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Case study

How to build and operationalise a hospital command centre

Danielle Crawley, Nicole Engler, Jessica Stellmaker, Tamara Buechler, Mary Bany, Benjamin Dangerfield and James Newman
Management in Healthcare: A Peer-Reviewed Journal, 9 (1), 46-56 (2024)
https://doi.org/10.69554/EFTP6260

Abstract

In the ever-evolving healthcare landscape, hospitals routinely grapple with daily disruptions and unforeseen events affecting resources and capacity. This paper explores the implementation and impact of the Rochester Hospital Operations Command Center (RHOCC) as a strategic response to challenges faced by the Mayo Clinic Hospital campuses in Rochester. The RHOCC, developed with an expedited timeline in response to capacity issues, exacerbated by COVID-19, serves as a centralised hub for real-time monitoring, coordination and decision-making related to patient flow. The process of establishing the command centre involved role identification, skill set determination, location of important personnel in an organised central space and vendor selection to develop the necessary infrastructure. Dashboards were developed to provide real-time actionable insights into external transfers, surgical and other planned admissions, emergency department status, patient throughput and discharges. These dashboards include colour-coded keys highlighting thresholds related to patient flow metrics and are used to facilitate daily huddles and enhance transparency and data-driven decision-making among hospital stakeholders. The outcomes of implementing the RHOCC include improved efficiency and collaboration, as well as a significantly enhanced ability to proactively respond to factors affecting census. The development of a command centre — driven by leadership endorsement and a commitment to continuous improvement — emerges as a transformative strategy in healthcare innovation. The RHOCC’s approach of building capability, fostering inclusion and articulating a vision of providing superior care while driving impactful improvements, positions it as a leading force in creating operational efficiencies to define healthcare delivery.

Keywords: command centre; hospital management; hospital coordination; census management; hospital census; patient flow

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Author's Biography

Danielle Crawley , MA, CSM, is a senior health systems engineer at Mayo Clinic, with over 20 years of experience in healthcare, ranging from clinical experience in mental health to healthcare engineering and consulting to hospital administration. Crawley has a bachelor’s degree in Healthcare Administration and Communications from Montana State University and a master’s degree in Health and Human Services Administration from Saint Mary’s University, Minnesota, and is a certified scrum master. She also holds an Instructor of Healthcare Administration in Mayo Clinic’s College of Medicine and Science and Gold Quality Fellowship through the Mayo Clinic. Crawley has implemented many highpriority, complex care models in the ambulatory and inpatient settings, which include a hospital command centre, a violent patient care unit, behavioural health group programmes and outpatient 3D skin imaging.

Nicole Engler , MA, is an operations manager supporting Mayo Clinic’s and the state of Minnesota’s largest capital investment to redefine healthcare. With more than 20 years of healthcare experience, Engler’s experience spans programme/project management, marketing/communications, emergency management and operations management for Mayo Clinic, Minnesota Department of Health and the American Cancer Society. Engler has led strategic initiatives at Mayo Clinic, including managing its emergency response to COVID-19 as incident commander; service line and product development; international healthcare consulting and developing a prototyping programme to identify and test innovative concepts prior to implementation. Engler holds a master’s degree in health and human service administration from St. Mary’s University in Minneapolis, Minnesota, and is an instructor in healthcare administration in Mayo Clinic’s College of Medicine and Science.

Jessica Stellmaker is a supervisor for specimen operations in the Department of Laboratory Medicine and Pathology at Mayo Clinic and Mayo Clinic Laboratories. Her previous roles were in the Value Creation Unit in Radiology and operations manager for patient flow at Mayo Clinic Hospital. Stellmaker has been an instructor for the Quality Academy Lean Collaborative; she is also a Gold Mayo Quality Fellow and an Instructor in Health Care Administration, Mayo Clinic College of Medicine and Science and holds a Lean Six Sigma Green Belt through Purdue University. Stellmaker has more than a decade’s experience as a motivated leader, facilitator, presenter and coach at Mayo Clinic and other academic institutions and is currently providing leadership and coaching across the practice, focusing on people first leadership behaviours and system thinking principles.

Tamara Buechler , MD, MHA, is an assistant professor of medicine and the Vice Chair of Hospital Internal Medicine at Mayo Clinic in Rochester, Minnesota. She is an expert in discharge process, care transitions and patient flow and serves as Chair of the Mayo Clinic Hospital Discharge Subcommittee, Associate Chair of the Rochester Hospital Operations Command Center, Vice Chair of Hospital Optimization and Medical Director for patient flow and care management. Dr Buechler has also served as assistant medical director for the Office of Mayo Clinic Experience since 2017. She is a quality improvement expert, achieving the top rank of Gold Fellow in the Mayo Quality Fellows programme.

Mary Bany , MA, serves as operations administrator overseeing hospital operations and the command centre at Mayo Clinic in Rochester, Minnesota, USA. In the 17 years that she has worked at Mayo Clinic, she has held important administrative leadership roles, including education and ambulatory patient access. Bany chairs the Rochester Building Subcommittee and serves as secretary for the Enterprise Operations Command Center and Mayo Clinic Discharge Subcommittees. Her 30-year-long career in healthcare began in a practice management and managed care software company, followed by the National Chronic Care Consortium. Bany is a Mayo Clinic Silver Quality Fellow and serves on the board of directors for the University of Minnesota Alumni Association.

Benjamin Dangerfield , DO, is a consultant within the Division of Hospital Internal Medicine at Mayo Clinic in Arizona. He began at Mayo Clinic in 2015 and currently holds the academic rank of Assistant Professor of Medicine at Mayo Clinic College of Medicine and Science. Dr Dangerfield received his Doctor of Osteopathic Medicine (DO) degree from Arizona College of Osteopathic Medicine, in Glendale, Arizona and went on to complete his Internal Medicine residency at Mayo Clinic. Dr Dangerfield currently serves as the Medical Director for the Arizona Operations Command Center at Mayo Clinic Arizona.

James Newman Jamie Newman, MD, MHA, MACP, is an associate professor of medicine and is the Medical Director of the Rochester Hospital Operations Command Center and Vice Chair of the Mayo Clinic Accountable Care Organization. He is board certified in internal medicine and geriatrics

Citation

Crawley, Danielle, Engler, Nicole, Stellmaker, Jessica, Buechler, Tamara, Bany, Mary, Dangerfield, Benjamin and Newman, James (2024, September 1). How to build and operationalise a hospital command centre. In the Management in Healthcare: A Peer-Reviewed Journal, Volume 9, Issue 1. https://doi.org/10.69554/EFTP6260.

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cover image, Management in Healthcare: A Peer-Reviewed Journal
Management in Healthcare: A Peer-Reviewed Journal
Volume 9 / Issue 1
© Henry Stewart
Publications LLP

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