So have you ever had a hard time getting a kid into the car? You ready to go, you’re running late and someone is just being fussy, arching their back, and refusing to be a good cooperator. That’s nothing compared to what Chicago’s Children’s Memorial Hospital is up against. They are getting ready to move into a new facility and have to manage the logistics of getting all of their patients from Point A to Point B (Patients, prep work crucial in move of Children’s Hospital, Chicago Tribune, May 30).
During the course of a single Saturday, Children’s Memorial Hospital will move out of its 131-year-old home, most of it spent at Lincoln and Fullerton avenues, and into the new, $855 million Ann & Robert H. Lurie Children’s Hospital of Chicago in the Streeterville neighborhood.
The 31/2 -mile journey has taken more than three years to choreograph and $30 million to plan and execute.
As many as 200 children, from premature infants to teenagers, including dozens in intensive care, need to be moved, one by one, most with their own ambulance and medical team.
This presents some serious operational challenges. For one, they don’t know how many patients they will have to move or just what kind of shape each will be in.
Because the census and condition of patients can change drastically in a matter of days, the number of patients and required resources likely won’t sharpen until a day or two before. Based on dozens of simulations, hospital officials project the final figure will be closer to 165, but they are planning for more.
Second, they have limited capacity for the most complicated cases. Ambulances may be relatively easy to come by, specialized equipment and the right personnel are not.
Because the hospital has access to only seven transportable Isolettes — incubatorlike capsules that hold the smallest, weakest babies — but could have two dozen infants who require them, some of those patients will be the first to go.
The idea is to transfer an infant from a hospital incubator into a mobile one for the ambulance ride, then transfer that patient again into one of the Lurie hospital’s new models. From there, a team of workers will clean and sanitize the mobile units and return them to the Lincoln Park hospital for the next set of babies.
The cycle will continue until everyone is gone.
At any given time, more than a dozen ambulances will be cycling between the two hospitals, all on a Saturday in Chicago with locals and tourists out en masse.
There is also the question of when to move the care givers from one location to the next as one scales up and the other down. Doctors and nurses can travel with patients but there is also the rest of the support infrastructure (e.g., the pharmacy). The article reports that they basically have to run two hospitals until all the patients are out of the old facility.
So how are they planning all this? For one, they are doing lots of dry runs.
In a cramped, windowless conference room in the basement of Children’s Memorial on May 17, three hospital transition leaders and a consultant surrounded themselves with 10 large white sheets of paper, each representing a group of patients that needed to be moved.
Using inpatient data from a week before, the team estimated that 164 sick children would need to be moved, the last of whom would leave the Lincoln Park hospital at 4:30 p.m. That was assuming no breaks for the transport teams, doctors or nurses. And no complications.
“If we could be done by 7 p.m., we’d be thrilled,” said Sherri Ewing, the hospital’s associate chief nurse executive.
The team has performed the exercise countless times during the past 18 months, each with a different set of patients with different problems. The simulated moves have taken 10 to 18 hours and required 16 to 25 ambulances.
The planning also builds in some of the considerations discussed above. For one, the moving begins with the some of the sickest patients. That makes the most use of their limited incubator capacity. They are also taking steps to reduce the number of patients in the hospital. Postponing any elective surgeries is an obvious decision. The day before transition they will begin diverting ambulances so patients will not have to undergo two moves.