27 Healthcare in the time of a pandemic and beyond: the innovative large-scale and integrated saudi national health command centre

Alharbi, Muaddi; Senitan, Mohammmed; Ohanlon, Tim; Smith, Sidney C.; Mominkhan, Dalia; Alqahtani, Sarah; M, Mohammed Alabdulaali

doi:10.1136/leader-2021-fmlm.27

Cited by 2 publications

(7 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A recent report from Saudi National Health Command Centre (NHCC) indicated that emergency admissions mortality was below 2%. 6 The mortality rate reported by the authors agrees with our findings of this study. What must be noted though is that the NHCC is a hub at a national level and its report appears to have compared pre-COVID-19 and post-COVID-19 pandemic data.…”

Section: Discussionsupporting

confidence: 92%

“…The impact of command centres on patient safety in complex multiple department hospitals is rarely reported in the literature, mainly due to the novelty of this type of initiative in acute care. A recent report from Saudi National Health Command Centre (NHCC) indicated that emergency admissions mortality was below 2% 6. The mortality rate reported by the authors agrees with our findings of this study.…”

Section: Discussionsupporting

confidence: 92%

“…In the last 5 years, a number of hospitals in Canada, China, the UK, USA and Saudi Arabia have been piloting ‘command centres’ for the purpose of patient-flow management. Although not from systematically conducted studies, preliminary reports suggest that command centres have a positive impact on patient care delivery process 6–10. For example, in Johns Hopkins Hospital USA, patient transfers from other hospitals improved by 46%, ambulances dispatches reduced by 43 min and bed allocation for emergency admission patients reduced by 3.5 hours 7…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effect of a hospital command centre on patient safety: an interrupted time series study

Mebrahtu

McInerney

Benn

et al. 2023

BMJ Health Care Inform

View full text Add to dashboard Cite

Background Command centres have been piloted in some hospitals across the developed world in the last few years. Their impact on patient safety, however, has not been systematically studied. Hence, we aimed to investigate this. Methods This is a retrospective population-based cohort study. Participants were patients who visited Bradford Royal Infirmary Hospital and Calderdale & Huddersfield hospitals between 1 January 2018 and 31 August 2021. A five-phase, interrupted time series, linear regression analysis was used. Results After introduction of a Command Centre, while mortality and readmissions marginally improved, there was no statistically significant impact on postoperative sepsis. In the intervention hospital, when compared with the preintervention period, mortality decreased by 1.4% (95% CI 0.8% to 1.9%), 1.5% (95% CI 0.9% to 2.1%), 1.3% (95% CI 0.7% to 1.8%) and 2.5% (95% CI 1.7% to 3.4%) during successive phases of the command centre programme, including roll-in and activation of the technology and preparatory quality improvement work. However, in the control site, compared with the baseline, the weekly mortality also decreased by 2.0% (95% CI 0.9 to 3.1), 2.3% (95% CI 1.1 to 3.5), 1.3% (95% CI 0.2 to 2.4), 3.1% (95% CI 1.4 to 4.8) for the respective intervention phases. No impact on any of the indicators was observed when only the software technology part of the Command Centre was considered. Conclusion Implementation of a hospital Command Centre may have a marginal positive impact on patient safety when implemented as part of a broader hospital-wide improvement programme including colocation of operations and clinical leads in a central location. However, improvement in patient safety indicators was also observed for a comparable period in the control site. Further evaluative research into the impact of hospital command centres on a broader range of patient safety and other outcomes is warranted.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of a hospital command centre on patient safety: an interrupted time series study

Mebrahtu

McInerney

Benn

et al. 2023

BMJ Health Care Inform

View full text Add to dashboard Cite

show abstract

“…There is a paucity of studies that investigate the impact of multidepartment hospital–based command centres on patient flow and data quality. A recent study in Saudi Arabia reported that the use of a ‘smart centre’ led to a reduction of intensive care unit lengths of stay by 10% in emergency admissions [ 7 ]. The intensive care unit length of stay reported by Alharbi et al.…”

Section: Discussionmentioning

confidence: 99%

“…A growing number of hospitals in Canada, China, the UK, the USA, and Saudi Arabia have been piloting a digitally enabled ‘command centre’ approach that draws information from electronic health records and other health information systems and displays consolidated information to a team of physically colocated coordinators. Although not systematic studies, early reports suggest that such technologies have benefits [ 7–11 ]. For example, one organization reports that ambulances were dispatched 43 min quicker, and bed allocation was reduced by 3.5 h for emergency department–admitted patients [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

The impact of hospital command centre on patient flow and data quality: findings from the UK National Health Service

Mebrahtu,

McInerney,

Benn

et al. 2023

International Journal for Quality in Health Care

View full text Add to dashboard Cite

In the last 6 years, hospitals in developed countries have been trialling the use of command centres for improving organizational efficiency and patient care. However, the impact of these command centres has not been systematically studied in the past. It is a retrospective population-based study. Participants were patients who visited the Bradford Royal Infirmary hospital, Accident and Emergency (A&E) Department, between 1 January 2018 and 31 August 2021. Outcomes were patient flow (measured as A&E waiting time, length of stay, and clinician seen time) and data quality (measured by the proportion of missing treatment and assessment dates and valid transition between A&E care stages). Interrupted time-series segmented regression and process mining were used for analysis. A&E transition time from patient arrival to assessment by a clinician marginally improved during the intervention period; there was a decrease of 0.9 min [95% confidence interval (CI): 0.35–1.4], 3 min (95% CI: 2.4–3.5), 9.7 min (95% CI: 8.4–11.0), and 3.1 min (95% CI: 2.7–3.5) during ‘patient flow program’, ‘command centre display roll-in’, ‘command centre activation’, and ‘hospital wide training program’, respectively. However, the transition time from patient treatment until the conclusion of consultation showed an increase of 11.5 min (95% CI: 9.2–13.9), 12.3 min (95% CI: 8.7–15.9), 53.4 min (95% CI: 48.1–58.7), and 50.2 min (95% CI: 47.5–52.9) for the respective four post-intervention periods. Furthermore, the length of stay was not significantly impacted; the change was −8.8 h (95% CI: −17.6 to 0.08), −8.9 h (95% CI: −18.6 to 0.65), −1.67 h (95% CI: −10.3 to 6.9), and −0.54 h (95% CI: −13.9 to 12.8) during the four respective post-intervention periods. It was a similar pattern for the waiting and clinician seen times. Data quality as measured by the proportion of missing dates of records was generally poor (treatment date = 42.7% and clinician seen date = 23.4%) and did not significantly improve during the intervention periods. The findings of the study suggest that a command centre package that includes process change and software technology does not appear to have a consistent positive impact on patient safety and data quality based on the indicators and data we used. Therefore, hospitals considering introducing a command centre should not assume there will be benefits in patient flow and data quality.

show abstract

27 Healthcare in the time of a pandemic and beyond: the innovative large-scale and integrated saudi national health command centre

Cited by 2 publications

References 0 publications

Effect of a hospital command centre on patient safety: an interrupted time series study

Effect of a hospital command centre on patient safety: an interrupted time series study

The impact of hospital command centre on patient flow and data quality: findings from the UK National Health Service

Contact Info

Product

Resources

About