WRHA Oculys Command Centre - Going with the flow
By: Tom Brodbeck @ The Winnipeg Sun
Published: December 3, 2017
Krista Williams, the Winnipeg Regional Health Authority's chief health operations officer, demonstrates how the new Oculys bed management software is helping hospitals better manage patient loads. TOM BRODBECK/Winnipeg Sun/Postmedia Network / SunMedia
“When I wake up first thing in the morning, I look at Oculys,” said Krista Williams. “Because I want to know the state of affairs before I start driving (to work).”
It’s 1:43 on a Friday afternoon at Grace Hospital and things are busy. There are 44 patients in the emergency department, some in the waiting room, others in the treatment area.
The ER is close to capacity, but there are no ambulance off-loads and one of the ER’s two resuscitation beds is open. Of the 44 ER patients, six are admitted to hospital, meaning they’re waiting for a bed upstairs on the medical ward.
Wait times are long today, but manageable. Close to half the ER patients are non-admitted – they’ll be treated and discharged. But five admitted patients have been waiting over eight hours for a bed and they need to move upstairs soon to make room for incoming patients.
The good news is there are four patient discharges about to occur upstairs and a possible nine more. ER staff only know that because of a new electronic bed management system they never had access to before.
“This is busy,” said Krista Williams, the WRHA’s chief health operations officer.
The Winnipeg Sun got a rare behind-the-scenes look this past week at how the new computer system, called Oculys, is revolutionizing how hospital staff do their jobs and why it’s having such a major impact on reducing hospital overcrowding.
On a busy day like this at the Grace, the key to returning to normal operations will be how well staff manage patient flow and how effectively they coordinate their efforts with other units – and other hospitals if necessary.
In the past, without a centralized electronic bed management system, that was a frustratingly difficult task. Staff and management were left largely in the dark when it came to patient volumes and bed availaility in other parts of large, spread-out hospitals. Calling around by phone and having in try to identify excess capacity in the system. That caused long delays and giant communication gaps that permeated the system, especially on busy hospital wards where staff are constantly diverted to address changing patient needs.
That lack of a centralized data system even trickled down to housekeeping staff who didn’t always immediately know when and where to clean and prepare rooms for new patients, or how to quickly communicate when they had completed their tasks.
“It was very burdensome for staff and for administration to manage flow because by the time you were able to get through the entire hospital and figure out what the flow is you would have to go back to the drawing board,” said Williams, who was one of the lead players in implementing the new software, now up and running at all Winnipeg hospitals. “We were looking for a solution that would help us understand flow and have a visible, transparent tool where all of the hospital departments would know the real status of the activity in the hospital at all times.”
And now they have it. Oculys is beamed into every hospital ward and unit in the city and is visible and accessible to staff in all areas of the hospital. It’s used by managers and senior administrators 24/7 to monitor patient flow and to help make resourcing and other decisions to keep the system moving. Many of them, including Williams, even have the program on their smartphones.
“When I wake up first thing in the morning, I look at Oculys,” said Williams. “Because I want to know the state of affairs before I start driving (to work).”
Williams credits the new program in large part for the sharp drop in ER wait times over the past six to 18 months because it has allowed staff and management to identify trouble spots early and move patients and resources around quicker to solve them. Part of the success of the program, said Williams, is that while the program contains considerable data and allows users to toggle between units, wards and sites, it’s simple and easy for everyone to use.
“We wanted every single staff member engaged to look at the information, understand it and see how they can contribute to managing the flow,” she said.
Meanwhile, up on the medical ward at Grace, the hospital’s chief nursing officer Shelley Keast is working with staff using real-time data from Oculys to identify capacity and help alleviate congestion in the ER. Keast says she doesn’t know how they used to operate without it.
“The connection between the entire program and understanding what’s incoming and what’s outgoing is really key,” said Keast, adding the program allows hospital wards and the region to work as a unit, rather than as separate entities. “It is such a fabulous tool.”
Later that afternoon, some of the congestion begins to clear. Discharge decisions are being communicated faster, rooms are getting cleaned quicker and patients are being transferred to where they’re supposed to be in a more timely fashion.
Winnipeg hospitals are facing big changes in the coming months. And it remains to be seen how the WRHA’s consolidation plan will impact wait times in the long run. But it’s not difficult to see how this new technology is a critical piece in the ongoing battle against hospital overcrowding.
All about Oculys (VitalHub Corp.)
VitalHub Oculys is a bed management/patient flow computer software system the Winnipeg Regional Health Authority now uses at all hospitals to keep track of all patients and bed capacity using real-time data.
The program was created at a hospital in Ontario and began as a pilot project at Grace Hospital in February 2016. It was expanded to other Winnipeg hospitals and has been in place at all sites since March 2017.
Staff from all wards and units use the program to get detailed, up-to-the-minute information about patient volumes, levels of acuity and bed availability in all areas of the hospital in order to respond quicker and more effectively to sudden spikes in patient volumes.
The program is visible on computer screens on all wards and is used by a wide range of staff, including housekeeping personnel, nurses and other health care workers.
Oculys uses data from three existing databases within the WRHA, including the Emergency Department Information System.