Desktop Preview Only
Command Centre

A digital revolution for delivering care.

Welcome to the Humber River Health Command Centre Experience. We are delighted to give you this virtual tour of the nerve centre that sits at the heart of our hospital and share with you our journey from an idea through development to outcomes and real results.

Start The Tour

If your primary interest is to see what the Command Centre can mean to your organization’s finances, then we have information for you.  For Humber, the cost has repaid itself many times over.  The savings generated through efficiencies driven by what we have learned and how we have improved staff, patient and medical/surgical workflows have allowed our hospital to to many things.  We’ve used those monies to buy new equipment, to hire new staff, and to add even greater capability to our Command Centre. On this site you will learn:

  • How the Command Centre facilitated a change in culture to focus on constant change management and continual improvement which has led to many system, processes and care improvements
  • How an initial investment can be modest in order to begin to see tangible benefits from a Command Centre
  • How the Humber journey has paved the way with tangible evidence to show the benefits of the Command Centre – making it easier to achieve approvals and support from senior executives, Boards or payors in your own organization
  • How the Command Centre paid immediate financial benefits and led to lasting changes with permanent savings
  • How reinvestment of savings can drive even greater benefits from the Command Centre
Begin your Command Centre virtual tour
What is a Command Centre?
Read more

First and foremost, a Command Centre is a centralized operating system that brings together data that is already being collected across your hospital so that more informed decisions can be made on how to improve your overall efficiency and deliver better care.

At Humber River Hospital, our Command Centre is comprised of people and advanced technology working together to drive better outcomes. We use state-of-the-art technology and have dedicated staff working together with frontline workers and administrators to leverage the data we see into better actions.

Where we are today is not where we started, and it is certainly not a requirement for you. Even the most analog hospitals can leverage the thinking and processes behind our Command Centre to improve outcomes, create a more data-driven culture, and begin a Command Centre journey of their own.

How it Works
Read more

Computers, algorithms and programmed functionshave long been part of many business and organizational functions, helping toidentify, monitor, analyze and implement improvements in businessfunctions.  However, as much as computerprocessing has played a significant role in advancing research into newmedicines and procedures, the healthcare world has been slow to adopt the samecapabilities to improves processes within a hospital, or to improve theinformation available to make better clinical decisions for a patient’simmediate health benefit.  Enter theCommand Centre.

Humber River Hospital’s leadership recognizedthe need and potential benefit to a hospital when they visited the DellComputers fulfillment centre in 2007. The Command Centre performed all of the functions described above tohelp Dell build each customized computer for its customers accurately, on-timeand on-budget.

How we Implemented
Read more

The story of Humber’s journey with the Command Centre is long and full of challenges but fortunately many more successes. We have a full description of our journey on this site <click here>.  

Because Humber was one of the very first to develop and implement a Command Centre, we did much of the learning for you, the new explorer of a Command Centre, and what it can do for your organization. The proofs we have today show the tangible benefits of a Command Centre in ways that had not yet been proven when we began.  Therefore the process of gaining buy-in and support from those who control the spending or those on the front-line of care should be far easier today than it was when we began.

We began slowly and looked first and workflow and patient flow improvements that would bring efficiencies and savings to our operations.  This was important because it solidified the support we had from our Board to spend the money in the first place.  They saw immediately the financial benefit of the Command Centre. Within its first year we had gained internal capacity equivalent to adding 35 new hospital beds.

What are the benefits?
Read more

The benefits of the Command Centre are myriad. Throughout this site and via the virtual tour you will learn of:

  • Financial benefits, both immediate and ongoing that come from both the process of change as well as the direct outputs of the command centre
  • Patient benefits in faster care, less inconvenience and movement throughout the hospital journey, better data and support for clinical decision making leading to better outcomes and overall a better experience for patients and families of HRH.
  • Workflow and information benefits to our staff and clinicians delivering services and patient care
  • Cultural benefits in the way that a Command Centre fosters a new mindset of constant change and improvement among staff and leadership
  • Capacity benefits in allowing your hospital to do more with less. At HRH we created capacity equal to 35 new beds in the first year alone.
  • And more

A Road Map to the Future of Care.

Our Journey

The Humber River Hospital's journey to implementing a Command Centre is one of vision, collaboration, consultation and commitment to a process knowing a necessary outcome. OUR journey may not be YOUR journey. In fact, yours should be simpler because the proof points that make selling the idea now exist, which was not the case when we embarked upon this path. We had to live the experience and develop the proof points to make the case for investment and expected benefits. Many of those benefits are now well-proven. You can learn from us, and others who have also joined the Command Centre ecosystem, to expedite your own journey, saving time, money and human resources while reaching potential benefits much more quickly.

From Idea to Execution

Computers, algorithms and programmed functions have long been part of many business and organizational functions, helping to identify, monitor, analyze and implement improvements in business functions. However, as much as computer processing has played a significant role in advancing research into new medicines and procedures, the healthcare world has been slow to adopt the same capabilities to improve processes within a hospital, or to improve the information available to make better clinical decisions for a patient’s immediate health benefit. Enter the Command Centre.

Read more

From Idea to Execution

Computers, algorithms and programmed functions have long been part of many business and organizational functions, helping to identify, monitor, analyze and implement improvements in business functions. However, as much as computer processing has played a significant role in advancing research into new medicines and procedures, the healthcare world has been slow to adopt the same capabilities to improve processes within a hospital, or to improve the information available to make better clinical decisions for a patient’s immediate health benefit.  Enter the Command Centre.

Humber River Hospital’s leadership recognized the need and potential benefit to a hospital when they visited the Dell Computers fulfillment centre in 2007. The Command Centre performed all of the functions described above to help Dell build each customized computer for its customers accurately, on time and on budget.

The idea germinated and was seeded with GE Healthcare, which at the time was consulting with Humber River Hospital on the IT required for its new hospital – the first fully-digital hospital in North America.

By 2016, the concept had been implemented at Johns Hopkins University in Baltimore and was ready to be advanced when Humber River Hospital asked GE Healthcare to work together on its development for Humber.

Today the Command Centre sits at the heart of Humber and provides continually updated, real-time, actionable information for staff and clinicians responsible for most of the core functions of the hospital.

The Command Centre is programmed to receive specific information from key systems in the hospital on a constant basis. It can analyze that data and based on continual machine-learning, it can make suggestions on needed action to be taken to improve operational performance or clinical care. Based on what it is asked to do, it can provide workflow improvement suggestions to minimize waits times for diagnostics within the hospital or to monitor patient vital signs beyond the basic information to proactively identify the potential for a clinical problem and alert caregivers before a significant incident occurs.

The key in all its functions is the involvement of frontline staff and clinicians who need to use it to develop the desired capability, the inputs, and commitment to actioning the outputs.

How we Began

In October 2015, Humber River Hospital opened a brand-new facility, combining three older hospital sites which were closed as acute care facilities at the same time. It was North America’s first fully digital hospital and was built to handle the expected capacity to properly serve our catchment area for the foreseeable future. The only problem? Demand grew much more quickly than imagined as word got out about the care, quality and patient experience at our new hospital. We soon realized we were going to exceed our new capacity by 2020. How could we address this?

Read more

How We Began

In October 2015, Humber River Hospital opened a brand-new facility, combining three aging hospital sites that were closed as acute care facilities at the same time. It was North America’s first fully digital hospital and was built to handle the expected capacity to properly serve our catchment area for the foreseeable future. The only problem? Patient volumes increased rapidly. We soon realized we were going to exceed our new capacity by 2020. How could we address this?

