“I’ve been working in the MGH Cardiac Surgery realm for 15 years, and my colleagues are more than a team. They’re my family,” says Alysia Monaco, AGACNP-BC of MGH Cardiac Surgery. “I treat them that way. I treat my patients that way, too.”
Monaco is an inpatient capacity operations coordinator; her role is mainly geared to improving patient throughput on the Cardiac Surgery service. She triages the inpatient cardiac surgery consults at MGH and externally referred patients based on acuity, surgeon and OR availability.
“People describe my role as an air traffic controller, and in many respects, it is. You have to find a spot for each patient with the appropriate surgeon and time the OR just right,” she says.
Monaco collaborates daily with many role groups across Cardiac Surgery and Cardiology including the OR staff, anesthesia, cardiac access, and nursing directors. Together they strategize where the post-operative patients will go, as well as the outside hospital transfers in addition to those patients already at MGH.
“Alysia is very focused on ensuring a smooth transfer experience to the MGH Cardiac Service for both the patient, their family, and staff members,” says Ann Marie O’Donnell, patient services coordinator, MGH Cardiac Surgery. “She is very comforting, friendly, and detail oriented in her explanations when interacting with family members during a very stressful time.”
Monaco says, “We have a finite number of beds and filling them feels like doing a puzzle; the work is in making the pieces fit. Capacity challenges, a growing patient network, and the complexities of cardiac care make this a dynamic and time-sensitive challenge. An acute patient may need to be here imminently because the hospital they’re coming from doesn’t have the level of specialized care they require. Other patients may be more stable, and in that case, I communicate to the outside facility – and sometimes to the patient directly – that they’re in good hands at their current hospital while we work on the logistics of getting the patient to MGH.”
Monaco says she enjoys her job in part because she works alongside a talented and supportive team who share the same patient-centric goals. The sincerity and support she feels from her MGH colleagues are the same qualities she hopes to impart on the patients coming for cardiac surgery.
“It can be hard to navigate the medical world as a patient, so I treat them as I would treat my own family by advocating, advising, and listening,” Monaco says. “I want to leave work each day knowing I did everything I could to get patients the care that they need, and the MGH team allows me to do that.”
Erin Hachey, RN, of Bigelow 11, and Ben Orcutt, director of MGH Patient Access Services, work together daily to mitigate capacity challenges, yet they typically only communicate through an app called Voalte.
Malinda Buck, a patient access bed manager supervisor in the MGH Capacity Center, is determined to get patients where they need to be: in rooms, healing, and then going home.
Amber Moore, MD, director of Inpatient Medicine in the Department of Medicine, is working to improve the process of patients seeking to transfer in from other care facilities.