Podcast Summary

Podcast: Becker’s Healthcare Podcast
Episode: Improving Patient Flow and Capacity at Cedars-Sinai with Heidi High
Guest: Heidi High, Executive Director of Capacity Management, Cedars-Sinai
Date: September 19, 2025
Host: Scott Becker

Episode Overview

This episode delves into the transformation of patient flow and capacity management at Cedars-Sinai, featuring insights from Heidi High, an experienced ICU nurse-turned-executive leader. The conversation highlights persistent challenges in hospital bed capacity, the evolution of patient flow management from paper-based processes to tech-driven systems, and the cultural and operational shifts that enable successful system redesign.

Key Discussion Points and Insights

1. Persistent Challenges in Patient Flow

• Capacity Limitations:
  • Cedars-Sinai faces continual challenges due to not having enough beds to meet patient demand.
  • “We do not have enough beds for all of the patients seeking our care... you want to be able to care for every single patient that comes to your site for care.” — Heidi High [01:50]
• Complex Collaboration Needs:
  • The larger the organization, the harder alignment becomes, even with a generally unified team.
  • “The bigger your organization gets, the bigger your team gets and the harder it can be to align.” — Heidi High [02:12]

2. Evolution from Paper to Technology

• Historical Context:
  • Early systems relied on paper, with information quickly becoming outdated during daily rounds.
  • “I remember rounding with a clipboard… by the time I had rounded on all 40-some units, of course the information was old.” — Heidi High [03:13]
• Cultural Change through Daily Huddles:
  • Instituted in 2019, daily cross-department huddles now bring together staff from nursing, environmental services, pharmacy, lab, physicians, and more.
  • These huddles foster transparency, fast information sharing, and coordination.
  • “That has been the most transformative from a cultural perspective.” — Heidi High [03:58]
• Optimizing Data Use:
  • Cedars-Sinai is “very data rich,” so the key is surfacing actionable information that directly drives behavior.
  • “How do we actually drive behavior? Using that technology has been an important journey.” — Heidi High [04:33]

3. Redesigning Discharge Workflows

• Empowering Those Closest to the Patient:
  • Moved critical information and actionable items directly into the hands of bedside nurses, not just charge nurses or leadership.
  • Example: Bedside nurses notified if their patient qualifies for the discharge lounge.
• Improvements Measured:
  • Tangible gains in both discharge lounge utilization and discharge order processing time.
• Support Services Prioritization:
  • Tools now allow services like CT, pharmacy, and transport to prioritize patients most urgently needing attention.
  • “Our support services departments have the information they need on who to prioritize.” — Heidi High [06:12]

4. Managing Culture Change and Staff Engagement

• Early and Open Involvement:
  • Brought nursing leadership into the process from the outset and actively listened to concerns.
  • “We have done a lot of celebrating. We have something that's called MOVE awards and they are tied to the metrics that we are trying to improve…” — Heidi High [07:11]
• Recognition and Ownership:
  • Celebratory acknowledgements (MOVE awards), and creating a sense of community (referring to the leadership group as “our BFFs, our best friends in Flo”).
• Psychological Safety:
  • Fostered a culture where staff could safely express skepticism or concerns about new systems.

5. Overcoming Resistance & Driving Adoption

• Initial Concerns:
  • Expected pushback when introducing systems outside the electronic health record.
• Surprising Buy-In:
  • Early buy-in emerged when nursing staff recognized the time and workload reductions from improved information sharing.
  • “As soon as they were able to see the value and the information that they were to gain… They started to spread the news themselves.” — Heidi High [08:14]
• Role of Nursing Staff:
  • Nurses constituted the large workforce necessary for the initiative’s success.

6. Lessons Learned & Advice for Others

• Collaborate Beyond the Institution:
  • Peer learning and commiserating with other capacity management leaders were invaluable.
  • “When you get outside of your organization and learn from what other organizations are doing, it really helps… sometimes just in commiserating in the struggle and the challenges…” — Heidi High [09:49]
• Ongoing Learning:
  • Validating and refining initiatives by benchmarking with others helped ensure best practices.

Notable Quotes & Memorable Moments

• On the Core Challenge:
  • “We do not have enough beds for all of the patients seeking our care.” — Heidi High [01:51]
• On Technology’s Impact:
  • “Whatever system that we're using, the most important part of that has been what information we actually bring to the surface…” — Heidi High [04:21]
• On Engaging Staff:
  • “If you bring them to the table, give them the safety in being able to express their concerns... and have them help with the joint ownership of the problem, we've really made great strides.” — Heidi High [07:38]
• On Unexpected Buy-In:
  • “I did not expect such early buy-in, but as soon as they were able to see the value... they started to spread the news themselves.” — Heidi High [08:14]
• On Learning from Others:
  • “When you get outside of your organization and learn from what other organizations are doing, it really helps... in validating that the initiatives that we're implementing are the right ones...” — Heidi High [09:49]

Timestamps for Key Segments

• Heidi High introduces herself & career: [00:54]
• Biggest challenges with patient flow/beds: [01:50]
• Evolution from paper to tech/daily huddles: [03:06]
• Redesigning discharge workflows, role of bedside nurses: [05:04]
• Driving culture change and staff engagement: [06:52]
• Buy-in and resistance to new tools: [08:33]
• Lessons learned and collaboration advice: [09:43]

Tone and Language

Throughout, Heidi shares candid reflections and practical advice, maintaining a warm, collegial, and solutions-oriented tone. The conversation is peppered with engaging anecdotes, appreciation for her team, and a focus on practical impact for both patients and staff.

Conclusion

This episode offers a concise, actionable roadmap for healthcare leaders seeking to improve capacity management and patient flow, emphasizing the importance of cultural change, transparent data, frontline empowerment, and peer collaboration. Heidi High’s practical experiences and lessons learned provide valuable insights adaptable to diverse hospital settings.