2-Hospital Health System - Northern California

A CA-based Health System including two acute-care medical centers, a behavioral health center and multiple urgent care, outpatient care, clinical laboratory and imaging centers. 733 licensed beds. Main campus serves as designated Level II Trauma Center for two-county region of 1.5 million plus people.


Increased total external transfer requests by 15%.

Increased the acceptance rate by 5%, from 64% to 69%.

Provided care for 321 additional patients

Contributed $3.75M to bottom line.

Improving patient access had a positive impact on the bottom line.

While the system now cares for an increased number of government-insured patients, the number of complex care and tertiary patients has increased as well.

The net effect is an improved margin contribution of $2000 per case over 1 year or a $3.75M increase to the bottom line.


Strengthen and optimize 5-
year-old regional transfer center to optimize patient access AND advance the Health System’s Community Service Mission. During the 5-year period, despite projections, requests for patient transfers were flat at less than 2,500 requests per year. And the acceptance rate of requests remained below 70% each year.


Once retained, HealthWorks quickly assumed a “team member” role, engaging and interacting with all levels and functions within the System. Many of the process improvements were the result of “insider ideas” from those with significant knowledge and who would be directly impacted by changes. “We asked our client what they do vs. telling them what to do and then put it in writing” – Kara Witalis, HealthWorks Engagement Leader

Developed Single System-wide transfer center policy

This was in lieu of separate policies for each campus/site. These included definitions, requirements and expectations system wide for acceptance or denial of transfer requests.

Process redesign & implementation

Expanded transfer center hours of operation to 24/7, routed all calls to single, centralized call center and added recording to monitor telephone interactions. Physicians and staff were trained in EMTALA and processes put in place to ensure compliance as well as to protect against patient “dumping”.

Reporting & Metrics

Designed and mapped workforce to new structure, developed and a 3-week orientation and training program and pilot tested new processes and procedures between the Transfer Center and a local community hospital, measuring results and making adjustments as needed.

Organizational Restructuring

Created and delivered an executive-level dashboard to continually monitor progress and results.

“We couldn’t have done it without HealthWorks. I knew intuitively where we needed to take the Transfer Center, but I needed help pulling all the pieces together.”

- Director of Trauma & Transfer Services

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HealthWorks is one of only three valuation and litigation firms in the U.S that specializes in trauma centers and trauma center planning and operations improvement. It is the only one of the three firms that also specializes in FMV. Included among HealthWorks 2,400 FMV opinions are more than 350 in the core specialties in trauma centers.