Humber River Hospital began seeking a means to improve our internal capacity without seeking government funding to expand a hospital we had just barely opened. Our CEO and COO recalled a tour of Dell’s fulfillment centre and their amazing Command Centre. Dell used to track all elements of its operations to achieve timely delivery of each customized computer. That visit, many years before, had resulted in a discussion with GE Healthcare about how the Command Centre concept could be used in a hospital setting. As Humber River Hospital was building its new fully digital hospital, GE Healthcare was at the same time developing the Command Centre idea.

By the time Humber River Hospital was seeking solutions to expand capacity, GE Healthcare had piloted the first Command Centre with Johns Hopkins University in Baltimore. So, when Humber River Hospital discussed its needs with GE Healthcare, the Command Centre was an easy sell. The hospital leadership already had a sense that it was what was needed, and GE Healthcare and Johns Hopkins had already begun to show the benefits to the Command Centre in creating efficiencies and maximizing capacity.

A specific proposal was developed and taken by hospital leadership to the Humber River Hospital Board of Directors. It was ambitious, but fitting for Humber River Hospital, that we use technology and change management to drive increased capability and capacity. The Board agreed to a significant investment, from the hospital’s own funds to implement the first generation of the Command Centre. With that buy-in from senior levels of the hospital, the initial stages were very much a top-down initiative. That changed as time went on.

As this was to be only the second Command Centre in the world in a hospital, it was not always easy to get buy-in. There was resistance, generally based on a fear of the unknown. Healthcare is not known for its rapid embrace of change. After all, you don’t experiment on a patient until you know with confidence something is very likely to work. So, Humber River Hospital leadership embarked on extensive internal consultation. Hundreds of team meetings, surveys and town halls were held across the organization. Each staff member was given multiple opportunities to provide input. The questions were posed: how can we make your job easier? What are things you wish you could do that you can’t today that would make the experience better for you and your patients?

Generation 1

From that, evolved Generation 1. Generation 1 was about increased capacity, how to do more with less, how to improve patient flow and staff workflow. How do you get doctors to get excited about that? Why should a nurse care about what rooms get cleaned and when? We made it about easing their workload in non-care areas, lessening the administrative burden and ensuring more time at the bedside of their patients, where the biggest impact can be made.  

Read more

Generation 1

From that, evolved Generation 1. Generation 1 was about increased capacity, how to do more with less, how to improve patient flow and staff workflow. How do you get doctors to get excited about that? Why should a nurse care about what rooms get cleaned and when? We made it about easing their workload in non-care areas, lessening the administrative burden and ensuring more time at the bedside of their patients, where the biggest impact can be made.

We can say with confidence that of all the changes that have been implemented and the 30+ Tiles that have been developed since, there has only been ONE single step added to a previously-existing workflow. One from literally thousands of little changes. Does that sound like any IT implementation you’ve ever been involved in?

It is important for all to understand that, yes, the technology is important, but the key to the Command Centre is actually real-time information coupled with timely action from staff and physicians. Technology is not there to dictate to staff what they must do, it is a tool to get what they need to make the best decisions at the right time to provide the best care possible. The Command Centre hasn’t displaced staff, it has provided a backstop or safety net which supports front line staff and physicians.

The other benefits are more fully explained in the Outcomes section of this website and the accompanying materials, with highlights including:

  • Net new internal capacity equal to having added the equivalent of 35 new beds
  • A short two-year return on investment
  • A permanent reduction in operating costs based on maintaining existing capacity and functions
  • Decreased wait times for inpatient diagnostics
  • Faster turnover of room cleaning
  • Reduction in Emergency Room wait times

As important as these benefits were, we also learned that sometimes the value from the Command Centre comes when the information it provides helps us to make decisions on what NOT to do and where we don’t need to spend additional funds. It is harder to quantify the avoided costs, but definitely was also a clear benefit to Humber River Hospital.

Bed Summary Tile
Summarizes bed availability, including which beds need to be cleaned.
Census Forecast Tile
Provides visibility of current and forecasted capacity over 24-48 hour time horizon highlighting tolerance levels.
Allied Health Tile
Provides an overview of the status of patient referrals for Physiotherapy and/or Social Work, and prioritizes patients awaiting discharge or on specific timelines.
Boarders Tile
Provides an overview of inpatients across multiple departments waiting for a bed or to be moved to next level of appropriate care and alerts staff when a patient has not been moved to their assigned bed for more than 60 minutes.
Length of Stay Tiles
Monitors the length of stay for patients admitted to HRH and those admitted from a nursing home, prioritizing their care needs based on risk.
Local News Tile
Displays local 24-hours news that indicates when there may be an event, accident or other incident that could result in increased demand on the hospital.
Delays in Care Tile
Identifies delays in care activities and highlights deviations from established clinical pathways and best practices.
Discharge Barriers Tile
Matches patients pending discharge with incoming inpatients who require a bed, collating a checklist for each patient’s status, relevant patient data for nurses, and prioritizes level of urgency to proactively alert frontline staff to any potential obstacles.
Unit View Tile
Allows frontline Command Centre staff to digitally “check in” on any unit in the hospital to monitor scheduled activities, capacity, patient discharges, and patient health risks for vulnerable patients.
Unit Under Pressure Tile
Identifies units that are under pressure based on staff resourcing, unit capacity, and code events occurring over the last 90 minutes.
Emergency Department Tiles
These tiles provide a live feed of the Emergency Department as well as a bird's eye view of capacity, waiting lists and patients waiting to be moved to the appropriate level of care.
Image Modality Tiles
Tracks imaging diagnostics in real-time across various imaging scans and image guided procedures.
Physician Task Tile
Tracks imaging diagnostics in real-time across various imaging scans and image guided procedures.
Enabling Support Services Tiles
The EVS Tile provides an overview of environmental and cleaning services needed across the hospital, integrated with professional expertise to indicate turnaround times. 
Medical Tube Map Tile
The Medical Tube Map shows a medicine clinical patient’s journey in real-time from admittance to acute care to when they are stable and ready for discharged to post-acute care facilities and/or a hospital closer to their home. 
Surgical Tube Map Tile
The Surgical Tube Map shows a surgical patient’s journey in real-time from being scheduled for surgery to discharge or transfer, providing visibility into status of all surgical patients at any given point in their treatment. 

Generation 2

These early, tangible benefits then made it much easier to expand the use of the Command Centre. In fact, the development of all of Generation 2 new clinical Tiles was driven by our frontline staff and clinicians.

All of the myths and concerns about the project and how it might be “big brother-ish” disappeared because the benefits had become obvious. The reluctance was replaced with eagerness, creativity and commitment to further improvements.  

Read more

Generation 2

Whereas Generation 1 focused on efficiencies and flow improvements, Generation 2 was all about preventing harm and becoming a high reliability organization. How to eliminate unnecessary errors, reduce unexpected events and provide early intervention that will impact clinical outcomes. Our staff came to the table with over 350 ideas for new Tiles that could provide clinical benefit. These were collected, consolidated, debated and boiled down to 30 main concepts by working with GE Healthcare, our doctors, nurses and frontline staff.

Our people drove the process.

