Desktop Preview Only
Command Centre

A digital revolution for delivering care.

Welcome to the Humber River Hospital 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.

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.

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

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.

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.

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
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.

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.

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.