AdventHealth Mission Control drives improved emergency department outcomes

AdventHealth Mission Control is proving to be a critical component in the emergency department by increasing success rates in several key areas, including connection, operational efficiency and optimizing patient outcomes across three Central Florida counties – Orange, Osceola and Seminole.

Relying on data that is updated every three to five seconds, the 12,000-square-foot, high-tech command center combines a complex blend of real-time data to forecast capacity across 18 emergency departments, including 11 hospitals, and track every patient – between 2,400 and 2,600 on any given day.

The largest system-based health care command center in the nation, Mission Control launched in 2019, roughly six months before the COVID-19 pandemic hit. The command center makes clinical operations across the Central Florida south region as streamlined and efficient as possible.

Featuring 60 wall-to-wall TV monitors, called tiles, AdventHealth Mission Control uses this data to create connectivity, operate efficiently and optimize outcomes by bridging gaps and decreasing delays to care.

“Like an air traffic controller, Mission Control helps land all of our patients at the right bed in the right place at the right time,” said Sanjay Pattani, MD, emergency medicine physician and associate chief medical officer of AdventHealth Mission Control.

Populated by 14 artificial intelligence apps, which process about 600,000 data messages each day, Mission Control provides AdventHealth a live view of the emergency rooms, inpatient floors, outpatient centers and other services, using artificial intelligence and machine learning to understand the patterns and take action.

“From a clinical standpoint, enormous amounts of data have historically been housed within various siloed departments, dashboards and tools. This is a challenge because the data isn’t usually available in a timeframe for clinical relevance,” Dr. Pattani said. “Typically, this data has been used to show a doctor what happened last week or last month, or yesterday, which is, quite frankly, limited in its usefulness. Clinicians need to know what is happening today and how to act on the data in a given moment. That’s the beauty of Mission Control. It provides critical access to real-time, actionable data to drive patient outcomes.”

Real-time data drives real-time decisions

During the height of the pandemic, Mission Control’s efforts centered around capacity management, particularly balancing ER wait times and volumes with capacity throughout the hospital system.

“I cannot imagine going through the pandemic without Mission Control. We were stretched, but without it, we could’ve been in a crisis,” said Dr. Pattani.

Mission Control tracks every movement during an inpatient’s stay, from the minute a patient arrives to the emergency department, to their bed assignment and scheduled procedures. In some cases, this process starts even before a patient arrives, as they are enroute with EMS.

“The emergency department is the first point of contact for Mission Control, and it acts like a barometer, allowing us to seamlessly balance the ‘front door to the hospital’ with the in-house daily progressions of care and procedural bed placement needs,” said Dr. Pattani.

The care coordination among specialists on non-elective, emergent care between the ER and ICU is a critical component of this system, Dr. Pattani explained, and Mission Control enables real-time juggling among patients from any entry point in the system, whether that is the operating room, post-anesthesia care unit (PACU), direct hospital admits from community physician practices, emergency department admits, or transfers from both within and outside the AdventHealth system.

“As the virus surged, Mission Control and its vertically integrated system played a huge role in guiding our clinical teams when capacity constraints dictated a need to pause performing elective procedures and when we could resume,” he said. “This ability to use artificial intelligence to predict capacity constraints is now a lifeline to our system.”

Creating connectivity and optimizing patient outcomes

Operating 24 hours a day, seven days a week, Mission Control staff work behind-the-scenes to seamlessly guide patient coordination.

The team of more than 50 nurses, EMS and flight dispatchers, transport techs and other specialists are impacting clinical care on multiple levels, from quality to operational efficiency. For example:

• Admitted patients in the ER have gotten a bed assigned 15 minutes faster.
• ER admission to bed placement times decreased by over 23 minutes.
• Lateral transfer of patients from one hospital to another due to overcapacity went from 357 pre-pandemic to over 2,450 — an increase of more than 600%.
• The phone call abandonment rate for AdventHealth’s Transfer Center decreased from 8% to 3%.
• Transport times among interhospital transfers has decreased over 15 minutes.

“This connection allows for simultaneous coordination of flight and bed placement to ensure a seamless patient transition,” said Dr. Pattani. “This drives operational efficiencies because there is less down time between helicopter flights, for example, which decreases delays in care, translating into lives saved and improvements in patient outcomes, especially among those with the highest acuity.”

Other clinical improvements directly tied to Mission Control are in the areas of pulmonary embolisms (usually related to blood clots), cardiogenic shock (heart failure), ST Elevation Myocardial Infarction (STEMI – a heart attack with a completely blocked coronary artery) and secondary traumatic stress (STS), all of which are some of the highest quality outcomes in the state.

Evolving into the future

Mission Control is the problem solver in a complex equation of clinical care, but Dr. Pattani says it is capable of so much more.

“Our goal is to positively disrupt how we deliver health care, and we believe we’ve just scratched the surface of its potential,” he said.

As the command center expands, which is set to happen in 2023, it will remain nimble and grow to meet the needs of the hospital system and drive decision making in new areas such as forecasting staffing needs.

For a closer look at Mission Control soon after it opened, click here to see the story that appeared on AdventHealth TV, the AdventHealth Central Florida Division’s weekly internal newscast for its team members.