Healthcare 360: Driving Change in Health Care

Podcast: A Discussion on Change in Health Care

On this week’s episode of Healthcare 360, Dr. Rob Fields sits down with Sandra Gaffney, DNP, RN, Nursing Director of the Beth Israel Lahey Health Transfer Center, and Alicia (Lish) Clark, MD, Medical Director of the Beth Israel Lahey Health Transfer Center, to discuss driving change in health care.

The Role of the Transfer Center

The Transfer Center plays an important role in day-to-day hospital operations. It’s the Transfer Center that’s responsible for moving patients and coordinating with other departments and hospitals when capacity issues arise. Gaffney describes the function of the Transfer Center as two-pronged: the first being the transfer of patients who initially required a lower level of care to a higher level of care and the second being bed management within the hospital.

All this needs to be done in a thoughtful, coordinated manner as many hospitals throughout the state are currently facing high volumes of patients and a lack of beds within the emergency department.

“More and more places are thinking about, ‘How do we manage overwhelming demand on a daily basis?’ and ‘How do we be a little bit more creative and thoughtful and patient-centered on getting patients what they need?,’” says Clark.

Staff within the Transfer Center also face challenges when trying to pitch transfers to patients as it can sometimes make them feel like they’re losing their autonomy. Though it was made easier during the pandemic because hitting capacity meant no beds were available at a particular hospital, initiating a patient transfer takes high-level communication skills and the right framing.

Conquering Capacity Challenges

During the COVID-19 pandemic, hospitals everywhere faced an unprecedented capacity crisis. For the Transfer Center, this meant accelerating the work they were already doing. They took a boots-on-the-ground approach, relying on frontline teams to make phone calls and coordinate with other hospitals.

“We needed to step on the gas, and I would say that all of the facilities within the network worked with us and did that,” says Gaffney. “We started looking at all sorts of patients and load balancing throughout the network and getting really good at it really fast with, really, not a lot of structure or system support behind it – just a lot of boots on the ground, teams doing the right things for patients – and that was genuinely accelerated by the crisis that we were facing in healthcare.”

Clark agrees, noting that getting everybody on board with patient transfers felt easier during that time as everybody within the hospital “had an aligned purpose” and the complexities of day-to-day stakeholder priorities didn’t matter as much.

“There wasn’t really a framework,” she says. “We sort of had to create it and do our best to really think about, ‘How do we triage the most critical priorities and work with a lot of these physician stakeholder teams and try to hear them all equitably?’”

Every other week, we’ll chat with a leading expert in healthcare to learn about the many challenges and opportunities facing the industry. Listen to the full conversation with Gaffney and Clark here, and check in regularly for new episodes of Healthcare 360.