Need for speed: How Mercy Health-Toledo transfers patients more quickly

Mercy Health-Toledo wanted to improve the process of transferring patients between facilities.

Chris Freeman, manager of central staffing and scheduling at Mercy Health, says the system has accelerated transfers and reduced boarding in the emergency department.

Officials in the health system knew the process could be better, and faster.

So they launched “Operation Top Gun” to speed up the transfer process, says Chris Freeman, manager of central staffing and scheduling at Mercy Health.

Freeman says the name of the program was coined by Jim Weidner, the chief operating officer of Mercy Health-Toledo, who recalled a memorable line from the Tom Cruise film: “I feel the need … for speed.”

Mercy Health-Toledo, part of Bon Secours Mercy Health, operates seven hospitals in the Toledo, Ohio area. The health system teamed with Conduit Health Partners, which works with hospitals to assist in patient transfers and provides other nursing services. The company was founded by Bon Secours Mercy Health in 2018.

So far, the results have been encouraging. By late spring, Mercy Health-Toledo had managed to reduce the patient transfer times by 34%, Freeman says. That has also reduced overcrowding in the health system’s emergency departments.

Freeman spoke recently with Chief Healthcare Executive® about the Top Gun initiative, some of the obstacles that had to be overcome, and the keys to success.

“What I loved about it was that everyone was committed to improving patient transfer times for our patients,” Freeman said.

Beyond one runway

Working with Conduit and the Mercy Health Life Flight network, health systems examined the process of transferring patients across the system.

Some of the smaller hospitals in the Mercy Health-Toledo system typically transferred patients Mercy Health-St. Vincent Medical Center in Toledo, because the hospital offers a Level One trauma center.

“It's kind of like our mothership,” Freeman says.

But with the development of a new transfer process, Mercy Health-Toledo and Conduit have better visibility on where patients may be able to get into a bed more quickly, avoiding a lengthy stay in the emergency department. Like many hospital systems around the country, Mercy Health-Toledo has struggled with patients staying for extended periods in the emergency departments, which can add stress to patients and their loved ones.

“Everyone wanted to send all their patients to St Vincent, and St Vincent can take any patient until they're full,” Freeman says. “So I think that load leveling was a challenge that we were able to overcome, which was great for the other hospitals up here in the Toledo market.”

Conduit serves as an air traffic controller, with the company working with Mercy Health’s dashboards to see the volumes at different hospitals, “which runways are backed up and which runways we could park the patients,” Freeman says.

With a better transfer process, “We're not parking all the patients on one runway,” he says.

Now, Mercy Health-Toledo has opened up the system to speed up all transfers, including those that aren’t coming from a Bon Secours or Mercy Health facility.

In the past, Mercy Health would wait on a bed assignment at another facility before engaging transportation, but now the transportation begins before calling the site, Freeman says.

“I think that was a big pain point that we were able to work through as a group,” he says.

‘Not being afraid to change’

The backing of Mercy Health leadership helped galvanize change.

“We had buy-in from the top leaders all the way down to people like myself that were involved there, and I think, really, the commitment to everyone on that committee to wanting to do better for our patients,” Freeman says.

Staff across Mercy Health-Toledo and Conduit worked together to analyze the patient transfer process and how it could be improved. Freeman credited staff for their willingness to work together on the problem.

“Mercy Health Toledo couldn't do this by themselves. Mercy Life Flight couldn't do this by themselves, Conduit couldn't do it by themselves. The willingness to collaborate together as a team, to come up with solutions to better our patients … I think that was vital,” he says.

He also said it was important to talk to staff members to get their feedback and also to explain the plan.

“We were very strategic. We didn't just say this is what we're doing and forget it,” Freeman says. “We connected the associates to the purpose of why we're doing this.”

Even in situations where patients are transferred to another hospital and they need to wait in the emergency department until a bed is available, Freeman says, “they're better served in the ED until we get that bed available.”

But with the improved transfer process, only a small portion of patients are waiting in the emergency department for a bed after a transfer, and the typical wait is around 40 minutes, he says.

Ultimately, more rapid transfers are offering patients better care, and more reassurance for families and other loved ones. For a patient in one of Mercy Health’s rural hospitals, they can now get a higher level of care more quickly.

“If you're the patient, or if you’re the mom or dad … that's a big win for us,” he says. “So it felt good for us.”

Change management can be difficult, Freeman says. “Sometimes the soft stuff is the hard stuff,” he says.

But he cited another element in the success of the program: “Just not being afraid to change.”