New Jersey’s Most Comprehensive Academic Health System Scores Early Wins — with More to Come — in Partnership with ABOUT

With ABOUT we got a one-stop shop for the technology and expertise we needed to successfully stand up our transfer center.

HEALTH SYSTEM SNAPSHOT

Most comprehensive academic health system in New Jersey and one of the largest in the country
Includes 12-acute care hospitals with 4,506 beds
Through a public-private partnership with Rutgers University, RWJBarnabas Health is jointly developing and operating a world-class academic health system
Approximately 9,000 physicians and 38,000 employees

CHALLENGES

Stand up a standardized patient transfer center for RWJBarnabas Health, which recently had operated as three separate transfer centers, and previously two separate health systems
Give referring physicians an easier, more efficient way to arrange safe and timely patient transfers
Prevent patient leakage and increase referrals from external hospitals

SOLUTION

ABOUT™ provided RWJBarnabas Health:

Purpose-built care orchestration solutions for consolidating, streamlining, and accelerating patient transfers
Executive dashboards delivering real-time analytics and insights into key aspects of patient transfer performance
Guidance with best practices and change management from a broad array of clinical and operational experts, many with real-life transfer/access center experience
Reduction in the overall median transfer time to 16 minutes

In slightly more than a year, RWJBarnabas Health has achieved several significant improvements — many well ahead of schedule — including:

Increase in the transfer request acceptance rate to 84.8%

RESULTS

Doubling of transfer center volumes from what was initially predicted — with half of transfers coming from outside the system

ABOUT RWJBARNABAS HEALTH

RWJBarnabas Health is the largest, most comprehensive academic health care system in New Jersey, with a service area covering eight counties and a population of 5 million. The system includes:

12 acute-care hospitals
Three acute-care children’s hospitals
Children’s Specialized Hospital with a network of outpatient pediatric rehabilitation centers
A freestanding behavioral health center
Two trauma centers
A satellite emergency department
Ambulatory care centers
Geriatric centers
The state’s largest behavioral health network
Comprehensive home care and hospice programs
Fitness and wellness centers
Retail pharmacy services
Affiliated medical groups
Multi-site imaging centers
Two accountable care organizations

RWJBarnabas Health is among New Jersey’s largest private employers.

CHALLENGES TO OVERCOME

No System Wide Coordination of Patient Transfers

Such was the challenge for RWJBarnabas Health, the New Jersey health system formed by the 2016 merger of Robert Wood Johnson Health System and Barnabas Health. Essentially, we were still operating as two separate health systems.

Lauren Saum, Assistant Vice President Mobile Health, RWJBarnabas Health: "Recognizing the critical importance of standardized and centralized patient care orchestration, RWJBarnabas Health leadership brought on two individuals with extensive transfer center backgrounds from another New Jersey health system: Jim Smith and Lauren Saum."

Smith serves as Vice President Mobile Health alongside Saum, who serves as Assistant Vice President Mobile Health at RWJBarnabas Health. Initially, Mobile Health encompassed the health system’s hospital-based emergency medical services (EMS), then evolved to also include patient transfer services. Smith and Saum clearly understood the difficult road ahead.

Aiming to Remove an Administrative Burden

Smith did not need statistics to tell him that improvement was needed. He points to the experience of the health system’s emergency room (ER) physicians as a prime case in point. "Our ER physicians talked about not having anyone to help them facilitate the transfer of patients to other hospitals in our system. They might call one hospital, and if the patient wasn’t accepted there, they’d hang up and call another one."

A cumbersome, time-consuming patient transfer process played out across RWJBarnabas Health. Getting to "yes" for a transfer request at times required multiple calls by the referring physician, and it also required approval by several physicians at the receiving hospital.

Smith states, "We needed a way to make sure that our patients who could receive care in our health system stayed in our health system. To do that, we had to create a path of least resistance for patient transfers, ensuring that handoffs from one facility to another were swift, seamless, and safe."

THE EVALUATION AND SELECTION PROCESS

Once on board with RWJBarnabas Health, Smith and Saum hit the ground running, tapping into their previous experience with another New Jersey health system and its transfer center. "From a technology standpoint, ABOUT offered more of a purpose-built solution for transfer centers," says Smith. "They also have a robust data collection and reporting component that gives us valuable insights into our patient transfer process and points us in the right direction."

From a pool of three solutions from prominent companies, they narrowed their choice down to two candidates. Ultimately, they selected ABOUT to be their technology and clinical partner. Smith notes that the other finalist in their evaluation did not offer the same level of internal expertise and, in fact, outsourced consulting services to another vendor. "With ABOUT we got a one-stop shop for the technology and expertise we needed to successfully stand up our transfer center."

THE RESULTS

The transformation of RWJBarnabas Health’s patient transfer function is ongoing, yet it operates much differently than it did before partnering with ABOUT a little more than a year ago. "Frankly, I think we’re ahead of where we expected to be right now," says Smith.

Smith and Saum attribute this progress to consolidated, standardized, and streamlined processes, coupled with well-trained transfer center staff who now have an industry-leading care orchestration solution at their fingertips. Smith states, "One of the greatest successes we’ve achieved is the way we accept patients now versus in the past. Whereas we once had multiple physicians involved with transfer requests, we’re moving toward single-provider acceptance. This has eliminated a big barrier to timely care, and overall it’s been very well received."

A prime example: the health system’s cardiothoracic service line, which instituted auto acceptance, as well as auto bed assignment based on the needs of each patient type.

Celebrating and Building on Early Successes

Overall, the health system’s median acceptance times have dropped to 16 minutes — already within the three-year goal of less than 20 minutes, according to Smith.

Smith and Saum will be the first to tell you that more work needs to be done — and they’re confident it’s coming — to build on these and other key metrics. However, RWJBarnabas Health is already reaping the rewards of what’s been accomplished so far.

EXECUTIVE SUMMARY

Transforming a health system’s patient transfer function is always a tall order. In the case of RWJBarnabas Health, the challenge was greatly magnified by the sheer size of the health system and the fact that it comprised two recently merged health systems.

Just slightly more than a year into its initiative, RWJBarnabas Health has made tremendous progress toward its goal of operating as one system of care, supported by a centralized, technology-enabled transfer center. Moreover, the measurables have surpassed expectations in key areas, especially the increase in transfer center volume and the number of patients arriving from other health systems. Here are specific accomplishments so far:

Reduced overall acceptance times to 16 minutes — well within the three-year goal of less than 20 minutes
Cut in half the acceptance time for cardiothoracic patients
Increased the transfer acceptance rate to 84.8%, close to the three-year goal of 90%
Reduced the transfer denial rate to 4.2%, within the three-year goal of less than 5%
Doubled transfer center volume (8,418 cases) versus what was initially predicted (4,200)
Realized half of incoming transfers from outside the health system

RWJBarnabas Health’s leadership understood the critical importance of choosing the right partner to help them achieve their objectives. Following a careful evaluation of three potential partners, the organization selected ABOUT.