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Ternwell Health SystemsHospital patient flow
Healthcare operations

Move patients through care with fewer hidden blockers.

A hospital operations workspace focused on bed placement, transfer readiness, discharge barriers, transport, and EVS turnover without recreating the EHR.

428Licensed beds
389Occupied
34Pending admits
71 forecastDischarges today

Scale and interface figures on this page are illustrative.

Operating thesis

Capacity is a dependency problem.

A bed can exist physically and still be unusable. The product makes placement, staffing, isolation, turnover, transport, and discharge barriers operationally explicit.

01

Fragmented context

Capacity teams could see census but not always the operational blockers preventing a bed from becoming usable.

02

Decision logic

Placement decisions needed service line, level of care, isolation, telemetry, staffing and room constraints in one view.

03

Operational handoff

Discharge readiness spans clinical orders plus transport, pharmacy, DME, family, post-acute placement and paperwork.

Product model

Coordinate the hospital, not the chart.

The experience adds an operational layer around source clinical systems instead of trying to become another EHR.

M01

Capacity board

Unit census, staffed beds, holds, pending movement and surge constraints.

M02

Placement queue

Admit/transfer requests with acuity, service, isolation and room requirements.

M03

Discharge barriers

Expected date of discharge plus non-clinical blockers and accountable owner.

M04

Bed turnaround

Discharge → dirty → EVS assigned → clean → inspected → available.

M05

Transport

Internal movement queue with priority, equipment and destination readiness.

Workflow logic

Every movement changes downstream capacity.

Placement, transport, turnover, and release are linked states, not independent tasks.

01RequestED admit request created from ADT/FHIR
02MatchRules find staffed beds meeting constraints
03PrepareUnit confirms room + EVS readiness
04MoveTransport task linked to patient movement
05ReleaseOrigin bed enters turnover state
Product surfaces

Representative application states.

Representative application states from the product. Figures shown on screen are illustrative.

SCREEN 01 · COMMAND CENTER

Hospital flow

Friday · 15:18

Ternwell FlowFri 15:18 · Main campus
Census

389 of 428 beds occupied

90.9% occupancy11 ED boarding
Occupancy90.9%
ED boarding11
ICU staffed beds3 free
Discharge blockers20
ICU91%Stepdown92%3 West · Medicine98%4 West · Medicine98%5 South · Cardiac95%5 North · Neuro92%6 North · Ortho88%6 South · Surgical95%7 East · Oncology92%7 West · Med-Surg90%Women's & L&D75%Pediatrics69%Each square is a licensed bed
OccupiedAvailableBeing cleanedHeld or unstaffedIsolation
5 South
96% occupied · 2 expected discharges before 17:00
Stepdown
Telemetry constraint until 17:00
Emergency
4 admits waiting more than 120 minutes
SCREEN 02 · PLACEMENT

Admit requests

Needs a bed, not another queue

Ternwell FlowFri 15:18 · Main campus
Waiting34
High acuity7
Isolation5
Ready now18
RequestWait
A-8842
Medicine · tele · no isolation
38m
A-8845
Neuro · q2 neuro checks
64m
A-8851
Oncology · protective precautions
52m
A-8853
Ortho · post-op day 0
27m
A-8857
Cardiac · tele · high acuity
96m
Best beds for A-8845 Neuro · q2 neuro checks
5N-508A96% match
Near nurses station · 1:4 RN ratio · Clean and staffed
5N-512B88% match
Near nurses station · 1:5 RN ratio · Cleaning done 14:41
6S-61161% match
Not on neuro unit · 1:4 RN ratio · Clean and staffed

Assigning 5N-508A also frees ED bay 6.

SCREEN 03 · DISCHARGE

Barrier board

Expected today

Ternwell FlowFri 15:18 · Main campus
Today

71 expected discharges

51 orders placed20 blocked22 out before noon · 31%
Order placed 51Blocked 20
Post-acute authorization6
T-1182Case Mgmt
SNF authorization pending
T-1196Case Mgmt
Rehab bed offered, awaiting insurer

+4 more

Equipment & DME5
T-1209DME
Home oxygen delivery at 16:00
T-1221DME
Hospital bed delivery tomorrow

+3 more

Ride & transport4
T-1214Family
Family pickup confirmed 18:30
T-1230Transport
Wheelchair van unavailable

+2 more

Medication & teaching3
T-1237Nursing
Insulin teaching not signed off

+2 more

Clinical hold2
T-1241Physician
Repeat labs before release

+1 more

SCREEN 04 · TURNOVER

Bed turnaround

5S-512B

Ternwell FlowFri 15:18 · Main campus
Room 5S-512B

Turnover on track for 14:41

On track
Discharged14:02
EVS assigned14:09
Clean target14:41
Next patientMatched
14:0014:1014:2014:3014:4014:50Discharge order14:02Wait for EVS7 minEVS travel14:16Terminal clean18 minNursing inspectionpendingClean target 14:41
RoomStageElapsedTarget
5S-512BInspection36m39m
5N-403ACleaning21m39m
6N-621Waiting EVS24m39m
3W-310BCleaning12m39m
SCREEN 05 · TRANSPORT

Movement queue

Internal patient transport

Ternwell FlowFri 15:18 · Main campus
Waiting18
Priority4
Avg wait17m
Teams6 active
JobRouteModeWaiting
T-8821ED → 5 SouthWheelchair22m
T-8824 PriorityICU → CTMonitor + RN9m
T-8830PACU → 7 EastBed31m
T-8833ED → RadiologyStretcher14m
T-88364 West → DialysisWheelchair18m
T-8841MRI → StepdownBed6m
Teams 6 active
Team 1 · ICU → CTBusy
Team 2 · ED → 5 SouthBusy
Team 3 · PACU escortBusy
Team 4 · 4 West → DialysisBusy
Team 5 · returningFree soon
Team 6 · on breakBreak
Edge-state design

Failure states are part of the product model.

The cases below are intentionally modeled because real operating software is defined by what happens when data, people, or dependencies do not line up.

EDGE 01

Bed is empty but unstaffed

Show physical vacancy separately from staffed availability and exclude it from placement matches.

EDGE 02

Patient condition changes

Invalidate incompatible placement options and preserve why the prior match was withdrawn.

EDGE 03

EVS finishes but maintenance hold exists

Room remains unavailable until all blocking states clear.

System logic

The data model behind the interface.

The interface follows the domain relationships and rules below.

Canonical objects

EncounterBedUnitPlacement requestMovementBarrierTurnover taskTransport taskStaffing constraintExpected discharge

Domain rules

✓The system distinguishes physical beds from staffed/available beds.
✓Clinical source-of-truth fields remain linked back to the EHR; operational annotations are additive.
✓A “clean” room is not “available” if staffing, isolation, maintenance or unit hold constraints still apply.
Ternwell Health Systems · Case studyInterface figures are illustrative

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