This shift in thinking, we believe, is more important and impactful to our organization than the Command Centre itself. It reflects a shift in culture. Humber River Hospital now enjoys a culture of change or constant improvement and an organization-wide commitment to continue this thinking. A new staff member coming to Humber River Hospital from almost any other hospital will notice an immediate difference in the work environment and attitude of their colleagues. It is real, tangible and now ingrained in our organization’s DNA.

Our approach has gained broad acceptance in Ontario and Canada. The Ontario Ministry of Health went from passive observer of our journey to actively promoting our approach as a best practice for the rest of Ontario’s hospitals. Accreditation Canada which audits and accredits hospitals across Canada and beyond, cites Humber River Hospital as a leading example of high reliability based on our results.

The specific Generation 2 Tiles are outlined in our presentations and videos found on this site, with highlights including Tiles for:

  • Clinical Deterioration and Early Intervention
  • Perinatal Care
  • Risk of Harm
  • Seniors Care
  • And others
Risk of Harm Tile
Proactively alerts frontline professionals to patients who are at a higher risk of adverse events, like falls or sepsis, combined with best practice guidelines.
Seniors Care Tile
Monitors elderly patients’ mobility, dietary intake, frequency of ambulation, and medications causing risk.
Perinatal Care Tile
Monitors newborns and their mothers to alert experienced frontline professionals in the Obstetrical Unit of potential health risks to mom or baby.
COVID-19 Tile
This tile was swiftly added in response to the global pandemic to track testing trends and alert healthcare professionals to positive or suspected cases. This tile can be customized to apply to any future viral outbreaks, such as flu season.
Clinical Deterioration Tile
Develops an early warning score for every patient in the hospital that is comprised of physiological metrics unique to each patient with clinical expertise and observations.

Generation 3

Our journey doesn’t end with achievements within the hospital. We recognized that to have even greater impact and to leverage what we had built and what we had learned, we needed to extend the capabilities of the Command Centre and our organization out into the community.

The current model of care in Ontario, and really anywhere in the world, is unsustainable. It focuses largely on dealing with the most acute issues after they happen and not enough on early detection and prevention. This isn’t new, but the problem gets worse each year. Generation 3 for Humber River Hospital focuses on the community. How can we take what we know works within the hospital and extend that capability to the community to be an early warning system that will prevent adverse events and hospitalizations?

Read more

Generation 3

The entire healthcare system needs to shift from episodic, acute care to a continuous care model that avoids acute care needs where possible. From governance to funding to accountability, the focus must change. To do that, we need to look at ways to bundle people together to provide continuous oversight and active management of people’s health.

Generation 3 will leverage our Command Centre experience and concepts to coordinate care around the patient in the community and the home. It is about changing how we interact with our community. It is not enough to provide a wearable device and a call centre for people to report into. The experience of the Command Centre has given us learnings on analytics – how to pay attention to the right things and ignore what we don’t need to focus on. We can bring that to community providers and the patients they are responsible for. But many community partners are not provided the funding and do not have the scale to develop the tools themselves – sometimes not even the basic connectivity and tools to facilitate the interaction. That is where the hospital and the Command Centre come in.

We are able to develop the platform that all can use. We have the people, the experience and the history of innovation to give us the credibility to spread the capability beyond our walls. So, we are building it. We call it Healix™, a person-centred precision medicine platform that empowers the patient with self-management and real inclusion in their own health.

We are creating the platform for collaboration and information sharing to put the power and information in the hands of the circle of care for each patient. Those that need to know what is happening will get what they need, when they need it in order to proactively look after the patient in their care.

And if someone falls through the cracks, there is a backstop – the Command Centre. Anchored by a layer of care escalation algorithms, it will send alerts, it will monitor for action, and it will escalate if that action doesn’t happen – the same way it would for a patient within the hospital.

This next Generation allows monitoring of patients, maximizing opportunities to intervene earlier and adjust care plans as needed, and reduces reliance on health human resources for patient support. For the patient, this culminates in an experience that can be characterized by empowerment, education, reassurance, and real inclusion in their own health.

The approach is not new. What is new is the technology to facilitate it, the experience of organizations like Humber River Hospital to know what’s required and how to approach it, and a catalyst to cause a need to think differently. In this case, that catalyst has been COVID-19. We have all needed to adjust, to think differently because of the pandemic. Our community partners now need what has been on offer from the Command Centre rollout and now they are motivated to make it work. That shift in thinking is akin to the shift in thinking that happened in our own organization with the first generation of the Command Centre.

How does it work in real life? Here’s an example:

A hip replacement patient goes home from hospital. Instead of or in addition to a booklet, the patient has an app that allows for real-time education and delivery of the rehab program. The patient can provide inputs, even videos, to give feedback – fed into the Command Centre. If there is something concerning, such as an infection or a complication, the Command Centre can alert the appropriate members of that patient’s ‘circle of care’ that there is something that needs attention. If that action is not acknowledged and executed, the Command Centre can alert others until the patient receives the support they need.

This isn’t the future. This is now.

Patient Manager Tile
The Patient Manager Tile is tightly integrated with Healix and presents patient flags, pending tasks, barriers to pathway progression, and other alerts for outpatient visits, inpatient stays, and post discharge. It is a “personal” Tile that presents information pertaining to the provider’s patients, filtered by organization or Circle of Care member and, as a web application, the Patient Manager Tile can be viewed anywhere.

+ more

Updates & Upgrades

Humber River Hospital was one of the first hospitals to implement a Command Centre. Others have since followed in our footsteps, adapting and improving the Tiles along the way. In 2022, Humber River Hospital will update our Tiles to integrate the enhancements and learnings from our peers, as well as continue to lead the way with improvements from our own experiences. For example, we will add a Goals of Care Alert on the Patient Manager Delays in Care tile, and integrate a PACU Recovery Score, which is exclusive to Humber, and additional clinical criteria to flag when patients are ready to leave the PACU and to move back to inpatient areas.  

The Command Centre has been and will continue to evolve to meet emerging needs within our hospital, ensuring higher reliability care every step of the way.

Continue The Tour

A Road Map to the Future of Care.

Our Journey
From Idea to Execution
How We Began
Generation 1
Generation 2
Generation 3
Updates & Upgrades
OUR Journey

The Humber River Health's journey to implementing a Command Centre is one of vision, collaboration, consultation and commitment to a process knowing a necessary outcome. OUR journey may not be YOUR journey. In fact, yours should be simpler because the proof points that make selling the idea now exist, which was not the case when we embarked upon this path. We had to live the experience and develop the proof points to make the case for investment and expected benefits. Many of those benefits are now well-proven. You can learn from us, and others who have also joined the Command Centre ecosystem, to expedite your own journey, saving time, money and human resources while reaching potential benefits much more quickly.

From Idea to Execution

Computers, algorithms and programmed functions have long been part of many business and organizational functions, helping to identify, monitor, analyze and implement improvements in business functions. However, as much as computer processing has played a significant role in advancing research into new medicines and procedures, the healthcare world has been slow to adopt the same capabilities to improve processes within a hospital, or to improve the information available to make better clinical decisions for a patient’s immediate health benefit. Enter the Command Centre.

Read more

From Idea to Execution

Computers, algorithms and programmed functions have long been part of many business and organizational functions, helping to identify, monitor, analyze and implement improvements in business functions. However, as much as computer processing has played a significant role in advancing research into new medicines and procedures, the healthcare world has been slow to adopt the same capabilities to improve processes within a hospital, or to improve the information available to make better clinical decisions for a patient’s immediate health benefit.  Enter the Command Centre.

