-by-step instructions for each phase of the move, team members held pre-move “huddles,” prepared patients for the move, approved papers dubbed by the team as “Ticket to Ride” certificates, and escorted patients to the new buildings while monitoring vital signs and getting them settled on their new units. On the sending and receiving sides of the move, support staff made sure rooms were clean, provided meals and ran errands as needed.
From a command center in the new clinical buildings, managers authorized and supervised the move, kept the activity on a timetable and were available to handle any problems. Lead coordinators on the sending and receiving side of each unit confirmed when a patient had been safely relocated and convened a post-move huddle for members of all three teams.
Calculations for reducing the patient census leading up to the move helped simplify the process. Final preparations began one week before the move, when caregivers told patients and families what to expect and and confirmed that patients had correct ID bands.
All patients were moved in their beds with the exception of those in pediatric psychiatry, who walked in a group to their new unit. The work group also collaborated with patient and family advisory groups to ensure their support during the move.