Carilion Transfer and Communications Center (CTaC)
Our internationally benchmarked Transfer and Communication center was established in 2012 and serves as the central command center, serving seven hospitals, and multiple clinics across 20 counties in southwestern Virginia and southern West Virginia.
Overview
About Us
Established in 2012, CTaC has been the central command center for Carilion Clinic, serving southwestern Virginia and southern West Virginia. Over twelve years, CTaC evolved into the first integrated healthcare operations center globally, incorporating "distributive situational awareness" science and technology to produce high reliability outcomes. Carilion expanded capabilities across six campuses, including three rural sites, ensuring comprehensive coverage for patient transfers and logistics.
Internationally benchmarked, the CTaC is recognized by the wider medical community globally, attracting visits from health systems in the United Kingdom, Singapore, and other countries. Ohio’s Kettering Health Network opened a similar $10 million command center, inspired by CTaC's procedures and software. The system eliminated 30 minutes of wasted time per patient within eight years, totaling 720,000 hours per year and has contributed to a .3-day reduction in the time patients spend in intensive care.
Internationally Benchmarked
Process
Strategic Goals and Responsibilities
The strategic goals of the CTaC include improving throughput, capacity utilization, healthcare logistics, reducing variation, inefficiency, and enhancing transportation response. The system is responsible for patient transfers, movement, and throughput for all six Carilion Hospitals, ensuring smooth transitions and efficient healthcare processes.
Distributed Situation Awareness (DSA)
The implementation of distributed situation awareness (DSA) principles ensures specialists remain fully aware of operational aspects, improving communication and coordination. The idea of DSA aligns with high-reliability organizations, like NASA, air traffic control, NASA, maritime navigation units, air traffic control centers and other operations requiring pinpoint movement and precision timing and contributes to improved reliability and patient care outcomes.
Operational Components
- System Transfer Center Nurse Specialists manage patient transfers.
- Bed management optimizes bed utilization, contributing to significant improvements in system capacity utilization.
- EVS dispatch ensures timely environmental services, contributing to improved EVS turnaround times.
- Internal transporter dispatch streamlines patient movement within the hospital.
- Helicopter & ground ambulance dispatch coordinates emergency transport, improving response times.
- Non-Emergency ambulance insurance authorization hub handles logistical aspects of non-urgent patient transport.
- Virtual Care Operations Center (using TeleTracking software) manages healthcare logistics and throughput, contributing to improved emergency department throughput.
Technological Integration and Efficiency Improvements
The CTaC utilizes advanced tracking software to manage helicopters, ambulances, and beds, contributing to improved response and utilization of transportation. Real-time monitoring of the bed board reduces variation and inefficiency, improving overall patient movement. The CTaC has allowed significant improvements in emergency department throughput, EVS turnaround times and precision patient movement.
Research
Research and Collaboration
Carilion conducted peer-reviewed research regarding outcomes, design, and use of distributive situational awareness science, collaborated with Virginia Tech’s Office of Graduate Department of Industrial and Systems Engineering for research and development initiatives.
Future Development and Solutions
Carilion’s focus is on continued growth and evolving solutions to meet patient volume demands and plans to develop a remote telemetry center and virtual sitters for proactive patient monitoring and resource optimization.
Timeline
A Quick Glance Back
2001 Transfer Center developed in Department of Nursing
2005
- Bed placement and transfer acceptance
- No connections with services, MEC, administration
- No quality measures, reporting, protocols, or risk management connection
2009 Transfer Task Force created
- Stakeholder membership
- 3 months of intensive sessions
- Assessment of patient feedback-what do they want from a Transfer Center?
2011 Emergency Services Division created
Transitioned to Carilion Clinic Patient Transportation Leadership (Air & Ground Transport)
- CTaC
- CCPT
- EM physician group
- EM Residency
- Urgent Care
- CRMH ED operations
2012 First Integrated Mission Control Center Built
- CTaC-Carilion Transfer and Communications Center
2017 ParkView Mission Control Center
- Moved off CMC Campus
- Used Evidenced base science for design.
- Designing service level capacity management model
- Designed for expansion, including population health, telemedicine
2018
- Service capacity management system design.
- CWS OR Flow Implemented
- EVS improvements
2019
- Implementing all community sites with Teletracking.
- Portal re-design custom views for unit manager, case management, and post acute referral center.
2020
- Virtual Care Center
- Surgical & Emergency POD
- COVID19 operations
2023
- Crystal Spring Tower Planning (CRMH)
- Back Transfer, Swing Bed Utilization
- Remote Tele-Consulting (ATC)
2024
- System triage and real-time care coordination
- System wide emergency physician triage of urgent care, SNF, and mobile health
- Virtual care expansions to remote nursing, wearable monitoring
- CTAC for ambulatory care
- Post Acute Referral CTAC