Humber River Health’s leadership recognized the need and potential benefit to a hospital when they visited the Dell Computers fulfillment centre in 2007. The Command Centre performed all of the functions described above to help Dell build each customized computer for its customers accurately, on time and on budget.

The idea germinated and was seeded with GE Healthcare, which at the time was consulting with Humber River Health on the IT required for its new hospital – the first fully-digital hospital in North America.

By 2016, the concept had been implemented at Johns Hopkins University in Baltimore and was ready to be advanced when Humber River Health asked GE Healthcare to work together on its development for Humber.

Today the Command Centre sits at the heart of Humber and provides continually updated, real-time, actionable information for staff and clinicians responsible for most of the core functions of the hospital.

The Command Centre is programmed to receive specific information from key systems in the hospital on a constant basis. It can analyze that data and based on continual machine-learning, it can make suggestions on needed action to be taken to improve operational performance or clinical care. Based on what it is asked to do, it can provide workflow improvement suggestions to minimize waits times for diagnostics within the hospital or to monitor patient vital signs beyond the basic information to proactively identify the potential for a clinical problem and alert caregivers before a significant incident occurs.

The key in all its functions is the involvement of frontline staff and clinicians who need to use it to develop the desired capability, the inputs, and commitment to actioning the outputs.

How we Began

In October 2015, Humber River Health opened a brand-new facility, combining three older hospital sites which were closed as acute care facilities at the same time. It was North America’s first fully digital hospital and was built to handle the expected capacity to properly serve our catchment area for the foreseeable future. The only problem? Demand grew much more quickly than imagined as word got out about the care, quality and patient experience at our new hospital. We soon realized we were going to exceed our new capacity by 2020. How could we address this?

Read more

How We Began

In October 2015, Humber River Health opened a brand-new facility, combining three aging hospital sites that were closed as acute care facilities at the same time. It was North America’s first fully digital hospital and was built to handle the expected capacity to properly serve our catchment area for the foreseeable future. The only problem? Patient volumes increased rapidly. We soon realized we were going to exceed our new capacity by 2020. How could we address this?

Humber River Health began seeking a means to improve our internal capacity without seeking government funding to expand a hospital we had just barely opened. Our CEO and COO recalled a tour of Dell’s fulfillment centre and their amazing Command Centre. Dell used to track all elements of its operations to achieve timely delivery of each customized computer. That visit, many years before, had resulted in a discussion with GE Healthcare about how the Command Centre concept could be used in a hospital setting. As Humber River Health was building its new fully digital hospital, GE Healthcare was at the same time developing the Command Centre idea.

By the time Humber River Health was seeking solutions to expand capacity, GE Healthcare had piloted the first Command Centre with Johns Hopkins University in Baltimore. So, when Humber River Health discussed its needs with GE Healthcare, the Command Centre was an easy sell. The hospital leadership already had a sense that it was what was needed, and GE Healthcare and Johns Hopkins had already begun to show the benefits to the Command Centre in creating efficiencies and maximizing capacity.

A specific proposal was developed and taken by hospital leadership to the Humber River Health Board of Directors. It was ambitious, but fitting for Humber River Health, that we use technology and change management to drive increased capability and capacity. The Board agreed to a significant investment, from the hospital’s own funds to implement the first generation of the Command Centre. With that buy-in from senior levels of the hospital, the initial stages were very much a top-down initiative. That changed as time went on.

As this was to be only the second Command Centre in the world in a hospital, it was not always easy to get buy-in. There was resistance, generally based on a fear of the unknown. Healthcare is not known for its rapid embrace of change. After all, you don’t experiment on a patient until you know with confidence something is very likely to work. So, Humber River Health leadership embarked on extensive internal consultation. Hundreds of team meetings, surveys and town halls were held across the organization. Each staff member was given multiple opportunities to provide input. The questions were posed: how can we make your job easier? What are things you wish you could do that you can’t today that would make the experience better for you and your patients?

Generation 1

From that, evolved Generation 1. Generation 1 was about increased capacity, how to do more with less, how to improve patient flow and staff workflow. How do you get doctors to get excited about that? Why should a nurse care about what rooms get cleaned and when? We made it about easing their workload in non-care areas, lessening the administrative burden and ensuring more time at the bedside of their patients, where the biggest impact can be made.  

Read more

Generation 1

From that, evolved Generation 1. Generation 1 was about increased capacity, how to do more with less, how to improve patient flow and staff workflow. How do you get doctors to get excited about that? Why should a nurse care about what rooms get cleaned and when? We made it about easing their workload in non-care areas, lessening the administrative burden and ensuring more time at the bedside of their patients, where the biggest impact can be made.

We can say with confidence that of all the changes that have been implemented and the 30+ Tiles that have been developed since, there has only been ONE single step added to a previously-existing workflow. One from literally thousands of little changes. Does that sound like any IT implementation you’ve ever been involved in?

It is important for all to understand that, yes, the technology is important, but the key to the Command Centre is actually real-time information coupled with timely action from staff and physicians. Technology is not there to dictate to staff what they must do, it is a tool to get what they need to make the best decisions at the right time to provide the best care possible. The Command Centre hasn’t displaced staff, it has provided a backstop or safety net which supports front line staff and physicians.

The other benefits are more fully explained in the Outcomes section of this website and the accompanying materials, with highlights including:

  • Net new internal capacity equal to having added the equivalent of 35 new beds
  • A short two-year return on investment
  • A permanent reduction in operating costs based on maintaining existing capacity and functions
  • Decreased wait times for inpatient diagnostics
  • Faster turnover of room cleaning
  • Reduction in Emergency Room wait times

As important as these benefits were, we also learned that sometimes the value from the Command Centre comes when the information it provides helps us to make decisions on what NOT to do and where we don’t need to spend additional funds. It is harder to quantify the avoided costs, but definitely was also a clear benefit to Humber River Health.

Bed Summary Tile
Summarizes bed availability, including which beds need to be cleaned.
Census Forecast Tile
Provides visibility of current and forecasted capacity over 24-48 hour time horizon highlighting tolerance levels.
Allied Health Tile
Provides an overview of the status of patient referrals for Physiotherapy and/or Social Work, and prioritizes patients awaiting discharge or on specific timelines.
Boarders Tile
Provides an overview of inpatients across multiple departments waiting for a bed or to be moved to next level of appropriate care and alerts staff when a patient has not been moved to their assigned bed for more than 60 minutes.
Length of Stay Tiles
Monitors the length of stay for patients admitted to HRH and those admitted from a nursing home, prioritizing their care needs based on risk.
Local News Tile
Displays local 24-hours news that indicates when there may be an event, accident or other incident that could result in increased demand on the hospital.
Delays in Care Tile
Identifies delays in care activities and highlights deviations from established clinical pathways and best practices.
Discharge Barriers Tile
Matches patients pending discharge with incoming inpatients who require a bed, collating a checklist for each patient’s status, relevant patient data for nurses, and prioritizes level of urgency to proactively alert frontline staff to any potential obstacles.
Unit View Tile
Allows frontline Command Centre staff to digitally “check in” on any unit in the hospital to monitor scheduled activities, capacity, patient discharges, and patient health risks for vulnerable patients.
Unit Under Pressure Tile
Identifies units that are under pressure based on staff resourcing, unit capacity, and code events occurring over the last 90 minutes.
Emergency Department Tiles
These tiles provide a live feed of the Emergency Department as well as a bird's eye view of capacity, waiting lists and patients waiting to be moved to the appropriate level of care.
Image Modality Tiles
Tracks imaging diagnostics in real-time across various imaging scans and image guided procedures.
Physician Task Tile
Tracks imaging diagnostics in real-time across various imaging scans and image guided procedures.
Enabling Support Services Tiles
The EVS Tile provides an overview of environmental and cleaning services needed across the hospital, integrated with professional expertise to indicate turnaround times. 
Medical Tube Map Tile
The Medical Tube Map shows a medicine clinical patient’s journey in real-time from admittance to acute care to when they are stable and ready for discharged to post-acute care facilities and/or a hospital closer to their home. 
Surgical Tube Map Tile
The Surgical Tube Map shows a surgical patient’s journey in real-time from being scheduled for surgery to discharge or transfer, providing visibility into status of all surgical patients at any given point in their treatment. 
Generation 2

These early, tangible benefits then made it much easier to expand the use of the Command Centre. In fact, the development of all of Generation 2 new clinical Tiles was driven by our frontline staff and clinicians.

