- In Customer Stories
- Posted 04/06/2016
BJC Healthcare selected Lanner and its WITNESS Simulation Software to facilitate decision making, mitigate risk and enable multiple teams to work together as they set about transforming the Washington University Medical Center in St. Louis.
Improving Patient Experiences
BJC HealthCare’s Campus Renewal Project is a long-term
project designed to transform Washington University
Medical Center (WUMC) through new construction and
renovations. The objectives of the project are
focused on improving the patient and family experience
from both a clinical and campus perspective. BJC
HealthCare is one of the largest non-profit health care
organizations in the United States.
A 12-story expansion of Barnes-Jewish Hospital includes
the Women and Infants program, Siteman Cancer Center,
surgical programs, and diagnostics and treatments. An
expansion of St Louis Children’s Hospital will include an
all-private neonatal intensive care unit adjacent to the
Women and Infants program in the new Barnes-Jewish
Hospital expansion, private inpatient beds, diagnostics and
outpatient clinic space.
The second phase includes additional renovation and new
construction at Barnes-Jewish Hospital, with a focus on
increased critical care capabilities and additional private
inpatient rooms, along with development of programs in
medical and surgical services.
Both phases of the project will incorporate significant
improvements to parking, traffic flow and navigation for
The anticipation of providing patient care in brand new space provides opportunities for caregivers and support staff to examine best practices internally and externally, to hone and build on best practices and to be prepared on day one to provide exceptional care to patients. However, planning for this kind of transformation has to be thorough, sensitive and pragmatic, and with acceptance from those involved.
New work environments and processes inevitably
results in culture change, which can introduce
a degree of reticence, and this project was no
exception. One of the primary challenges at the
outset was to bring both obstetric, pediatric
and neonate teams together to review current
working practices and reach consensus on future
“To do things better, we needed to fully understand
how staff work today, processes that work well and
those that don’t, and limitations and bottlenecks
hindering best practices,” comments Margaret
Tobin, Campus Renewal Activation Lead. “The
health care environment is complex, and it can be
emotional caring for patients and their families.
Coupled with the size of our hospitals and acuity of
patients, we faced challenges reaching consensus.”
“We had a wealth of experience and expertise;
however, we needed a means of applying greater
rigor and objectivity to this experience to inform
Having had previous experience of simulation
and modeling as a proven decision-making tool,
project leadership determined that simulation
was the optimum route to achieve this level
of robust planning. The project team selected
and worked with Lanner, to establish a suite of
models to support planning and decision-making
“The complexity of such a large, multi-faceted project is immense. Lanner’s WITNESS Simulation provided credible support tools that demonstrated
the immediate and long-term impact of decisions we needed to make now. It supported collaboration across teams, gave us confi dence that we were
headed in the right direction and enabled us to mitigate risk,” Margaret continues “Introducing the physicians, clinical staff and support staff to the
simulation tools and methodology, and providing them the opportunity to understand and appreciate the benefits, facilitated early acceptance of the
process, which enabled us to achieve consensus on our design.”
One of the first, and most successful, projects the team tackled with Lanner was the Women and Infants program at Barnes-Jewish Hospital. The clinical team initially pointed to the unpredictable nature of labor and delivery resulting in the variability in current processes.
However, when analyzing the processes further using the model, clear patterns and trends emerged, informing the basis for planning.
"Working with Lanner to create process maps for incoming and outgoing patient flow allowed us to make robust, informed decisions to optimize processes. The WITNESS model took all subjectivity away and enabled us to move forward with fact-based data-driven
decisions rather than allowing emotions to lead us.”
The team first looked at how many beds were required for the Women and Infants program. Currently, 59 beds are available within 30 rooms, but as part of the overall plan, the team wanted to increase the number of private rooms. Having established an exhaustive
number of questions to feed into the model, they concluded that 34 private rooms would accommodate the annual 4000 deliveries - for 99% of the time. For the remaining 1%, the team devised a strategy transferring labor and delivery overflow to the postpartum unit.
“This is a great example of how the WITNESS model enabled us to simultaneously reduce the number of beds in the department and increase quality of care and overall experience for patients,” Margaret explains. “Debate around such an emotional topic could have dragged on; instead we reached a conclusion within six months. When people understand the ‘why’ behind a decision they are more likely to accept it, thus enabling us to move forward.”