1. Driving Change with VPS Data: Shaping Care Delivery and Operational Management Sherri Kubis RN, BSN, CCRN Danielle Traynor RN, BSN, CCRN Children’s Hospital of Philadelphia

2. Goals  Describe Successful Utilization of VPS Data in Care Delivery and Operational Management Efforts:  Care Delivery  Care Model Initiative  Operational Management  Daily Flow  Predicted Flow  PACU Utilization

3.  Care Model & Innovation Transformation Committee  Hospital Operating Plan Directive with the goal: “Develop a care model to deliver excellent patient care by optimizing the human and physical resources and care processes with attention to responsible stewardship.”  Four units chosen to initiate investigations and pilot testing  PICU VPS Team requested as permanent team member to provide relevant data and insight into PICU population, multiple patient cohort characteristics and care delivery. Care Delivery

4.  Utilized VPS Data to provide a comprehensive descriptive analysis of the PICU patient population over the course of the three prior years.  Age, LOS, Severity of Illness, Discharge Disposition  Medical and Surgical Services  Reason for ICU admission (Primary Dx and/or Chronic Condition necessitating ICU level of Care)  ICU level of Care Interventions  Census and Capacity Trends  Utilized VPS Data to provide in depth review of specific populations identified that Care Model adaptations could yield significant improvements in patient care quality and efficiency. Care Delivery

5.  Daily Patient Churn  Seasonal Capacity  Unit LOS in relation to Hospital LOS Utilized VPS Data to Analyze Census Trends

6. 1-Interventions or therapies only delivered in the ICU 2-Ventilation dependent patients admitted for separate ICU need 3-Neurologic ICU Care 4-Patients admitted for Airway ICU Monitoring 5-Other Utilized VPS Data to Analyze Patient Types and Prevalence

7.  Identified PICU discharges to General Care Floor with Non-Invasive Ventilation present at Discharge  Compared PICU LOS to remaining HLOS Utilized VPS Data to Analyze Specific Patient Cohorts

8. Patient Flow and Capacity planning  Operational Management  Daily Flow  Predicted Flow  Scheduled vs Unscheduled  PACU Utilization  Manage capacity challenges and plan for expanded growth

9. Daily PICU Patient Flow Review Operational Management

10. Staffing and Assignment Planning Operational Management

11. Capacity Planning -PACU Utilization Operational Management  Benchmark reports revealed increased utilization of PACU beds from reference hospitals.  Supported plans to strategically utilize PACU for recovery and patient care during high volume/census.  Plan developed to identify patients within predetermined populations to recover in PACU.

12. Partnerships with Perioperative Area Have Optimized Appropriate Patient Placement less ‘double booking’ for same patient in 2 different inpatient locations

13.  Provided VPS data useful to the investigative phase of this Hospital Operating Committee  Information guided efforts in developing high impact Care Model changes  Identified unique populations in which care coordination among units is key  Admission and Transfer Guidelines for requiring non-invasive ventilation  Identification of post operative patients to be sent to PACU or surgical unit utilizing predictability of scheduled vs unscheduled and patient flow  Provided patient flow insight through VPS data that influenced workflow and staffing. Driving Changes with VPS Data

14. Driving changes with VPS Data…And it continues  Expanding our partnerships to other areas in the hospital  ED  Emergency Transport Team  Anesthesia Resource Center  Bed Management and Nursing Central Staffing Office  General Pediatric Units