All of the myths and concerns about the project and how it might be “big brother-ish” disappeared because the benefits had become obvious. The reluctance was replaced with eagerness, creativity and commitment to further improvements.  

Read more

Generation 2

Whereas Generation 1 focused on efficiencies and flow improvements, Generation 2 was all about preventing harm and becoming a high reliability organization. How to eliminate unnecessary errors, reduce unexpected events and provide early intervention that will impact clinical outcomes. Our staff came to the table with over 350 ideas for new Tiles that could provide clinical benefit. These were collected, consolidated, debated and boiled down to 30 main concepts by working with GE Healthcare, our doctors, nurses and frontline staff.

Our people drove the process.

This shift in thinking, we believe, is more important and impactful to our organization than the Command Centre itself. It reflects a shift in culture. Humber River Health now enjoys a culture of change or constant improvement and an organization-wide commitment to continue this thinking. A new staff member coming to Humber River Health from almost any other hospital will notice an immediate difference in the work environment and attitude of their colleagues. It is real, tangible and now ingrained in our organization’s DNA.

Our approach has gained broad acceptance in Ontario and Canada. The Ontario Ministry of Health went from passive observer of our journey to actively promoting our approach as a best practice for the rest of Ontario’s hospitals. Accreditation Canada which audits and accredits hospitals across Canada and beyond, cites Humber River Health as a leading example of high reliability based on our results.

The specific Generation 2 Tiles are outlined in our presentations and videos found on this site, with highlights including Tiles for:

  • Clinical Deterioration and Early Intervention
  • Perinatal Care
  • Risk of Harm
  • Seniors Care
  • And others
Risk of Harm Tile
Proactively alerts frontline professionals to patients who are at a higher risk of adverse events, like falls or sepsis, combined with best practice guidelines.
Seniors Care Tile
Monitors elderly patients’ mobility, dietary intake, frequency of ambulation, and medications causing risk.
Perinatal Care Tile
Monitors newborns and their mothers to alert experienced frontline professionals in the Obstetrical Unit of potential health risks to mom or baby.
COVID-19 Tile
This tile was swiftly added in response to the global pandemic to track testing trends and alert healthcare professionals to positive or suspected cases. This tile can be customized to apply to any future viral outbreaks, such as flu season.
Clinical Deterioration Tile
Develops an early warning score for every patient in the hospital that is comprised of physiological metrics unique to each patient with clinical expertise and observations.
Generation 3

Our journey doesn’t end with achievements within the hospital. We recognized that to have even greater impact and to leverage what we had built and what we had learned, we needed to extend the capabilities of the Command Centre and our organization out into the community.

The current model of care in Ontario, and really anywhere in the world, is unsustainable. It focuses largely on dealing with the most acute issues after they happen and not enough on early detection and prevention. This isn’t new, but the problem gets worse each year. Generation 3 for Humber River Health focuses on the community. How can we take what we know works within the hospital and extend that capability to the community to be an early warning system that will prevent adverse events and hospitalizations?

Read more

Generation 3

The entire healthcare system needs to shift from episodic, acute care to a continuous care model that avoids acute care needs where possible. From governance to funding to accountability, the focus must change. To do that, we need to look at ways to bundle people together to provide continuous oversight and active management of people’s health.

Generation 3 will leverage our Command Centre experience and concepts to coordinate care around the patient in the community and the home. It is about changing how we interact with our community. It is not enough to provide a wearable device and a call centre for people to report into. The experience of the Command Centre has given us learnings on analytics – how to pay attention to the right things and ignore what we don’t need to focus on. We can bring that to community providers and the patients they are responsible for. But many community partners are not provided the funding and do not have the scale to develop the tools themselves – sometimes not even the basic connectivity and tools to facilitate the interaction. That is where the hospital and the Command Centre come in.

We are able to develop the platform that all can use. We have the people, the experience and the history of innovation to give us the credibility to spread the capability beyond our walls. So, we are building it. We call it Healix™, a person-centred precision medicine platform that empowers the patient with self-management and real inclusion in their own health.

We are creating the platform for collaboration and information sharing to put the power and information in the hands of the circle of care for each patient. Those that need to know what is happening will get what they need, when they need it in order to proactively look after the patient in their care.

And if someone falls through the cracks, there is a backstop – the Command Centre. Anchored by a layer of care escalation algorithms, it will send alerts, it will monitor for action, and it will escalate if that action doesn’t happen – the same way it would for a patient within the hospital.

This next Generation allows monitoring of patients, maximizing opportunities to intervene earlier and adjust care plans as needed, and reduces reliance on health human resources for patient support. For the patient, this culminates in an experience that can be characterized by empowerment, education, reassurance, and real inclusion in their own health.

The approach is not new. What is new is the technology to facilitate it, the experience of organizations like Humber River Health to know what’s required and how to approach it, and a catalyst to cause a need to think differently. In this case, that catalyst has been COVID-19. We have all needed to adjust, to think differently because of the pandemic. Our community partners now need what has been on offer from the Command Centre rollout and now they are motivated to make it work. That shift in thinking is akin to the shift in thinking that happened in our own organization with the first generation of the Command Centre.

How does it work in real life? Here’s an example:

A hip replacement patient goes home from hospital. Instead of or in addition to a booklet, the patient has an app that allows for real-time education and delivery of the rehab program. The patient can provide inputs, even videos, to give feedback – fed into the Command Centre. If there is something concerning, such as an infection or a complication, the Command Centre can alert the appropriate members of that patient’s ‘circle of care’ that there is something that needs attention. If that action is not acknowledged and executed, the Command Centre can alert others until the patient receives the support they need.

This isn’t the future. This is now.

Patient Manager Tile
The Patient Manager Tile is tightly integrated with Healix and presents patient flags, pending tasks, barriers to pathway progression, and other alerts for outpatient visits, inpatient stays, and post discharge. It is a “personal” Tile that presents information pertaining to the provider’s patients, filtered by organization or Circle of Care member and, as a web application, the Patient Manager Tile can be viewed anywhere.

+ more
Updates & Upgrades

Humber River Health was one of the first hospitals to implement a Command Centre. Others have since followed in our footsteps, adapting and improving the Tiles along the way. In 2022, Humber River Health will update our Tiles to integrate the enhancements and learnings from our peers, as well as continue to lead the way with improvements from our own experiences. For example, we will add a Goals of Care Alert on the Patient Manager Delays in Care tile, and integrate a PACU Recovery Score, which is exclusive to Humber, and additional clinical criteria to flag when patients are ready to leave the PACU and to move back to inpatient areas.  

