As hospital capacity remains elevated after the COVID-19 pandemic, health systems are seeking to standardize clinical care across their footprints to reduce variation and facilitate smoother patient flow.
These standardization efforts are gaining momentum in care pathways, safety huddles, admission and discharge planning and employee workflows.
At Philadelphia-based Jefferson Health, which operates 32 hospitals and hundreds of healthcare facilities, one strategy that is standardizing care and improving patient navigation is a central call center.
Whereas before a patient might call several Jefferson practices to make an appointment or ask a medication question, the call center now streamlines those calls and schedules patients appropriately. Satisfaction scores, answer speeds and the rate of patients being seen have all improved, according to Baligh Yehia, MD.
Dr. Yehia, president of Jefferson Health, told Becker’s one of the system’s defining principles is “to be as standard as possible and as different as necessary.”
Across its enterprise, Jefferson has also synthesized its process for accessing translators. The system is also focusing on the emergency department in its goal to enhance patient throughput, Dr. Yehia said. To triage patients faster, the system is reconceptualizing the waiting room to be a treatment room.
“That’s a philosophical shift that has helped us to start to improve our workflow,” he said. “We get them triaged more quickly with a nurse, sometimes a doctor starts ordering their labs and their imaging, even though they don’t have a bed yet in the ER. So we’ve started to protocolize those sorts of things.”
However, standardization is rarely possible without accountability, according to Peter Pronovst, MD, PhD, chief quality and clinical transformation officer at University Hospitals.
At the 21-hospital, Cleveland-based system, Dr. Pronovost said numerous roles and tasks are being standardized to improve patient throughput. A hypothetical standardized protocol is, during afternoon rounds, every unit needs to identify two patients who can be discharged the next morning. The unit staff then needs to complete those orders by 9 a.m. and discharge the patients by 11 a.m.
Efforts to standardize not only affect physicians and nurses, he said, “But physical therapy: How are they prioritizing which patients they’ve seen to get people out? Phlebotomists, what’s their turnaround time? Are we making hourly rounds?”
Dr. Yehia said barriers to standardization are disparate EHR systems and a forceful top-down push that disregards the input of front-line staff.
Overall, Jefferson investigates well-performing practices or ideas at individual hospitals and works to protocolize them.
“I think standardization not only can help with efficiency, I think it helped with delivering higher quality and safer care, better patient experience, and for us, I think helped improve access to care,” Dr. Yehia said.
