For Southcoast’s BFFs, Success Requires a Mix of Juggling, Conjuring, a Splash of Charm and a Whole Lot of Knowledge and Hard Work

They are Southcoast’s “BFFs”: Bed Flow Facilitators, a group of more than a dozen highly experienced, highly skilled nurses working 12-hour shifts who make sure patients are admitted to the right unit and the right bed.

Like that of countless other employees who make Southcoast’s three hospitals run smoothly 24 hours a day, 365 days a year, their work is often unseen to patients, families and the public. But as with magicians who appear to make the impossible possible, they don’t really use magic. They use their experience, knowledge, skill and a heavy dose of hard work.

“We’re the eyes and ears of all the beds,” says Marion McHugh, Manager of Southcoast’s Transfer Center, the department that finds the right place for each patient admitted to the hospital for treatment.

The Bed Flow Facilitators keep a close watch on where beds are available at each of the hospitals. They continually monitor patient flow in and out of our emergency departments.

“We look ahead. We conduct a Bed Call Meeting every morning at separate times with all three hospitals. Either a Manager or Resource Nurse is on the call from all the floors. The daily census, discharges, and floor activity is reviewed,” McHugh says. “We print the daily operating room schedule and the catheterization lab schedule, so we know who is coming in.”

For most patients, except those coming through surgery, the process often begins in the Emergency Department. The Bed Flow Facilitators take the calls from the ED and assign a Hospitalist to the patient being admitted. It’s a busy around-the-clock job. Their work is complex and nuanced, and pressured when the emergency room is full, the hospital is full, or the right bed is not immediately available.

“One day a few weeks ago we had 300 calls in a 24-hour period; normally we have 200 to 250,” McHugh says.

A Bed Flow Facilitator must be flexible, able to multitask, and in possession of sound critical thinking skills. They also must be able to communicate well and negotiate. “Doing the job well requires a lot of planning, and sometimes a lot of calls and a lot of conversations.”

“To make sure patients receive the best care, we have to determine where in the hospital patients should be placed,” McHugh says. “We review patients’ records, lab results, mobility, physician/nurses’ notes. We make sure we have the bed needed for the patient. Do they need telemetry, intensive care, are they at risk of falling … what level of care is required? It’s not always cut and dry. For instance, if we have a patient with both neurological and respiratory problems, we must work with the physician and determine whether the best place is in a unit specializing in neurology or pulmonary.”

Bed Flow Facilitators also handle transfers of patients to and from higher and lower levels of care within the hospital. They also facilitate transfers to each hospital within Southcoast or to tertiary hospitals in Boston or Rhode Island. They coordinate calls among Transfer Centers, Physicians and Specialists in those hospitals to ensure the transfer’s completion.

COVID-19 brought new demands to the job, as if it weren’t challenging enough.

“We adjust to operational changes as they occur. We’re also attuned to patients’ COVID status. We make sure every patient has been tested before being placed anywhere,” McHugh says. “We keep patients with COVID-19 together, which is a challenge with semi-private rooms. It involves a lot of collaboration, a lot of talking with the floors and Resource Nurses.”

“The staff have been troopers,” she says. “We are all team players, and despite the stress, everyone has stayed healthy. We’ve had very few sick calls, fortunately. We work together as a team. We attribute some of that to humor – our ability to laugh when the situation calls for it.”

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