The Command Centre has been and will continue to evolve to meet emerging needs within our hospital, ensuring higher reliability care every step of the way.

Continue The Tour
Overview

At its essence, the Command Centre is a tool that provides analytics and actionable data that allows our staff, clinicians and administrators to make better and timelier operational and clinical decisions. It takes real-time data, curates it into an analytic, provides it to staff who are watching, provides them with the information and the prompts them to act if there is something needing attention.

It is also important to note what the Command Centre is not. It is not a machine that tells staff what to do. It does not provide oversight or monitoring of people’s work habits. It does not dictate a course of action.

Also, importantly, it was key in our implementation not to force our staff and clinicians to change how they work or the tools they are used to using to do that work. Our nurses carry an ASCOM phone with them – that hasn’t changed. They use a Meditech based EMS – that hasn’t changed.

‍

Learn more
The Flow

Inputs come into the Command Centre from our existing systems. At Humber River Hospital, eight different IT systems feed data into the Command Centre, but the majority of the required data comes from our EMR.

It analyzes the data based on the desired outputs developed by our team and using the analytics engine developed and perfected by GE Healthcare. In many cases, the information fed to the Command Centre is drawn from broader and deeper sources of information beyond what the doctors or nurses have at their fingertips. It then provides actionable data out to the teams that need the information. At the same time, it is monitoring to ensure action is taken based on that data. If action is not taken, it can provide alerts and escalate attention to ensure what’s needed gets done. Simple? Yes, but much goes on behind the scenes.

Learn more
Examples

Our experience showed an immediate return on our investment. We fully recovered all of our investment in only two years of operation after implementing the Command Centre. And those savings came almost exclusively from the implementation of our Generation 1. The quick return made it easy to justify further investment in Generation 2 Tiles with strong confidence in the benefits we would see. Each step became a further proof point for the next decision to expand the Command Centre capabilities. It is our expectation that each new Command Centre, learning from us and others, will realize benefits faster and have an easier time justifying the required investments to make improvements. We have already done the learning and developed the proof points, which are entirely replicable with the caveat being that each hospital organization is different with different funding models. The general approach however, is universal.

Example 1
Learn more

Humber River Hospital created a capacity increase the equivalent of 35 net new beds in the first year of the Command Centre implementation. What does this mean? With a hospital footprint of 688 beds, Humber River Hospital is one of the largest regional hospitals in Ontario. By creating new workflow and patient flow processes, assisted by the monitoring, analysis and prompts of the Command Centre, Humber River Hospital was able to increase its capacity by 5% within one year. This contributed to an elimination of the need for temporary beds in non-clinical areas of the hospital, an alleviation of wait times in our emergency room and an increase in ED visits by 8% at the same time, less stress for our staff and a better overall patient experience.

We also brought about a 76% decrease in wait times for treatment by allied health professionals (PTs, OTs and others), a range of 16%-27% decrease in wait times for diagnostic results and a 13% decrease in ALC  days in hospital.

All of these add up to the creation of the 35-bed equivalent increase in overall capacity, which made a substantial difference to our operations and quality of care. We are certain your organization can create similar efficiencies under most any circumstance.

Example 2
Learn more

Perhaps the greatest outcome of our Command Centre implementation has been the complete and, we believe, permanent shift to an overall culture of continuous improvement. We say this because the change in mindset now permeates all aspects of our operations. A new employee - be they frontline, administrative or support - will come to Humber River Hospital and find a substantial difference in culture relative to our peers. We find this manifests in many ways that reach well beyond the use of the Command Centre. It means we don’t settle for the “way it’s done”. Our people are invested in the success of the organization and the complete care of our patients, they demand more of their colleagues, which also drives forward a positive steady improvement.

This came about prompted by the work to develop the Command Centre. The extensive consultations and change management work meant a level of buy-in that is hard to attain without a catalyst for change. That buy-in led to early successes which provided the direct evidence of the benefits of the approach and prompted an incredible process of generating hundreds of new ideas for use of the Command Centre – all driven by the work and creativity of our staff and clinicians. That spirit and approach continues, and Humber River Hospital is determined to ensure it will be a permanent symbol of what can be achieved when we develop the right culture. We believe this can be a key part of any organization’s legacy, driven by the changes needed to implement and take advantage of a Command Centre.

Example 3
Learn more

It would be fair for doctors and nurses to say “why should I care about how long it takes staff to clean an inpatient room?” We set out to demonstrate that all the little process and workflow changes we implemented in Generation 1 of our Command Centre would make a tangible difference to their daily routines and ability to best serve patients. We succeeded.

There were many positives from the early days of our implementation, but the ones that made the biggest impact to our clinical teams were the faster delivery of diagnostic results through better and faster processing of both the patients and the workflow to facilitate results, and the ability to free up time in their day to spend more time at the bedside of their patients. This is where the biggest human impact on health outcomes is derived. Better care, more care, more use of their clinical expertise through greater interaction with the patients.

We all wish we had more time for what we are best at and what we most enjoy, don’t we? That is a key benefit of the Command Centre and one that then helped to drive participation from our clinical teams for more use of the Command Centre, in particular for Generation 2, and its support of our clinicians for better clinical decisions, avoidance of never events and overall better health outcomes. From an early resistance or indifference to change to driving new ways to utilize the Command Centre, our clinicians and frontline staff have become real champions of this new culture around the Command Centre we have built at Humber River Hospital.

Example 4
Learn more

‍

Generation 2 Tiles focused on the safety of patients and better health outcomes. Tools, such as a Clinical Deterioration Tile, help identify and provide actionable data for clinicians to intervene before a patient deteriorates to the point of needing higher level intervention.

In general, the input of information and the use of the tool to help to analyze data and provide actionable outputs leads to better decision-making both operationally and clinically. Aside from the minute-to-minute updates to the Tiles and the information they provide to our frontlines, the Command Centre also gives us system-wide data with which to make longer-term decisions.

We have taken established industry standard measurements and run them through the Command Centre to give us a view of the data more rich than we could achieve on our own. At any given time we can pull 28 different quality measurements and look at them through an historical lens to track our progress and measure our current trends. This view allows us to make appropriate decisions on staffing allocations and changes in workflow or patient flow all to create capacity and a better overall patient experience.

“You can’t manage what you can’t measure”

The old adage is true. So we’ve taken it to heart with the tools that we have. The Command Centre provides us both the real-time ability to provide feedback to the frontlines and alerts for actions that need to be taken. Along with the AI capabilities provided by GE Healthcare, the Command Centre also provides us longer term analytics, allowing us to make management decisions on a regular basis to make continuous improvements. Our system allows us to measure 28 core quality functions today, with new capabilities being developed and added all the time. For instance, we now track the following continuously (and analyze against historical data):

Generation 1

  • Time it takes to identify, clean and turn over a patient room
  • The time it takes to transfer a patient to and from surgeries or diagnostics
  • The time it takes to return diagnostic results
  • Decrease in ER readmission rates
  • Delays in care by clinician/allied health professionals
  • Delays in discharge times

Generation 2

  • Movement of patients from inpatient to ICU beds
  • Decrease in Code Blue calls
  • Decrease in sepsis incidents
  • Decrease in patient falls
  • Decrease in pressure sores
  • Decrease in birthing trauma rates

These and other analytics allow us both to track and demonstrate progress (continuous improvement goals), and also to stop and course correct with real-time data where there are consistent issues that are outside our norms. Many of these analytics are supported by GE Healthcare’s Artificial Intelligence capabilities, bringing insights and recommendations we would not be able to identify and implement on our own.

