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RapidView provides real-time snapshots of the facility; improves patient access

Patient flow

RapidView provides real-time snapshots of the facility, improves patient access

After reading this article, you will be able to:

  • Identify departments that benefit from the RapidView system
  • Recall the data collected by the RapidView system
  • Explain how the RapidView system works

A small room just off the admissions area at Tufts Medical Center in Boston contains what many in the facility describe as the nerve center of the hospital. It looks like the bridge of the Starship Enterprise. Multiple plasma screen monitors blink with yellow, green, and blue squares.

Employees sit seated in front of the monitors, analyze the colors and icons as they enter new data into the computers below, and relay information to callers.

To the outside observer, the screens look like a bunch of flashing lights, but these screens are actually a snapshot of the entire facility. They are a part of Tufts’ RapidView system, powered by McKesson’s Horizon Enterprise Visibility™ solution.

RapidView isn’t a tool that benefits just one department. The system helps improve every aspect of the facility, from housekeeping to employees to physicians.

RapidView allows us to access timely, correct information so we can better align patient needs with our resources,” says Terry Hudson-Jinks RN, MSN, vice president of patient care services at Tufts Medical Center.

Reading the board

This is where June Stark, RN, BSN, MEd, director of case management and quality support services at Tufts Medical Center starts her day—in the admission discharge transfer (ADT) center. With just a three- to five-minute scan of the screens, Stark can tell whether Tufts has enough discharges to meet the scheduled admissions.

“There is an art to it,” Stark says. “After a while you can just look at the screens and know if it’s going to be a busy day.”

Each screen in the ADT center represents a floor of the hospital and each square represents a room. The color of a room is based on what type of patient is occupying the bed—a green room means the patient is an inpatient, blue means the patient is receiving observation services, etc.

This morning Stark notices the squares on one floor are almost all solid green, which means discharge orders have not been written for those patients. She sends a page to the nurses and case managers on that floor telling them to make sure the latest data are in the system and to promote additional discharges.

When Stark checks the boards later in the day she hopes to see a few green and white striped squares where green squares appeared in the morning. Green and white striped squares mean a physician wrote a discharge order and a discharge is pending.

A striped square also displays how many minutes have passed since the physician wrote the order. This makes it easy to track how quickly patients are discharged after the physician writes the order.

Improving patient flow

RapidView system is partly a response to the Massachusetts mandate that EDs can no longer divert patients, says Melissa Culkins Bair, RN, MS, nursing director of the ADT Center at Tufts Medical Center.

“One of the reasons we came up with the bed board [RapidView] was so that we could improve patient flow because we couldn’t have the ED closing the door,” Culkins Bair says.

RapidView improves patient flow by providing up-to-the-minute information for healthcare professionals, admitting staff members, and housekeeping staff members. Before RapidView, there was no mechanism to track such information.

“We worked in silos before centralizing patient access with RapidView. We didn’t always have up-to-date information on unit-based throughput, leaving us uninformed on the clinical priorities,” Culkins Bair says.

Electronic timers within the RapidView system keep track of everything.

For example, when staff members discharge a patient, this is communicated automatically by messages fed from clinical information systems to all employees by turning the green and white square brown, which means the room is dirty.

The housekeeping staff members and all other hospital employees on that floor see the brown square on one of the many LCD screens mounted in the common areas. Housekeeping goes to the brown room and signs in that he or she has begun cleaning. This turns the square brown and white and also starts the clock. Once finished, the crew member signs off that the room is clean and moves on to the next brown square.

This time-keeping feature makes staff members more accountable because it allows administrators to see how the patient moves along the continuum in real time. If it took three hours longer than expected to clean the room, managers can investigate the reason for the delay and take steps to improve the process.

RapidView also makes the ADT Center staff members’ job a lot easier. With a scan of the screens, they can determine whether the hospital has any open beds, when beds will be open, whether a patient has an infectious disease, along with other patient information.

“The key to RapidView is that it is correct and it is timely,” says Hudson-Jinks. “Because the variables keep changing minute to minute, your information cannot be 20 minutes old.”

According to Hudson-Jinks, this access to timely information allowed Tufts to lower length of stay, treat more patients in 2009, and turn away fewer patients in acute need from surrounding communities.

Improving patient quality

“The thing that makes this system different is that it’s not just a bed tracking system. It has clinical features,” Culkins Bair says.

RapidView allows the medical staff to get an idea of the patient’s case at a glance. For example, if the patient is on fall precaution, deidentified text appears on the screen that communicates this information to healthcare professionals. Healthcare professionals see this information on their floor’s screen.

Icons also help healthcare professionals track where a patient is in the facility. If a patient is in radiology for testing, an icon appears on his or her room, and a timer starts. This way, staff members can tell family, visitors, and other healthcare professionals where the patient is and when he or she is expected to return.

There are also icons that appear to tell healthcare professionals that lab work has come back. A trained observer can even tell whether the results were normal or abnormal based on the icon’s color.

In addition, RapidView has changed the way Tufts structures its ADT process. An RN works alongside an ADT Center staff member to ensure that patients are placed properly on the front end according to their condition.

Saving time

The RapidView system is also saving the Tufts staff a lot of time. The ADT Center staff no longer needs to make as many calls to each floor asking how many discharges are expected for the day or how many beds are available.

“Before, we relied on too many people to call and tell us information, whereas now, the information comes to us,” says Hudson-Jinks.

As a result, the hospital’s processes are streamlined and that in turn allows staff members to handle high volumes with relative ease.


Adapted from Case Management Monthly, January 2010.