UCHealth extends lifesaving line

February 13th, 2017
a screen shot at the DocLine command center
A screen in the DocLine command center offers a one-look view of the emergency department ambulance bays and helipads at each UCHealth hospital.

Inside the gleaming new command center for UCHealth DocLine sit two new computer workstations. It’s a compact space, but those who occupy it will have an eye on many thousands of miles, watching and working to ensure that patients accepted for transfer to a UCHealth hospital get to their destination as quickly and safely as possible.

It’s part of UCHealth’s ongoing effort to integrate and streamline its service to referring providers around the state and region. The new command center on the fifth floor of Anschutz Inpatient Pavilion 2 at UCHealth University of Colorado Hospital opened Jan. 19. It’s home to critical care-trained nurses and specialists who staff DocLine, which on Feb. 1 became the single phone number for referring providers requesting a patient transfer to any UCHealth hospital or a consultation with a UCHealth physician.

Accepting patients for transfer only begins the process of getting patients the care they need at a UCHealth hospital. That’s why Feb. 1 also marked the launch of UCHealth LifeLine, which will coordinate critical care transport for patients accepted for admission across the system – sometimes from hundreds of miles away.

It’s a vital piece of the patient care puzzle, said Rob Leeret, senior director of DocLine. He noted that DocLine staff handle tens of thousands of calls from referring providers annually. They play a key role in smoothing patient transfers for both referring and admitting providers. But these staff have also had to help arrange air and ground patient transport, and that has been a sticking point at times, he added.

Senior DocLine Director Rob Leeret stands near four screens DocLine
Senior DocLine Director Rob Leeret stands near four screens DocLine communications specialists will use to survey the state and regional landscape and make decisions about how best to transfer patients to a UCHealth facility.

“The benefit of DocLine is it’s a single phone call for referring providers,” Leeret said. “But DocLine staff have to handle a great amount of phone traffic, and they don’t always know the transport landscape.”

That makes it tough to, say, locate and arrange fixed-wing transport for someone in Gillette, Wyoming, as UCHealth providers wonder what has become of the critically ill or injured person who needs care.

Eyes on the skies, boots on the ground

The solution lies in filling those two workstations with communications specialists skilled in managing critical-care transport, Leeret said. After a DocLine nurse works with a UCHealth physician to accept the patient, specialists will take the baton and coordinate dispatch with centers in multiple states. They will also help to keep accepting providers informed about each patient’s status and relay information and instructions to providers in the field if an individual’s health status changes or variables like weather cause delays.

“The goal is to eliminate frustration,” Leeret said. “We want to monitor the patient from the minute the call comes in and bring in our physicians to change the plan of care for the patient, if necessary.”

The LifeLine launch is part of UCHealth’s Feb. 1 rebranding, which emphasizes a commitment to innovation, quality care, customer service and superior patient outcomes, said DocLine Executive Director Richard Zane, MD. It’s also overdue, he added.

Leeret at one of the DocLine workstations with six screens
Leeret at one of the workstations where specialists will handle critical-care transport communications. The screen at the lower far right displays algorithms that are part of decision-making software loaded into the system.

“In order to meet the promise we are making, we have to deliver service,” Zane said. “LifeLine is part and parcel of becoming an integrated system that delivers tertiary and quaternary care and a one-stop shop for both referring providers and for dispatch.”

Building a fleet

In keeping with the rebranding, the idea of LifeLine is also to standardize UCHealth’s disparate transport arrangements. The situation has been fragmented, with separate vendors operating helicopters for UCHealth Medical Center of the Rockies and UCHealth Memorial Central. The same was true for critical-care ground transport for UCHealth’s hospitals in northern Colorado and Colorado Springs; UCHealth University of Colorado Hospital until recently had no critical-care ground transport affiliation.

As of Feb. 1, Falck is now the critical-care ground transport vendor for UCH. Poudre Valley Hospital EMS and AMR continue to serve northern Colorado and Colorado Springs, respectively. But critical care ground transport has now been rebranded to UCHealth LifeLine, and will be staffed with UCHealth clinical care providers. Work is underway to dispatch all critical care ground transport through the DocLine command center. Leeret said that will occur over the next couple of months.

A Falck ambulance, rebranded with the UCHealth LifeLine logo,
A Falck ambulance, rebranded with the UCHealth LifeLine logo, outside the Emergency Department at University of Colorado Hospital.

It’s a first step, with integration of air services to follow, he added, noting that UCHealth is “actively working” with rotor wing vendors to rebrand the helicopters to LifeLine. The goal is to dispatch the helicopters through DocLine by the summer.

Meanwhile, the tools for sophisticated transport management are in place in the DocLine command center. Near the dispatch workstations, large screens simultaneously display real-time weather patterns; views of the ambulance bays and helipads at UCHealth hospitals; the emergency department status of hospitals around the Denver metro, Colorado Springs, and northern Colorado regions; and the location of every hospital in the state.

Guided steps

Computers with multiple large-screen monitors at the workstations are also equipped with software that assist communications specialists with transport decisions. The program was developed at Indiana University Health by Michael Thralls, MBA, RN, CMTE, now manager of Memorial Star Transport for UCHealth Memorial Hospital. He’s worked on implementing it at UCHealth with the input and guidance of the regional medical directors.

DocLine Executive Director Richard Zane speaks with UCH Emergency Department nurse Dawn King in front of the newly branded UCHealth LifeLine critical care ambulance.
DocLine Executive Director Richard Zane speaks with UCH Emergency Department nurse Dawn King in front of the newly branded UCHealth LifeLine critical care ambulance.

Thralls said the software guides the communications specialists through an algorithm with the accepting and bedside physicians based on a patient’s acuity, location, and the level of care being provided. That information helps the communications specialists sort out not only the type of transport and crew required, but other needs, like equipment, medications, and intubation.

“The questions drive the type of critical-care transport we will use,” Thralls said.

At Indiana, a 20-hospital system, the software helped to reduce response time and improve decision-making, he said.

“The change was a challenge, but overall it was well-received,” Thralls said, adding that medical directors in neonatology, pediatrics and trauma vetted it before implementation.

For Zane, who also serves UCHealth as chief innovation officer, such tools are necessary to meet the needs of the broader community.

“What we are doing is about having an uninterruptible ethos of caring for patients, from the least to the most complicated,” he said. “We need a system that for referring providers that feels like, ‘Whatever you need, we’ll take care of you.’”

For physicians who need transfer requests, direct admissions or specialist consultations, DocLine may be reached at 1.844.285.4555.

About the author

Tyler Smith is a freelance writer based in metro Denver.