Improving Hospital Operational Efficiency Must Include Patient Flow Improvements

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The healthcare reform law has created an impetus for hospitals to improve efficiencies, squeezing as much waste out of their processes as possible, while improving quality. As part of the Patient Protection and Affordable Care Act, hospitals agreed to $155 billion in Medicare reimbursement cuts over 10 years and could face additional cuts resulting from the Budget Control Act of 2011, which creates a super committee to identify $1.5 trillion in federal spending cuts that could include Medicare reimbursements. How can a hospital executive not think about ways to become more efficient?" asks Anthony Sanzo, president and CEO of Teletracking Technologies.

According to Mr. Sanzo, improving patient flow is one way to significantly improve the efficiency of an entire hospital, but it can be overlooked when hospitals focus only on process improvement within various individual departments. "Anything a hospital can do to eliminate delays and dead bed time can improve its bottom line," he says.

Hospitals with the most efficient patient flow processes usually got there by implementing both technical and human process changes, says Mr. Sanzo. These hospitals know immediately when a patient bed is available and ready to be cleaned, benchmark the time it takes to turnover rooms, have-real time data on available beds so new patients can be assigned and in a bed within 1-2 hours and benefit from less congested emergency departments and the additional revenue that comes with quicker turnover. So, how do they do it?  Here are four best practices.

1. Gain executive support for improving patient flow.
The hospitals that are able to most successfully improve patient flow have support for doing so from the top. "If it's seen as important by the executive-level, then patient flow is everybody's business," says Mr. Sanzo.

2. Engrain the importance of patients flow in the hospital's culture. To this end, having executive buy-in is a starting point, but making flow a part of a hospital's overall culture also requires keeping the issue at top of mind. This can be achieved by creating a patient flow committee that first determines the baseline for the hospital on various measures of patient flow and then meets regularly to track improvements or identify any variance. Common measures include: time from when a patient presents to bed assignment, bed turnover time and how many times a bed is turned per year.

3. Include patient flow measures in organizational and employee benchmarks.
Nearly all hospitals regularly track performance against a category of goals, such and quality, financials and patient safety, and often, these same goals trickle down to executive and individual employee performance measures. Mr. Sanzo says hospitals should include patient flow as an additional category of measurement since it has such a significant impact on a hospital's performance.

"First and foremost, attention must be paid to knowing what the triggers are for success and failure and building them into executive and employee expectations and goals," he says. For example, a hospital would establish an expectation that admitting a patient into an assigned and clean bed will take place within 1 hour. Then, management could track how each employee performed against that benchmark. For instance, certain employees would be evaluated on how long it took to assign the bed, and others would be evaluated on how long it took to clean the bed or ready and transport the patient to the assigned bed.

4. Automate, automate, automate. Where possible, automate patient flow processes. For example, a nurse typically is charged with alerting environmental staff about an open bed that needs cleaning by manually entering the bed's status into some type of computer software system. Top-performing hospitals set expectations for how quickly a nurse will do that (often within minutes), but the most advanced hospitals automate that process and will soon use real time locating system technology to automatically trigger the "entry" that a patient vacated a bed. The entry then automatically notifies personnel it is ready to be assigned to another waiting patient.

Through both human and technological process improvements, hospitals can significantly improve patient flow, which then impacts overall organizational efficiency as well as the bottom line.

More Articles on Patient Flow:

5 Strategies to Improve Patient Flow in a Busy Hospital
Study: OR Availability Delay Greater Than Two Hours Increased Hospital Costs 39%
TeleTracking Technologies' Second Generation Real Time Locating System Now Available

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