A phone call comes into the Penn Medicine Transfer Center. The nurse who answers learns that another hospital in the region has a patient in cardiogenic shock-his brain and vital organs aren't receiving enough oxygen, his heart not pumping enough blood. To survive, he needs to go on extracorporeal membrane oxygenation (ECMO), a highly specialized life support system that takes over heart function and is usually only available at major medical centers.
Immediately, Transfer Center managers activate a Penn cardiologist and cardiovascular surgeon to review the patient's case and develop a rapid cycle plan for rescue. To carry out that plan, they locate an available bed at Penn Presbyterian Medical Center. They connect the regional hospital providers on a phone call with the PennSTAR flight team, which is preparing a helicopter to transport the patient, and with the care team at the hospital who will be ready as soon as the helicopter touches down. Environmental services staff are mobilized to prepare the patient's room.
Cases like this one are considered Level 0, meaning the goal is to get the transfer patient into a Penn Medicine facility within two hours.
But finding and creating capacity to admit patients to the hospital is something that happens all the time-not just in life-threatening emergencies. Behind the scenes of a busy health system like Penn Medicine, it takes a carefully orchestrated interplay of clinical decision making and timely resource management to get patients into hospitals when they need to be there, getting the care they need.
Penn Medicine teams make miracles happen for patients in crisis every day: life-saving trauma response, emergency stroke rescue, urgent neurosurgery. The health system is also home to other types of highly specialized care that few other centers can offer for rare and complex health problems-including one of the largest organ transplant centers in the nation. At the same time, countless patients continue to rely on Penn Medicine for more common surgeries and medical treatments that require hospital-level care. Across this spectrum, demand consistently exceeds the available hospital beds.
Health systems nationwide are facing increased capacity pressure. Though Penn Medicine isn't the first to address this common pain point, the health system is seeing early successes as it scales up and centralizes once-disparate departmental and hospital-based capacity efforts with the goal of creating a system-wide solution. With seven acute-care hospitals spanning a geographic range of hundreds of miles, from central New Jersey to central Pennsylvania, it's a substantial challenge.
