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Driving Change with VPS Data:Shaping Care Delivery and Operational Management
Sherri Kubis RN, BSN, CCRN
Danielle Traynor RN, BSN, CCRN
Children’s Hospital of Philadelphia
Goals Describe Successful Utilization of VPS Data in Care Delivery
and Operational Management Efforts: Care Delivery
Care Model Initiative
Operational Management Daily Flow Predicted Flow PACU Utilization
Care Model & Innovation Transformation Committee
Hospital Operating Plan Directive with the goal:
“Develop a care model to deliver excellent patient care by optimizing the human and physical resources and care processes with attention to responsible stewardship.”
Four units chosen to initiate investigations and pilot testing
PICU VPS Team requested as permanent team member to provide relevant data and insight into PICU population, multiple patient cohort characteristics and care delivery.
Care Delivery
Utilized VPS Data to provide a comprehensive descriptive analysis of the PICU patient population over the course of the three prior years.
Age, LOS, Severity of Illness, Discharge Disposition Medical and Surgical Services Reason for ICU admission (Primary Dx and/or Chronic Condition
necessitating ICU level of Care) ICU level of Care Interventions Census and Capacity Trends
Utilized VPS Data to provide in depth review of specific populations identified that Care Model adaptations could yield significant improvements in patient care quality and efficiency.
Care Delivery
Daily Patient Churn Seasonal Capacity Unit LOS in relation to Hospital LOS
Utilized VPS Data to Analyze Census Trends
1-Interventions or therapies only delivered in the ICU 2-Ventilation dependent patients admitted for separate ICU need3-Neurologic ICU Care 4-Patients admitted for Airway ICU Monitoring5-Other
Utilized VPS Data to Analyze Patient Types and Prevalence
Identified PICU discharges to General Care Floor with Non-Invasive Ventilation present at Discharge
Compared PICU LOS to remaining HLOS
Utilized VPS Data to Analyze Specific Patient Cohorts
Patient Flow and Capacity planning Operational Management
Daily Flow Predicted Flow
Scheduled vs Unscheduled PACU Utilization
Manage capacity challenges and plan for expanded growth
Daily PICU Patient Flow Review
Operational Management
Staffing and Assignment Planning
Operational Management
Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec
7pm-11pm 4.6 4.0 5.1 3.8 4.5 4.5 4.1 4.0 4.6 4.7 4.0 4.5
11pm-7am 6.7 7.3 7.3 6.9 7.0 6.4 6.3 5.9 6.3 6.2 7.5 6.7
4.6 4.0 5.1 3.8 4.5 4.5 4.1 4.0 4.6 4.7 4.0 4.5
6.7 7.37.3
6.97.0 6.4 6.3 5.9
6.3 6.2 7.5 6.7
Average Unscheduled PICU Ad-missions 7pm-7am
Capacity Planning -PACU Utilization
Operational Management
% of CHOP Unit Admissions
% VPS Reference Group Unit Admissions
% Difference
Operating Room
28.9 % 16.0% 12.9%
PACU
3.7% 12.8% 9.1%
Benchmark reports revealed increased utilization of PACU
beds from reference hospitals. Supported plans to strategically utilize PACU for recovery
and patient care during high volume/census. Plan developed to identify patients within predetermined
populations to recover in PACU.
Partnerships with Perioperative Area Have Optimized Appropriate Patient Placementless ‘double booking’ for same patient in 2 different inpatient locations
Sep Oct Nov Dec Feb Mar Apr May Jun Aug2013 2014
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Provided VPS data useful to the investigative phase of this Hospital Operating Committee
Information guided efforts in developing high impact Care Model changes
Identified unique populations in which care coordination among units is key
Admission and Transfer Guidelines for requiring non-invasive ventilation
Identification of post operative patients to be sent to PACU or surgical unit utilizing predictability of scheduled vs unscheduled and patient flow
Provided patient flow insight through VPS data that influenced workflow and staffing.
Driving Changes with VPS Data
Driving changes with VPS Data…And it continues
Expanding our partnerships to other areas in the hospital EDEmergency Transport Team Anesthesia Resource CenterBed Management and Nursing Central Staffing
OfficeGeneral Pediatric Units