'Big Day Is Finally In Sight': Moving Patients Requires Precise Execution

'Big Day Is Finally In Sight': Moving Patients Requires Precise Execution

Final preparations under way for Center for Care and Discovery's Opening on Feb. 23

February 18, 2013

After about five years of planning and construction, the single biggest expansion project in University of Chicago Medicine history is headed into the homestretch, as employees prepare to move approximately 200 patients into the new Center for Care and Discovery on Saturday, Feb. 23.

Move-day orchestrators spanning nearly every medical center department and section have dedicated months to developing an exhaustive playbook of procedures, transfer routes, staffing assignments, communications and schedules literally down to the minute -- all designed to guarantee that no element of patient care, safety or comfort is compromised.

Patients being moved from Mitchell Hospital to the new facility are suffering from serious illnesses or are recovering from difficult surgical procedures. They include hematology/oncology, intensive care unit, and multispecialty patients. Mitchell Hospital, which will get a facelift, will continue to house the Burn and Complex Wound Center, obstetrics and gynecology, and the Emergency Department, among other units.

The transfer of patients, equipment and supplies necessary for their care presents complex and demanding logistical challenges that require precise execution for the teams of physicians, nurses and staff. Charting the course of operations at the Center for Care and Discovery began in 2011, when UChicago Medicine's Operational Excellence team applied lean methodologies to create better processes and workflows across the medical campus. Lean principals in a hospital setting are meant to improve quality of patient care and lower costs by eliminating wasted time, labor and materials.

"An undertaking of this scale obviously requires a great deal of planning, focus and unwavering commitment from all involved," said Debra Albert, RN, MSN, MBA, chief nursing officer and vice president of Patient Care Services. "We've devoted thousands of hours to careful consideration for every detail in the safe transfer of our patients to their new home while offering peace of mind to their loved ones. Now, the big day is finally in sight and we're looking forward to seamless execution of the plan. We're ready."

The near-final blueprint for the day reveals a plan with military-style precision. Detailed timelines, process maps, task sheets and checklists converge to form an extensive, highly synchronized mission. All told, more than 500 employees will participate in some element of the daylong event. While it appears daunting, the foundation holds surprising simplicity: Four core teams, dubbed "Sending, Transport, Receiving and Support," are the nuts and bolts of the operation, responsible for ensuring proper communication, patient flow, safe transport and preparation for arrival.

Before sunrise on Feb. 23, a Patient Move Command Center staffed by dozens of clinical and administrative leaders will come to life. A patient census report, move sequence and room assignments will be finalized. A final assessment will confirm all systems go. Road closures will go into effect at 6 a.m. At 7 a.m., the first intensive care unit and hematology/oncology patients will be moved. Patients recovering from other medical and surgical procedures will follow.

The entire move will take place indoors, a consideration made during the earliest planning sessions for the new hospital. One by one -- spaced every three minutes, or five minutes for the most critically ill -- patients will receive a reassuring send-off from their rooms in Mitchell, and teams of nurses, physicians and transporters will wheel them steadily along stretches of corridors, across bridges and into elevators with essential medical equipment in tow. Minutes later, teams of receivers at the other end will welcome each patient to their new quarters.

An assessment will be made, followed by a report. Then the process will be repeated until all patients in Mitchell are moved.

The goal is for the last patients to be safely settled within nine hours of the move's kickoff. Of course, said Albert, the timeline is barring any unanticipated setbacks. But even those have been considered. Every scenario deemed possible has been contemplated, reviewed and a solution placed on standby.

"Because there is such a complex web of moving parts, the smallest details could make a big difference," Albert said. "That's precisely the reason for the painstakingly thorough planning process. We've demanded a lot from everyone involved over the past months, and they've responded in unprecedented fashion. The efforts of our faculty, nurses and staff have been inspirational."

While logistics for the big move are largely buttoned up, organizers say there's still a lot to be accomplished in these final days. Work is under way to keep the census at an ideal level with well-timed discharge management and scheduling of elective surgeries. Emergent surgical needs will take residence at Comer Children's Hospital throughout the move.

Many move-day coordinators and participants have brought their experience from the move of pediatric patients into Comer Children's Hospital in February 2005, and others have lent their insight from large patient moves elsewhere. Most agree that the degree of preparation for Saturday is unlike anything they've ever experienced -- from the number of patients to the distance to be covered to the sheer volume of the facility, which covers roughly two city blocks.

While the medical campus has focused on the Center for Care and Discovery operations, activity at Mitchell Hospital will ramp up after the move of patients this month. Mitchell will undergo renovations, which include turning all of its in-patient rooms into single-occupancy rooms and updating the nurse-call system.

With some hurdles left to clear, the mood on the medical campus is upbeat, optimistic and confident. In halls and hubs, excitement is brimming as the long-awaited opening day draws near. Chatter abounds on what many are calling a once-in-a-lifetime experience to help open a new hospital.

"We have a lot of things to do for sure, but that's heightened by the fact that we have a whole new building of critical thinkers," said Michael McMann, director of Operations Planning. "This is the University of Chicago Medicine, and this is what we do."