Johns Hopkins nurse Pete Travers, bed management program director in the Johns Hopkins Hospital Judy Reitz Capacity Command Center, loves solving problems. And the one that has engaged her since she joined the Command Center in 2022 is one all hospitals face: how to efficiently and safely move patients through hospital admission to discharge so all patients get the care they need. 

“My mission is to decrease our emergency department ‘boarding,’ which has ballooned over the past few years,” says Travers, referring to the practice of holding patients in the ED until a bed opens up. “Anything that can be done to shave time off the progression of a patient through the hospital, without compromising their care, helps minimize time patients have to wait to be admitted.”

To that end, Travers has spearheaded three nurse-led initiatives. In 2022, she worked with an interdisciplinary team to launch the Aligned Early Discharge Initiative (also known as Two by Noon), which involves discharging two patients on each hospital unit by noon every day. The initiative has already helped speed up patient admissions.

Then, in spring 2024, her team piloted a “discharge lounge” — a comfortable and fully staffed space where discharged patients can wait for a friend or relative to take them home, freeing their hospital room for another patient. The pilot was such a success that a permanent lounge officially opened in February 2025. 

The third of those initiatives was the creation in August 2024 of a brand-new position in the Command Center, a “clinical nurse expediter” who is tasked with researching and resolving specific issues causing unnecessary delays.

Travers says longtime Johns Hopkins nurse Chevel Brown — who had been helping out on the discharge lounge when it was still a pilot program and had become fascinated with the “patient throughput” challenge — was perfect for the job.

“Chevel is super-flexible, tactful, enthusiastic and incredibly resourceful; she’s been fabulous,” Travers says.

Brown says she loves the problem-solving, “and having to learn the workings of every department in the hospital.” A key part of her job is facilitating communication. One important task is “repatriation,” coordinating a patient’s return to their home hospital when they’ve come to Johns Hopkins for specialized care. Or she might reach out to housekeeping to alert them to clean a newly vacant room, or to relevant staff to persuade them to move quickly to provide one last service a patient needs before discharge. 

“A perfect example was one Friday when a nurse called for help at 4 p.m. saying her patient needed a wearable cardiac monitor before they could be discharged,” says Brown. She called the appropriate department, which found the order for the monitor but reported that it had been incorrectly completed. Brown reached out to the provider, who corrected the order. The monitor was immediately delivered, and the patient went home. 

“And this was all between 4 and 4:30 p.m. on a Friday, so it saved the patient from having to spend the whole weekend in the hospital,” Brown says.

Nurses are uniquely suited to solving the patient backlog problem, Travers says, noting, “We interact with everybody and can see the process from all points of view. We live here, and we know the hospital inside and out.”