Example 5
Learn more

Example 1

A nurse sees a patient, takes their vital signs and identifies an Early Warning Score of 5 - which signals potential clinical deterioration. The Command Centre is able to monitor that patient via interfaces between the vital signs monitor, our EMR and the Command Centre. The data is then displayed on Tiles, visible both in the Command Centre and on the units, providing simultaneous awareness of any deteriorating patients to the Charge Nurse on the unit and to Command Centre staff. The Command Centre alerts that this patient should be monitored hourly. Should two hours pass with no monitoring, the Charge Nurse is alerted by the Command Centre, enabling an opportunity to follow-up with the Primary Nurse for that patient and prioritize care as required. If more time passes and the patient has not been seen or acknowledged in the system, the Clinical Expediter in the Command Centre will see the alert on the Tile and follow up with the nurse on the floor. This helps us eliminate the human error element of the equation, making sure a patient or a needed task does not fall through the cracks leading to an improved quality of patient care.

Example 2

A nurse calls for transport of a patient. The system alerts the transportation staff, but if the patient transport team is short staffed or overrun with requests, the nurse has no way of knowing that. If the issue is going to cause undue delay, the nurse and transport managers will be alerted, and the patient can be assessed for urgency by providing and comparing the information from all requests around the hospital. Then, Transport staff are taking patients in the most urgent order, not just as requests come in.

Example 3

A physician orders an ultrasound for a patient. They will have expectations on when they should receive the results based on experience, but the physician has no line of sight on what volume of orders the imaging department may be dealing with. Prior to the Command Centre, there was no visibility to track that process. Now we have established benchmarks to help monitor and manage to ensure that ultrasound is done in a timely fashion. After 24 hours, the imaging technologist is made aware the order is still waiting. After 36 hours, managers are alerted so they can assess whether they need additional staff to deal with a backlog. A process that before might have taken five days is now shortened because we have visibility and actionable prompts to ensure timelines are met.

Example 4

All housekeeping requests are now fed into the Command Centre, along with data regarding incoming patients. If there are five patients in ER waiting for an inpatient bed, those five rooms can be prioritized for cleaning. Staff can now prioritize which rooms to clean and when so that they are not cleaning rooms that do not need to be turned over immediately, while not cleaning rooms that are urgently needed.

Example 5

GE Healthcare developed a new way to identify and assist a ‘Unit Under Pressure’. Essentially, through working with Humber River Hospital and others, they developed a rich set of inputs, put it through their machine learning to analyze if there is a unit in the hospital that is struggling and can provide suggestions on how to manage and improve the situation. Are there unexpected staff absences? Is there increased acuity of the patients? Are there beds waiting to be cleaned? As managers, we can look at it and know not to send new patients there if there are alternatives. We can assess over time if there is an ongoing problem and what to do about it.

‍

These are but a few of the examples to illustrate how the Command Centre provides tangible, actionable supports for our teams to make better decisions in their daily routines.

Command Centre & Staff

So, who sees all this actionable data and the alerts the Command Centre sends out?

Physicians see a rich set of data via the EMR system they are accustomed to accessing. Nurses get alerts on their ASCOM phones and can check the EMR system for further detail. Managers get visibility of what is happening under their purview so they can make decisions on staffing, prioritizing and ensuring that patients are getting the attention and care they need, when they need it. This is perhaps the most powerful benefit. Managers now have visibility and data on what is happening, in real time and, in some cases, what the Command Centre can help predict (census changes for instance) to facilitate decisions on staffing levels and deployment to priority needs.

Learn more

Overview

At its essence, the Command Centre is a tool that provides analytics and actionable data that allows our staff, clinicians and administrators to make better and timelier operational and clinical decisions. It takes real-time data, curates it into an analytic, provides it to staff who are watching, provides them with the information and the prompts them to act if there is something needing attention.

It is also important to note what the Command Centre is not. It is not a machine that tells staff what to do. It does not provide oversight or monitoring of people’s work habits. It does not dictate a course of action.

Also, importantly, it was key in our implementation not to force our staff and clinicians to change how they work or the tools they are used to using to do that work. Our nurses carry an ASCOM phone with them – that hasn’t changed. They use a Meditech based EMS – that hasn’t changed.

What has changed is the quality of the information they receive and how it allows all of our staff to work more efficiently and effectively for the benefit of our patients.

Each of the work processes or clinical support tools have been designed to operate and display through what we call a Tile. There are currently over 30 existing Tiles in the Humber River Hospital Command Centre. As described in our journey, the clinical Tiles have been developed from ideas and suggestions made by our staff. These ideas were aggregated, synthesized and formalized through our work with GE Healthcare.

When you see images of our wall of analytics you see the Tiles displayed in a NASA-style array that gives our Command Centre that space control look-and-feel. But, in practicality, the hard work is behind the scenes. The wall of analytics is simply a display of the real-time activity being monitored and analyzed by the Command Centre to ensure necessary action is being taken, driven by the IPOMS (Interactions Procedures and Operating Mechanisms) developed by our team. These IPOMS are the key actions that result from the analysis and data provided through the Command Centre. The Tile design was largely a process of deciding what information needed to be pulled from our existing systems in order to provide the Command Centre with the data needed to help support decision-making.    

The Flow

Inputs come into the Command Centre from our existing systems. At Humber River Hospital, eight different IT systems feed data into the Command Centre, but the majority of the required data comes from our EMR.

It analyzes the data based on the desired outputs developed by our team and using the analytics engine developed and perfected by GE Healthcare. In many cases, the information fed to the Command Centre is drawn from broader and deeper sources of information beyond what the doctors or nurses have at their fingertips. It then provides actionable data out to the teams that need the information. At the same time, it is monitoring to ensure action is taken based on that data. If action is not taken, it can provide alerts and escalate attention to ensure what’s needed gets done. Simple? Yes, but much goes on behind the scenes.

The actionable data is fed back through our EMR system, so it is available to the clinicians and staff that are relevant to the patient or task in question. Alerts are sent to their ASCOM phones letting them know that a patient is demonstrating deterioration, or that an imaging result is completed and ready for their attention.

If the alert is not acknowledged and acted upon, the Command Centre and its staff act as the failsafe mechanism. If a test result is not provided within established timeframes, staff are alerted to give it attention. If a patient is identified in need but not treated within established timeframes, an additional alert goes out. The entire process is monitored within the Command Centre and visible on the Tiles.

‍

Command Centre & Staff

So, who sees all this actionable data and the alerts the Command Centre sends out?

Physicians see a rich set of data via the EMR system they are accustomed to accessing. Nurses get alerts on their ASCOM phones and can check the EMR system for further detail. Managers get visibility of what is happening under their purview so they can make decisions on staffing, prioritizing and ensuring that patients are getting the attention and care they need, when they need it. This is perhaps the most powerful benefit. Managers now have visibility and data on what is happening, in real time and, in some cases, what the Command Centre can help predict (census changes for instance) to facilitate decisions on staffing levels and deployment to priority needs.

