Expanding Transfer and Command Center Operations

Los Angeles County’s municipal health system is the nation’s second largest, annually caring for 600,000 patients at 19 health centers and four hospitals. In the past, the county’s Department of Health Services (DHS) struggled with bringing insured patients back from out-of-network hospitals, with 15,000 to 20,000 patients annually being treated in other facilities. The results were suboptimal patient experiences and increased cost to the county. To enhance patient care and reduce costs, DHS implemented a Command Center, known as the Transfer Center, to centralize operations for patient transfers, particularly repatriations from out-of-network hospitals. FUSE Executive Fellow Ernest Shahbazian supported this work, helping DHS streamline operations and researching ways to further lower costs and improve patient care.

Ernest focused on developing workflows, staffing plans, metrics, and reports. He also communicated and socialized the changes with internal and external stakeholders, including relevant leadership. The launch of the Transfer Center has improved the average repatriation rate from 18 patients per month to more than 60, a greater than 300 percent increase. Its success has led DHS to implement local Command Centers at each of its four county hospitals to improve communications and coordination. Ernest is helping plan and implement the new centers and developing the processes that connect them to the main Transfer Center. He also is continuing to work on improving the process of repatriations while lowering the demand for the service, which includes examining transportation options, ensuring patients are receiving follow-up care, and improving the patient flow in and out of the hospital.