COVID-19 outbreak offers glimpse of Capacity Coordination Center’s future

Awele Anigekwu, bed management associate, was among the Center employees who helped YNHHS delivery networks prepare and care for an influx of COVID-19 patients.

Since 2017, Yale New Haven Hospital’s Capacity Coordination Center has physically and operationally integrated staff from different departments, supplied them with real-time data and enhanced the hospital’s ability to manage bed capacity, staffing and patient movements.

In January, Marc Tangredi, RN, became the Center’s director, and was charged with expanding Center tools and processes to other Yale New Haven Health hospitals. The expansion was expected to take at least two years.

Then the COVID-19 pandemic began. The Capacity Coordination Center (CCC) became a key asset for rapidly reconfiguring YNHHS hospitals as a part of a system-wide disaster response.

“CCC staff threw themselves into ensuring that patients with COVID-19 across the health system’s geographic areas could access the care they needed,” said Ian Schwartz, MD, YNHHS senior vice president, Clinical Operations, and chief clinical operations officer.

On a regular day, the CCC team’s work can be complex – like assembling a constantly moving puzzle. During COVID-19, “it was like playing darts in a hurricane while at sea,” Tangredi said.

“It was a lot harder to hit that target – where patients are receiving the right care in the most appropriate settings, and we’re maximizing our staffing and facilities throughout the health system. We were dealing with constantly changing recommendations as the world tried to determine the best course. Thanks to the collaboration between the delivery networks in the health system, we were able to maximize our resources and be fully prepared.”

Before large numbers of COVID-19 patients began arriving, CCC staff guided efforts to safely discharge and move other patients. The health system ultimately converted 50 nursing units into COVID-19 units that were spread across 15 new COVID-19-designated floors.

“This requires so much collaboration between multiple disciplines and different departments,” said Lisa Spears, RN, a CCC clinical bed manager. “I am impressed with how the staff at each of the hospitals made all of the changes we asked of them, without hesitation. Each hospital handled the volume and acuity of COVID-19 patients without becoming overwhelmed.”

CCC staff already had electronic dashboards displaying real-time data on YNHH bed capacity, patient transport status, ED operations and other activities. To prepare for COVID-19, staff with Information Technology Services and the Joint Data Analytics Team (JDAT) had to accelerate their work on dashboards for other YNHHS hospitals.

“Normally, it would take over a year to build those dashboards, but ITS and the JDAT built some in two months,” Tangredi said. “That’s no small feat.”

The need for social distancing also sped up the CCC’s planned move from a room in YNHH’s North Pavilion to a larger space. With many Finance employees working from home, the CCC now temporarily occupies an area at Medical Center South.

As the number of hospitalized COVID-19 patients has decreased, the Capacity Coordination Center has helped restore nursing units to their previous functions, but is prepared to rapidly scale COVID-19-designated beds up and down as needed in the future. Center staff can also “take a step back” and develop a comprehensive plan for expanding capabilities to the other delivery networks, Tangredi said.

“It won’t be just about finding more capacity,” he said. “It will be about being more efficient with the capacity we have.”