Administrators get their own set of data at regular intervals allowing them to benchmark performance, set continuous improvement goals, report to funders or regulators and make better decisions related to hospital operations.

Access is provided to those who need it, at the level they need it at and not to those who do not.

The Tiles themselves are not just visible to the staff in the Command Centre. The managers in the ED have access to the ED Tile to help them manage patient follow in the ED. The managers in Medical Imaging have access on their desktops to the Imaging Tile to give them the information needed to prioritize and manage their workflow.

The Role of Command Centre Staff

The Humber River Hospital Command Centre also has permanent staff who monitor, manage and action the data developed by the Command Centre. We even have several staff who are there 24/7:

  • Patient Flow Manager, Corporate
  • Patient Flow Manager, Emergency
  • Patient Flow Manager, Clinical Expediter
  • Support Services Supervisor

Along with many others who are there during the busiest hours of the hospital:

  • Command Centre Administrative Director
  • Command Centre Medical Director
  • Bed Allocation Clerk
  • Medical Imaging Flow Technologist
  • Home Care Manager and Admin. Staff
  • OR Schedulers (2)
  • Workforce Planning – NRT (2)
  • Nurse Resource Centre Manager
  • IPAC Clinician
  • Scope + Navigator & Clerk
  • Redeployment Officer
  • Ontario Health Team Staff

The key is there are trained staff to help manage workflow, ensure the information is supplied to those who need it, and are there to help ensure follow up if there are actions required that are not being addressed.

Having those staff members together in one room with the visibility of what is happening across the hospital also allows them to talk and coordinate to manage workflow and patient flow in a way that eases pressures, maximizes efficiencies and ensures nothing, and no one, is falling through the cracks. This collaboration, aided by real-time data is tremendously powerful for us, and anyone using the Command Centre in the way that we do.

For example, a physician may request that a patient gets down to dialysis or to medical imaging for study and then plans their day around the assumption that the patient will be transported at the correct time. However, the physician is unaware of other things that could be happening within the hospital, such as a flood of trauma patients to the ER, or a shortage of porters that shift, that could cause a potential delay in transporting their patient. Within the Command Centre, we have the Medical Imaging Technologist sitting in front of the Support Services Supervisor, so they are able to talk, identify what is required to resolve, move portering and housekeeping staff around so they are where they are most needed, thus ensuring patients awaiting urgent tests, like the one in this example, are prioritized.

The IP

Many hospitals ask us if they need to engage GE Healthcare in order to implement a Command Centre. Our answer is always – you don’t have to, but you’ll be missing out on the intellectual property they have developed over years of crunching clinical data, analyzing hospital processes and the machine learning that continually improves as more and more data is poured into the computers and more and more hospitals join the Command Centre ecosystem.

If your organization wants to try to do it alone or it cannot afford the full GE Healthcare suite of capabilities, one can always start in a more modest way. But the biggest benefits will come from fully embracing the full functionality of the Command Centre and fast-tracking to the benefits because of the hard work undertaken by those who have come before you. It is worth it in every way.

In joining this ecosystem, each new hospital also saves an incredible amount of time and money by leveraging what the rest of us have built. Many of the Tiles we have developed are now universal across all hospitals using a Command Centre. They have proven their worth and been perfected in their operation. Rather than spend months or years in development and change management processes, they can be dropped into a new organization with relative ease. The change management required in that scenario is a fraction of what we invested in.

And the system continues to evolve as each organization using a Command Centre adds to its features, developed new ways of harnessing its capabilities and then shares that knowledge with the others. It would take years of work and investment for any hospital to replicate this on their own and cost much more we expect.

Content Coming Soon...

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Suspendisse varius enim in eros elementum tristique. Duis cursus, mi quis viverra ornare, eros dolor interdum nulla, ut commodo diam libero vitae erat. Aenean faucibus nibh et justo cursus id rutrum lorem imperdiet. Nunc ut sem vitae risus tristique posuere.

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Suspendisse varius enim in eros elementum tristique. Duis cursus, mi quis viverra ornare, eros dolor interdum nulla, ut commodo diam libero vitae erat. Aenean faucibus nibh et justo cursus id rutrum lorem imperdiet. Nunc ut sem vitae risus tristique posuere.

Hospital System Executive
See more

Content Coming Soon...

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Suspendisse varius enim in eros elementum tristique. Duis cursus, mi quis viverra ornare, eros dolor interdum nulla, ut commodo diam libero vitae erat. Aenean faucibus nibh et justo cursus id rutrum lorem imperdiet. Nunc ut sem vitae risus tristique posuere.

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Suspendisse varius enim in eros elementum tristique. Duis cursus, mi quis viverra ornare, eros dolor interdum nulla, ut commodo diam libero vitae erat. Aenean faucibus nibh et justo cursus id rutrum lorem imperdiet. Nunc ut sem vitae risus tristique posuere.

Hospital System Executive
See more

Content Coming Soon...

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Suspendisse varius enim in eros elementum tristique. Duis cursus, mi quis viverra ornare, eros dolor interdum nulla, ut commodo diam libero vitae erat. Aenean faucibus nibh et justo cursus id rutrum lorem imperdiet. Nunc ut sem vitae risus tristique posuere.

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Suspendisse varius enim in eros elementum tristique. Duis cursus, mi quis viverra ornare, eros dolor interdum nulla, ut commodo diam libero vitae erat. Aenean faucibus nibh et justo cursus id rutrum lorem imperdiet. Nunc ut sem vitae risus tristique posuere.

Hospital System Executive
See more

Content Coming Soon...

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Suspendisse varius enim in eros elementum tristique. Duis cursus, mi quis viverra ornare, eros dolor interdum nulla, ut commodo diam libero vitae erat. Aenean faucibus nibh et justo cursus id rutrum lorem imperdiet. Nunc ut sem vitae risus tristique posuere.

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Suspendisse varius enim in eros elementum tristique. Duis cursus, mi quis viverra ornare, eros dolor interdum nulla, ut commodo diam libero vitae erat. Aenean faucibus nibh et justo cursus id rutrum lorem imperdiet. Nunc ut sem vitae risus tristique posuere.

Hospital System Executive
See more

Content Coming Soon...

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Suspendisse varius enim in eros elementum tristique. Duis cursus, mi quis viverra ornare, eros dolor interdum nulla, ut commodo diam libero vitae erat. Aenean faucibus nibh et justo cursus id rutrum lorem imperdiet. Nunc ut sem vitae risus tristique posuere.

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Suspendisse varius enim in eros elementum tristique. Duis cursus, mi quis viverra ornare, eros dolor interdum nulla, ut commodo diam libero vitae erat. Aenean faucibus nibh et justo cursus id rutrum lorem imperdiet. Nunc ut sem vitae risus tristique posuere.

Hospital System Executive
See more
For Stakeholders & Administrators

Request a virtual tour of our Command Centre

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Suspendisse varius enim in eros elementum tristique.

Request A Tour
For Patients &
Our community
See what sets Humber River apart

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Suspendisse varius enim in eros elementum tristique.

Visit HRH.ca

Have more questions?

Request more information now. Our team is more than happy to discover your specific needs and respond to your questions

Request More Information

Thank you!
Your request has been received.
Oops! Something went wrong while submitting the form.
Location
Our world-class hospital is located near your community at Keele & 401.
Get Directions   
More Information
HRH.ca   
Contact Information
Copyright 2022. Humber River Health  |  View our Privacy & Confidentiality Policy  |  HRH.ca